What is a biomechanical assessment?

A biomechanical assessment is a clinical assessment carried out by a suitably qualified practitioner who will assess you holistically for dysfunction in your posture. Many overuse injuries within your musculoskeletal system (muscle, joints, ligaments and tendons of your whole body) are due to abnormal movements and tissue stress created when a joint complex or muscle is not functioning correctly. There are many reasons for this, and if they are not revealed in the assessment, the pain may continue causing more severe dysfunction.

Why would I need a biomechanical assessment & gait analysis?

Dysfunction and asymmetry in your posture can create a wide variety of over-use injuries – like sports injuries in runners for example. These can be debilitating and upsetting because they stop you from training and doing the activity you love most.

There are a wide variety of sports injuries that can occur in the structure of the body involved with the action of running, mainly in the lower limbs. These include Achilles tendinosis, shin splints (medial tibial stress syndrome), runners knee syndrome (patellofemoral joint syndrome), hip pain, lower back pain, and many more from head-to-toe.


The assessment which often involves taking numerous measurements and tests involving your feet, legs and pelvis are designed to identify asymmetry in function between each side of the body, but also your foot function, leg length status and pelvic function both statically and while moving. This often involves using specialist technology like video gait analysis on a treadmill or the use of high-speed cameras, or a pressure plate analysis etc.

Specialist practitioner Clifton Bradeley explains that there are specific reasons overuse injury occurs: “Sometimes we have to think out of the box and beyond the normal mechanisms of injury to discover why athletes get injured. I don’t think it is good enough these days to blame all injuries on ‘flat-feet’ and poor shoe selection. We need to consider the broader factors that create the abnormal force in the body in the first instance. We need to consider the Newtonian aspects of postural adaptation to the physics applied to our body by gravity and ground reaction forces. We are in effect caught between these two great forces, i.e. gravity meets Newton’s third law. If there is asymmetry in the skeletal structures, e.g. leg length inequality, then the body will adapt to keep the upper body stable and eyes scanning the horizon. Adaptation to stabilise the body’s centre of mass involved most of the joints and muscles of the body eventually leading to excessive force building up in specific areas like a knee, hip and lower back. If this is not corrected, it will cause debilitating pain”.

Examples of biomechanical dysfunction

  • Flattening of the medial longitudinal arch of the foot.
  • Muscle imbalance in various muscles of the body.
  • One leg is longer than the other. 
  • Asymmetry in function between each leg and foot.
  • Excessive internal rotation of the tibia & femur.
  • Pelvic obliquity and twist.
  • Spinal dysfunction and poor posture.
  • Etc.

The data obtained from the assessment is carefully analysed to see whether it is responsible for the injury. An experienced specialist in this field should easily be able to explain why the damage has occurred based on the data obtained, and they will then implement a treatment protocol to start to address the issues highlighted. This may involve:

  • Strength & conditioning
  • Changing the brand and category of running shoes.
  • Stretching and mobility.
  • In-shoe bespoke orthotics insole made to a prescription from the assessment.
  • Modifying your training & running style.
  • A referral to another expert like a physiotherapist.

Orthotic therapy is incredibly successful from the right specialist, who has an interest in running, like Clifton. The success rate with orthotics is over 95% in combatting the underpinning reasons why injury occurs in the first place. Orthotics are extremely popular around the world in countries like Germany, Australia and the US.

When should I book a biomechanical dysfunction?

If your injury is slow to recover or recurrent, and other practitioners are struggling to give you the right answers or solution, then book a biomechanical assessment with a reputable practitioner – preferably one who has run at a high level. Your chances of recovery are much higher. Especially if your current practitioner only assesses and treats you on the couch and not dynamically. Running injuries are caused while running not lying on a couch!


Make sure that if you decide to schedule an assessment that you use a medically trained practitioner like a podiatrist, physiotherapist or doctor – and not a massage therapist or sports scientist who cannot legally make a medical diagnosis of your overuse injury. Medical practitioners are HCPC governed, and this is extremely important as it offers you protection as a patient.