Cross-Over Gait Correction

How to Fix a Cross-Over Gait

The best way to work on crossover gait is to perform running drills! Many runners are simply unaware that they run with a cross-over gait. Specific running drills to address a this type of gait will significantly improve running efficiency and decrease risk for injury. At our Mission Valley sports injury clinic, we stress the importance of running drills to all of our running patients.

There are three main drills that significantly reduce cross-over gait: increasing cadence, running wider, and activating the hip stabilizers while moving through gait.

  1. Cadence– I talk extensively about cadence in our blog post here. In a nutshell, by increasing running cadence, there is less time for your feet to travel across midline.  Slow cadence allows more time for your feet to creep over midline.
  2. Run wide using a track line– Run around a track with lane lines (or white bicycle lane line). Run so the line is in the middle of your body. The goal is to land with the inner right foot touching the right outer border of the line and vice versa for the left foot. It may feel like you are running VERY wide but with practice it will feel more normal. Practice this drill on the straight away on the track about 4-6 times. Over time you will start to run wider naturally.
  3. Walking hip hikers– The goal is to activate the gluteal muscles, and hold while taking a step. This builds the mind body connection to the hip/core muscles while moving during gait. Watch the video below for a detailed look at the walking hip hiker.

What about increasing core strength?

Core and gluteal strengthening drills alone will not magically get rid of a cross-over gait; again working on correcting the gait will do that. That being said, working on the core and gluteal muscles in conjunction with gait retraining, will support proper running gait. The stronger the supporting muscles are, the more capable they are to resist fatigue during workouts and races. Some runners have no issues with their gait for runs between 3 and 10 miles. Once long runs increase to the 12, 14, 16 mile range, gait issues begin to occur. In this scenario, strengthening workouts to the core and gluteal muscles is paramount to avoid running form breakdown during longer runs. Here are a few of our favorite core and gluteal strengthening exercises:

Gluteal bridge

Lay flat on your back, knees bent, and feet flat on the floor just wider than hip width apart. Brace your abdomen to engage the core. Press through your heels to lift the pelvis upward until it is in line with the knees and shoulders. Avoid arching through the back. Add a band around the knees for more gluteal activation. Sets: 3 Reps: 10-20

Bridges improve core and gluteal muscle strength, important for running               Bridges improve core and gluteal muscle strength, important for running

Monster walking 

Place a medium resistance mini-loop band around the ankles. Spread feet shoulder width apart and sit into a shallow squat, keeping your core engaged. Step forward and slightly outward with one foot and then repeat with the other. Take 5-10 steps forward and 5-10 steps backward. Continue until you feel a good exercises burn in the muscles of the outer hip. Sets: 3 Reps: Go until it burns

Walking with a band strengthens the gluteus medius muscle to improve hip and low back stability               Walking with a band strengthens the gluteus medius muscle to improve hip and low back stability

Crab walking     

Place a medium resistance mini-loop band around the ankles. Spread feet shoulder width apart and sit into a shallow squat, keeping your core engaged. Take a step to the side, then take the same distance step with the other foot in the same direction; important to not over step inward with the follow up step as this looses tension in the band. Take 5-10 steps one direction and 5-10 steps back in the other direction. Continue until you feel a good exercises burn in the muscles of the outer hip. Sets: 3 Reps: Go until it burns

Walking with a band strengthens the gluteus medius muscle to improve hip and low back stability               Walking with a band strengthens the gluteus medius muscle to improve hip and low back stability

Dead bug

Lay on your back, with your knees and hips bent to 90 degrees and arms held straight in front of shoulder. Brace your core by squeezing back and abdominal muscles. Slowly lower one leg towards the ground, resisting the back from arching up off the ground. Alternate legs keeping a slow pace the entire time. If this version of the dead bug is too difficult, keep the knee bent when moving the leg and perform heel taps. Sets: 3 Reps: 10 per leg

Dead bug improves lumbo-pelvic muscle control important for running               Dead bug improves lumbo-pelvic muscle control important for running

Side plank

Begin by laying on your side with the elbow tucked underneath the shoulder and feel sacked. Keep the body as straight as possible and lift the pelvis off the ground. Focus on contracting the muscles on the side closest to the floor. Perform the side plank on both sides. Sets: 3 Reps: 1 Hold: 30-60 seconds

Side plank improves lateral core stability which is important for running

Self Myofascial Release to the Gluteal muscles

Take a look at the video below. By using a lacrosse ball into the muscles, muscle tension will decrease which can help with soreness, pain, tightness in the area.

These strategies help with correcting a cross-over gait. If you are experiencing shin, knee, hip, back, or foot pain from running, I highly recommend getting the injury evaluated. A targeted approach to your specific injury can prevent time lost to injury. At our Mission Valley office, we perform Active Release Technique, Graston technique, and rehabilitative exercise to keep our endurance athletes competing pain free!

Do you Run with a Cross-Over Gait?

Do you Run with a Cross-Over Gait?

A cross-over gait, also known as a “tightrope” gait, involves running with your feet crossing the midline of your body. As each foot crosses midline, it appears as if you a running along a tightrope. This running style decreases running efficiency and may set you up for future injury (or prolong your current injury!). The areas commonly injured are the inner shin/tendons, knee, outer hip/IT band, and lower back. Beginner runners, and runners with weak core/gluteal muscles tend to run with this type of gait. 

Do you run with a cross-over gait?

The absolute easiest way to diagnose a cross-over gait is by having a gait analysis performed. A professional gait analysis is recommended but a quick video recorded by a friend can be show if the feet cross midline. Setting up a camera behind a treadmill while running solo is another easy way check for cross-over gait (see runner below).  As you watch the stride, look for where the foot lands in relation to the body’s midline.

Other signs of a cross-over gait include: excessive wear on the outside bottom of shoes, scuff marks on the inner legs ( you actually hit yourself with your foot from running too narrow!), side to side head bob noticed visually when looking straight ahead, and inline foot prints when running on sand or dirt. The main symptom of a cross-over gait is recurring injury to the same area with running. Symptoms tend to lessen with treatment and rest but return with increased running volume, intensity, or both. 

 Why is a cross-over gait less efficient?

Simply put, you are wasting energy moving side to side; the more energy spent moving side to side, less energy spent moving forward. Cross-over gait puts a lot more demand on tissues which will cause the muscles of the core, hip, lower leg to work extra hard. The demand will create more fatigue which in turn will decrease efficiency further. 

How does a cross-over gait cause injury?

With a cross-over gait, the foot strikes at or across midline , forcing our joints to work in a non-stacked position. The lower extremity performs best with a stacked orientation to absorb shock/strain with muscles. With the joints working at a slight angle, several tissues now have to work harder to absorb shock and slow down joint movement. The following injuries are commonly associated with a cross over gait:

  1. Posterior shin splints/Posterior Tibialis tendinopathy– While running with a cross-over gait, the foot lands excessively on the outside part of the foot and as the body weight shifts forward, the foot quickly flattens. The slapping down of the foot is often viewed as “over pronation” when in reality, the foot and ankle are pronating too quickly. The posterior tibialis muscle (and other lower leg muscles) must contract powerfully to slow this motion down. This causes excessive strain of the muscle causing shin and tendon pain. Over pronation is not the issue and is a reason why changing footwear in these cases is not helpful. 
  2. Knee pain– As the leg moves toward middle, the inner knee structures get over stretched. The kneecap likes to move in a straight line over the knee. If the muscles are contracting around an angled joint, abnormal tracking of the knee cap occurs.  Patients often have pain at the front part of their knee. If chronic irritation occurs, it can cause swelling around the knee/knee cap.
  3. Outer hip/IT band pain– Again as the leg moves inward, the outer hip elongates, allowing the pelvis to “drop”. This over stretches the outer gluteal muscles. As the hip muscles become more strained, the less stability they are able to provide. Trochanteric bursitis, iliotibial band syndrome are two common conditions that arise from overused/weakened hip muscles. 
  4. Lower back pain– Keeping in mind with what occurs at the hip, the low back joints and muscles get stretched abnormally as the pelvis “drops” due to weak gluteal muscle stabilization. Local low back pain is common from this constant side to side joint irritation. Symptoms may be significantly worse if a runner  has disc degeneration and/or low back joint degeneration.
Cross-over gait injuries

Potential sites for injury with cross over gait

A runner with a cross over gait and a cadence of 180 steps per minute, will cross over 5,400 times during a 30 minute run! Running with a cross-over gait will only worsen as fatigue sets in, setting runners up for injury. It is important to identify this running pattern and address the deficiencies to avoid injury. If you have chronic injuries or recurrent injuries to the same body part, you may be running with a cross-over gait. In our upcoming blog posts, we will be discussing ways to fix a cross over gait and run more efficiently.  

If you are interested in being evaluated for running injuries, our office is conveniently located in Mission Valley, San Diego!