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Writer's pictureLuke Nelson

The "Knee Window" of Running Gait

🦵The "knee window" provides a quick and simple method to assess for increased pelvic drop, hip adduction, knee valgus, and a narrow step width 🏃‍♀️

🔎 To assess this "knee window", using the view from behind, we should see a gap, or window, between the knees throughout the majority of gait. If we see this gap close, it may indicate any combination of increased pelvic drop, hip adduction, knee valgus, or a narrow step width.


A narrow step width can result in:

⬆️ loading of the tibia & ITB (Meardon 2014, Meardon 2012)

⬆️ Peak hip adduction & rearfoot eversion angles as step width decreases. (Brindle 2013)


Increased hip adduction & knee valgus may result in:

⬆️ knee load, so important for those with patellofemoral pain (Nakagawa 2012, Stefanyshyn 2006)

⬆️ Peak hip adduction during running is a risk factor for future patellofemoral pain in female runners & associated with the persistence of PFP. (Noehren 2013, Davis 2020, Neal 2016)

⬆️ Lateral hip stress (gluteal tendinopathy)

🦵Ischiofemoral impingement


Pelvic drop

🤕 From Bramah's 2018 retrospective study, pelvic drop was the most important variable predicting the classification of participants as healthy or injured.

📊 For every 1° increase in pelvic drop, there was an 80% increase in the odds of being classified as injured. (Bramah 2018)


👋Runners & health professionals like & share this if you found it useful


🤓Health professionals, to learn more about treating runners, check our upcoming Online & Face to Face “MAT Assessing the Runner” courses.



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📚 References

  • Bramah, C., et al. (2018). "Is There a Pathological Gait Associated With Common Soft Tissue Running Injuries?" Am J Sports Med: 363546518793657.

  • Brindle, R. A., et al. (2013). "Changing step width alters lower extremity biomechanics during running." Gait Posture.

  • Davis, I. S., et al. (2020). "Gait Retraining as an Intervention for Patellofemoral Pain." Curr Rev Musculoskelet Med 13(1): 103-114.

  • Meardon, S. A., et al. (2012). "Step width alters iliotibial band strain during running." Sports Biomech 11(4): 464-472.

  • Meardon, S. A. and T. R. Derrick (2014). "Effect of step width manipulation on tibial stress during running." Journal of biomechanics.

  • Nakagawa, T. H., et al. (2012). "Frontal plane biomechanics in males and females with and without patellofemoral pain." Med Sci Sports Exerc 44(9): 1747-1755.

  • Neal, B. S., et al. (2016). "Runners with patellofemoral pain have altered biomechanics which targeted interventions can modify: A systematic review and meta-analysis." Gait Posture 45: 69-82.

  • Noehren, B., et al. (2013). "Prospective evidence for a hip etiology in patellofemoral pain." Med Sci Sports Exerc 45(6): 1120-1124.

  • Stefanyshyn, D. J., et al. (2006). "Knee angular impulse as a predictor of patellofemoral pain in runners." Am J Sports Med 34(11): 1844-1851.

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