Understanding the Planes of Motion and Common Gait Compensations 🏃‍♀️🏃‍♂️

Walking and running are fundamental human movements that involve complex interactions between muscles, joints, and neural control mechanisms. Understanding these movements through the lens of the planes of motion can provide valuable insights into common gait compensations and how they affect overall biomechanics.

The Planes of Motion

In biomechanics, the human body moves through three primary planes of motion: the sagittal plane, the frontal plane, and the transverse plane. Each plane represents a different type of movement:

1. Sagittal Plane: Divides the body into left and right halves. Movements in this plane include flexion and extension. For example, forward and backward motions like walking or running predominantly occur in the sagittal plane.

2. Frontal Plane: Divides the body into front (anterior) and back (posterior) halves. Movements in this plane include abduction and adduction. Examples are side-to-side movements like lateral leg raises or side shuffles.

3. Transverse Plane: Divides the body into top (superior) and bottom (inferior) halves. Movements in this plane include rotation. Examples are twisting movements like turning the head or rotating the torso.

Common Gait Compensations in Walking and Running: 

Walking and running should primarily occur in the sagittal plane. Any deviation from this plane is considered a compensation, which can be analyzed to develop a treatment program for rehabilitation, injury prevention, and reducing metabolic energy wastage.

Understanding the role of barefoot biomechanics can provide deeper insights into common gait compensations. Let's explore these compensations and their implications.

1. Pronation 

Description: Pronation involves the natural inward rolling of the foot after heel strike, crucial for shock absorption and adaptation to varying surfaces. However, when pronation becomes excessive or occurs at the wrong time due to inefficient movement, footwear ,orthotics or weak extrinsic and intrinsic foot muscles, it can lead to biomechanical imbalances. 

Compensation: If pronation doesn't occur from heel strike through to late midstance then the foot rolls outward excessively during the push-off phase of walking or running. This movement takes place predominantly in the frontal plane and is characterized by insufficient inward roll, causing the foot to remain on the outside edge and toe off occuring through the 2nd - 5th toes. 

When you have excess pronation occuring from heelstrike through to late midstance (which does not occur that often), The body compensates by increasing the internal rotation of the lower leg, which can lead to knee pain, shin splints, and plantar fasciitis. Barefoot biomechanics emphasize the importance of strengthening the foot's intrinsic and extrinsic muscles to maintain optimal pronation levels (Myers, 2009). 

2. Supination

Description: Supination, can occur when the foot rolls outward excessively during heel strike through to late midstance and the push-off phase of walking or running. This movement takes place predominantly in the frontal plane and is characterized by insufficient inward roll, causing the foot to remain on the outside edge.

Compensation: When supination is excessive, the body's natural shock absorption is compromised. This lack of adequate pronation can lead to increased stress on the outer structures of the foot and lower leg. The body compensates by relying more heavily on the bones and joints for stability, which can result in conditions such as ankle sprains, iliotibial band syndrome, and stress fractures. Barefoot biomechanics emphasize the importance of foot strengthening and proper alignment to maintain optimal supination levels, promoting natural shock absorption and reducing the risk of injury (Myers, 2009).

The use of bespoke insoles, majority of the time without arch support depending on the clients requirements , can help promote ideal pronation function where required.

3. Dorsiflexion

Description: Inefficient dorsiflexion refers to the limited upward movement of the foot at the ankle joint, where the toes move towards the shin. This movement is crucial for proper foot clearance during walking and running. Inefficient dorsiflexion can occur at three main stages of gait - heel strike, midstance and swing phase.  It predominantly affects the sagittal plane of motion.

Compensation: When dorsiflexion is restricted, the body compensates by altering other aspects of gait. Common compensations include increased hip and knee flexion to lift the foot higher, which can lead to overuse injuries in these joints. Additionally, individuals may adopt a toe-out gait or excessive pronation or supination to avoid the need for adequate dorsiflexion, resulting in increased stress on multiple structures of the foot and lower leg. This can cause conditions such as Achilles tendinitis, plantar fasciitis, and anterior knee pain. improving anterior compartment stregth through barefoot, neurological and motor control stretching, strengthening, and mobility exercises can improve overall gait efficiency and reduce soft tissue , joint stresses and injury risk (Neumann, 2017).

4. Limb Length Discrepancies

Description: Limb length discrepancies occur when one leg is longer than the other, which can be due to structural differences in bone length or functional imbalances in muscle or joint alignment. This discrepancy affects the overall balance and symmetry of the body during walking and running, influencing movements across all planes of motion.

Compensation: To compensate for limb length discrepancies, the body often adopts several biomechanical adjustments. These include pelvic tilt, increased lumbar spine curvature, and asymmetrical gait patterns. The longer limb may exhibit increased pronation to shorten its functional length, while the shorter limb may present with supination to lengthen its stride. These compensations can lead to chronic issues such as foot, ankle, knee, hip pain and  lower back issues due to the uneven distribution of forces. Addressing limb length discrepancies often involves the use of full foot lifts ( NOT heel lifts) , bespoke insoles at promte ideal foot, ankle and global function from the feet upwards and targeted physical therapy such as sagital trunk stabilisation and DNS exercises to correct imbalances and improve functional alignment (Pavel et al 2014),(Perry & Burnfield, 2010).

5. Hip Drop

Description: Also known as Trendelenburg gait, this occurs when the hip drops on the swing leg side, indicating weakness in the hip abductors, stance side glute medius weakness and swing side abdominal weakness. This movement excessively engages the frontal plane.

Compensation: The opposite side's lower back and hip muscles work harder to stabilize the pelvis, often leading to lower back pain and hip bursitis. Barefoot exercises, Dynamic Neuromusuclar Stabilization (DNS) exercises and some barefoot running encourages natural alignment and can help strengthen these muscles, reducing hip drop (Pavel et al 2014), (Perry & Burnfield, 2010).

6. Excessive Trunk Rotation

Description: Excessive rotation of the trunk in the transverse plane during gait can be caused by ineffective trunk , core and sagittal plane stabilisation or compensatory patterns due to other imbalances.

Compensation: This can lead to inefficient energy use and strain on the lumbar spine, potentially causing lower back pain and reducing running efficiency. (DNS) exercises and some barefoot running  activties can promote better core engagement and stability, reducing the need for compensatory trunk rotation (Neumann, 2017), (Pavel et al 2014).

7. Out-toeing or Increased Progression Angle

Description: The feet point outward excessively in the transverse plane during walking or running, often due to structural issues such as External Tibial Torsion, one of the compensations of Internal Tibial Torsion, Femoral Tortional Issues, acetabulum depth and/or muscle imbalances.

Compensations: This can cause uneven wear and stressed on the joints and soft tissues, leading to foot, knee and hip pain. Barefoot biomechanics and exercises inconjuction with bespoke insoles to promte ideal foot function promotes natural foot alignment and strength, helping to reduce out-toeing (McGee, 2017).

8. Crossover Gait

Description: This occurs when the feet land too close to the midline of the body, moving out of the sagittal plane. It can be due to poor running form or muscle imbalances especially the Gluteus Medius and abdominals.

Compensation: This can increase stress on the IT band and lateral knee structures, often resulting in IT band syndrome and lateral knee pain. Barefoot exercises and running encourages a wider, more stable stance that can prevent crossover gait (Gait Guys, n.d.).

Conclusion

Understanding the planes of motion and recognizing common gait compensations can greatly enhance the assessment and treatment of movement-related issues. By focusing on these elements, health professionals can develop more effective intervention strategies, improving patient outcomes and reducing injury risks.

Want to Learn More?

Are you interested in learning more about gait analysis and how to address these common compensations effectively? Join our next upcoming webinar in July  where we delve deeper into the biomechanics of walking and running, offering practical insights and techniques to enhance your clinical practice. Foot & Ankle Rehab - Understanding and applying Foot Stabilisation Principles . Don't miss this opportunity to elevate your skills and improve client outcomes!

Register Now: https://www.thestabilisationacademy.com/registration-page-promtional-webinar-f-a-rehab

References

• Neumann, D. A. (2017). Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. 3rd edition. St. Louis: Mosby.
• Pavel Kolar et al.(2014).Clinical Rehabilitation. Prague: Alena Kobesová
• Perry, J., & Burnfield, J. M. (2010). Gait Analysis: Normal and Pathological Function. 2nd edition. Thorofare, NJ: SLACK Incorporated.
• McGee, S. R. (2017). Evidence-Based Physical Diagnosis. 4th edition. Philadelphia: Elsevier.
• Myers, T. W. (2009). Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. 3rd edition. Edinburgh: Churchill Livingstone.
• Gait Guys. (n.d.).  www.thegaitguys.com
• Michaud, T. C. (2011). Human Locomotion: The Conservative Management of Gait-Related Disorders. Newton: Newton Biomechanics.