Your Running Form Isn’t “Bad”: When Does Gait Actually Need to Change?

Have you ever watched a video of yourself running and thought,

Do I really run like that? or "That looks terrible!

Maybe your feet turn out. Your knees move inward. You heel strike. One hip drops. Or someone has told you that you overpronate, overstride, or have “bad running form.”

As a physical therapist who has spent much of my career evaluating and treating runners, I hear this all the time. And one of the first things I tell runners is:

Different doesn’t necessarily mean bad. I mean I might cringe and and make faces at your videos- but just because it looks crazy doesn't necessarily mean its all bad.

There is no single perfect way to run. Running gait is highly individualized—so much so that researchers have described it almost like a movement “fingerprint.”¹

When I perform a running analysis at my running clinic, Precision Performance, I’m not just looking for everything that is “wrong” with someone’s form. During the gait analysis I am trying to figure out if there is something about the way this person runs that is contributing to the problem they’re having.

What Am I Actually Looking For?

Running mechanics are only one piece of the puzzle.

Before analyzing someone’s gait, I want to know their story. How much are they running? What changed before the injury? Did they add mileage, speed or hills? When does it hurt? What happens afterward? What about the next morning?

I also look at strength, mobility, previous injuries, training demands and goals.

Two runners can look almost identical on video and need completely different treatment. One may need gait retraining. Another may need to get stronger. Another may simply be running more than their body is currently prepared to tolerate. And another may not need their running form changed at all.

When Should We Change Running Form?

I absolutely use gait retraining in my practice. Research supports it as a tool for modifying running biomechanics, and appropriately selected gait-retraining strategies may improve pain and function in some injured runners.¹˒²

But, changing running form redistributes load—it doesn’t make load disappear.

If I change a runner’s mechanics to decrease demand at the knee, I may increase demand somewhere else. That’s why I don’t change someone’s foot strike simply because heel striking has been labeled “bad.”

The same applies to cadence. There is no magic requirement that every runner run at 180 steps per minute. However, modest increases in step rate can alter lower-extremity mechanics and reduce energy absorption at the hip and knee.³ That can be useful for the right runner.

Your Garmin telling you your cadence isn’t 180 isn’t enough reason for me to change it. But if you have knee pain I just might.

What About Strength?

Getting stronger is important, but strength and gait retraining aren’t the same thing.

Research has shown that runners can improve hip strength without automatically changing their running mechanics.⁴

Sometimes, therefore, I’m trying to improve a runner’s capacity to tolerate load. Other times, I’m trying to change how that load is applied. Often we work on both.

That is why treating runners may involve strength, mobility, plyometrics, education, training modification and gait retraining rather than one magical corrective exercise. This multifactorial approach is also central to how I teach running-injury management.

If you’re healthy, running well and tolerating your training, I need a pretty good reason before changing the way your body naturally runs.

Research suggests gait retraining can be valuable in certain injured runners and may even influence injury occurrence in specific populations.²˒⁵ But that is very different from saying everyone needs to “fix” their form.

After years of treating runners, I’ve become much less interested in making someone look like the picture of a perfect runner.

I’m more interested in helping them become a healthy, durable runner who can handle the training required to reach their goals. Sometimes that means changing how they run. Sometimes it means getting stronger. Sometimes it means changing their training. And sometimes my job as their PT is to look at their supposedly “bad” running form and say:

Leave it alone.

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References

1. Davis IS, Futrell E. Gait retraining: altering the fingerprint of gait. Phys Med Rehabil Clin N Am. 2016;27(1):339-355.

2. Doyle E, Doyle TLA, Bonacci J, Fuller JT. The effectiveness of gait retraining on running kinematics, kinetics, performance, pain, and injury in distance runners: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2022;52(4):192-A5.

3. Heiderscheit BC, Chumanov ES, Michalski MP, Wille CM, Ryan MB. Effects of step rate manipulation on joint mechanics during running. Med Sci Sports Exerc. 2011;43(2):296-302.

4. Willy RW, Davis IS. The effect of a hip-strengthening program on mechanics during running and during a single-leg squat. J Orthop Sports Phys Ther. 2011;41(9):625-632.

5. Chan ZYS, Zhang JH, Au IPH, et al. Gait retraining for the reduction of injury occurrence in novice distance runners: 1-year follow-up of a randomized controlled trial. Am J Sports Med. 2018;46(2):388-395.