RUNNING ASSESSMENT CASE STUDY
This case study focuses on a 52-year-old male runner, referred to here as James.
The first step in our running assessment was to have James run on the treadmill while we recorded slow-motion video footage, which we then uploaded to our gait analysis software for detailed review.
Next, we conducted a thorough subjective assessment, discussing James’s running history, any pain or injuries, and most importantly; his goals. James is a recreationally competitive runner who has always been active but, over the past 12 months, has become increasingly motivated and committed to his running. Currently, he is running just over a 20-minute 5K at full pace and is eager to improve further. He has noticed some left lateral knee pain, particularly after tempo runs and when running downhill, which has become more apparent as his speed and distance have increased.
We also gathered data from James’s smartwatch and training logs:
- Race Pace: Approximately 4:05 min/km
- Weekly Mileage: Average of 30 km/week
- Typical Sessions: 5K time trial, interval session, long run (15 km), and tempo run
- Surfaces: Road and trail
- Cadence: 165–175 spm
- Height: 5’6”
- Other Training: Cycling and resistance training
During our goal-setting discussion, James expressed that while he is close to achieving his goal of a sub-20-minute 5K, his primary aim is to continue enjoying the process rather than focusing solely on specific race targets. He regularly participates in Saturday Parkrun events but is not currently training for longer-distance races.
We proceeded with an objective assessment, including functional and specific tests such as knee-to-wall, Y-Balance, single-leg squat, hop test, heel raise, and Ober’s test. We also conducted a focused assessment of the knee and hips. This revealed a small weakness in his left hip, which correlated with deficits identified during the functional tests.
Analysis of the slow-motion video (front and side views) showed a slight drop in his right hip during left foot strike consistent with our objective findings. We also noted a relatively low cadence for his height (171 spm) and a significant overstride angle. This indicated that James was overstriding and heel striking outside his center of mass, which increases loading forces on the joints and tendons and elevates injury risk.
Based on our assessment, we diagnosed James with a mild iliotibial band (ITB) syndrome, likely resulting from his recent increase in running frequency and intensity. The weakness in his hip was contributing to lateral knee pain, a common presentation in runners but also the slight one sided hip drop while running. This was likely exacerbated by his overstride.
To address this, we developed a progressive and sustainable exercise program targeting his hip strength, specifically focusing on the gluteus medius and minimus. We also discussed the benefits of increasing his cadence towards 180 spm to reduce overstride and improve running efficiency, as well as strategies to achieve this adjustment.
James now has a self-managed plan designed to enhance his running speed and efficiency while keeping him pain-free.
