Evaluating movement as part of our exam can add a lot of clinical information as well as provide our patients an opportunity to give feedback. It should serve to amplify but not replace our clinical exam.
Another benefit is getting initial feedback on our orthotic, bracing and other clinical interventions. It is optimum to observe front, back and side views if possible. It is easier to film walking and running on a treadmill but it is not essential.
Richard Blake, DPM ‘s book series, Practical Biomechanics for the Podiatrist provides a great outline of walking analysis from head to toe. It helps to video record walking or running and view key findings with your patient. A narrow hallway is a challenge for a longer side view. If you can film outside, filming from the side is much easier. When watching runners it is efficient if the hands come back to the middle of the side of the upper torso area. When your arms pull back your elbows should be angled outside and the back of your wrists should brush by your shirt as you pull back in distance running. Sprinting requires the elbows to be tucked in closer. You should be aware of angle of the camera which can distort your observations. Keeping the camera steady sounds easy but it takes a little practice so you can start with staff or family to develop your technique.
Frontal plane deviations like genu valgum or leg cross over are fairly easy to detect. Asymmetry can be detected a number of ways. if the head is higher on one side of single leg stance this indicates that the leg is longer on that side. Asymmetry can also be seen when one leg is crossing over more than the other. More subtle movements can be reviewed with slow motion video.
There are apps like coaches eye, dartfish and onform are examples. Another option is to have the patient bring video of them walking , running or participating in their sport.finally, make sure your review of the the video with your patients is not overly technical so that it becomes a tool for strengthening communication instead of a source of confusion.
