Abstract
Narrow step width has been associated with variables of increased stress on the hips and knees. The purpose of this case study was to examine the effectiveness of a gait retraining protocol and hip strengthening program. The objective of the gait retraining was to reduce the occurrences of Iliotibial band syndrome and soreness of the hips by changing the negative step width neuromuscular pattern of the subject to a wider step width. The variables of interest were step width, speed of gait, contralateral pelvic drop angle, hip adduction angle, and running economy. The strengthening program was performed in the evenings every other day for nine weeks. The gait retraining protocol progressed in routine and was performed in the mornings. Field data of a healthy collegiate female distance runner was collected in five phases of this twelve-week study. Three trials of a walk gait and two run gait speeds 3 m/s and 4 m/s were recorded using an ipad Air 2 at 120 frames per second. Measurements were determined with dartfish 7.0 on a lap top computer after the video was transferred from the iPad. Running economy and step width data during lab treadmill running was collected at 5, 6, 7, and 8 mph in phase one and five. Step width was widen in all gait conditions with a post study percent change of 79% for the walk (6.47 cm to 11.58 cm), 358% for the 3 m/s run (-3.8 cm to 6.8 cm), and a 237% for the 4 m/s run (-3.1 cm to 4.08 cm). Running economy data revealed an average O₂ cost (ml O₂•kg־¹•km ־¹) reduction of 1.69 % and a caloric unit cost (kcal•kg־¹•km ־¹) reduction of 2.27 % for the new gait compared to the pre-intervention gait at 5, 6, 7, and 8 mph speeds. The data from this study revealed that step width narrows as gait speed increases. Contralateral pelvic drop at the medium walk did not change from -6.6 degrees and stabilized at -8.7 degrees for the 3 m/s and 4 m/s run conditions during the protocol. Hip adduction data in all gait conditions revealed a reduction by two to three degrees (15%). Step width was stationary at the end of the twelve-week study with no change at 3 months post study. Conclusions: Long-term neuromuscular re-education of step width is possible. Step width gait retraining can improve running economy by 1.69% after neuromuscular adaptation occurs. This is important for well-trained distance runners seeking to improve their upper limits of performance. Step width narrows as gait speed increases in some runners, which may be a possible mechanism that leads to ITBS.