Patient guide · Tests & procedures
Biomechanical assessment, a structured gait, running and posture analysis to prevent and treat injury.
A structured assessment of gait, running technique and posture — including 2D or 3D video analysis, pressure-plate testing and functional movement screening. The foundation of orthotics, running rehab and return-to-sport programmes.
Key facts
The essentials in six lines.
A quick reference before the detail — what the test is, what it combines, and who runs it.
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Definition
A structured assessment of gait, running technique and functional movement.
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What it combines
Clinical exam, 2D or 3D video, pressure plates and a functional movement screen.
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Foundation for orthotics
The reference point for custom orthotic prescription.
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Guides running rehab
Objective inputs into a structured running-rehabilitation programme.
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Complements imaging
Works alongside MSK ultrasound and MRI when structural pathology is suspected.
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Who delivers it
A musculoskeletal podiatrist or sports physiotherapist with biomechanics training.
What happens
From arrival to plan — what happens, in order.
Seven steps, one clinician, one written plan at the end.
- 01
Consultation with MSK podiatrist or physio
A focused history — injuries, training load, footwear, goals and prior imaging.
- 02
Bring your running shoes
Ideally your current pair plus any older shoes — wear patterns tell a story.
- 03
Standing static assessment
Posture, alignment, foot posture index and functional leg length.
- 04
2D or 3D video treadmill analysis
Slow-motion capture of your gait and running form, front, side and back.
- 05
Pressure-plate (F-scan / Tekscan) analysis
Quantifies foot pressure distribution, centre of force and loading symmetry.
- 06
Functional movement screen (FMS)
Seven movement patterns scored for mobility, stability and asymmetry.
- 07
Structured report with orthotic and rehab plan
A written report with findings and a concrete plan — orthotics, exercises, next steps.
What it shows
The eight things a good assessment quantifies.
Not opinions — measured, repeatable metrics that anchor the orthotic and rehab plan.
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Overpronation / oversupination
Excessive or insufficient rearfoot motion during stance.
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Rearfoot / forefoot alignment
Static and dynamic alignment across the subtalar and midtarsal joints.
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Cadence, stride length, ground-contact time
The three running metrics that most reliably predict injury and performance.
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Knee valgus on landing
Dynamic knee collapse — a strong predictor of patellofemoral and ACL injury.
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Trunk lean and pelvic drop
Trendelenburg-pattern hip drop and compensatory trunk lean.
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Force-time symmetry
Loading rate and left/right symmetry from pressure-plate data.
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Foot pressure distribution
Where load actually goes through the foot in stance and push-off.
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Red flag: gross gait deviation with neurological signs — urgent neurological review
Do not defer. Foot drop or new neurological gait needs urgent neurology.
Next steps
What comes out of the report.
A biomechanical assessment is only useful if it produces a concrete plan you can act on. These are the routes we take.
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Custom orthotic prescription
Bespoke insoles designed against the biomechanical findings, not an off-the-shelf template.
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Footwear guidance
Shoe-model recommendations matched to your foot type, running style and training load.
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Running gait retraining
Cueing and drills to modify cadence, foot strike and trunk position.
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Strength and conditioning programme
Targeted work for identified deficits — glutes, calves, foot intrinsics, core.
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Physiotherapy for identified deficits
Hands-on physio for mobility restrictions and pain that block the rehab plan.
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Sports-medicine consultation
A sport and exercise medicine consultant when the picture is complex.
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Return-to-sport testing
Objective criteria — strength, hop tests, movement quality — before return to load.
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Follow-up assessment at 3 months
Re-scan the same metrics to confirm the plan is working, and iterate if not.
Red flags
When a biomechanical assessment isn’t the right first step.
Nine presentations that need a different specialist first — neurology, surgery, diabetic foot service or pain medicine.
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Foot drop
Inability to dorsiflex — needs urgent neurology, not a biomechanical assessment first.
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Neurological gait
Ataxic, spastic or hemiplegic gait patterns require neurological work-up.
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Antalgic gait masking pathology
A limp driven by structural pathology — MSK ultrasound or MRI first.
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Post-op malalignment
Persistent malalignment after surgery — back to the operating surgeon.
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Cavus / flat foot with pain
Painful pes cavus or adult-acquired flat foot needs a foot-and-ankle opinion.
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Post-stroke gait dysfunction
Coordinated with neurorehabilitation, not a stand-alone biomechanical review.
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Charcot foot
Suspected neuropathic arthropathy — urgent multidisciplinary diabetic foot service.
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Complex regional pain syndrome
CRPS features need a pain-medicine pathway before gait retraining.
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Post-op rehabilitation failure
Failed post-operative rehab warrants surgical review before further biomechanics.
Frequently asked
Everything we get asked about biomechanical assessment.
Straight answers on what it is, when it helps, and when it doesn’t.
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What is a biomechanical assessment?
A structured assessment of how you stand, walk and run — combining a clinical exam, 2D or 3D video analysis on a treadmill, pressure-plate testing and a functional movement screen. It produces a written report with a concrete orthotic and rehabilitation plan.
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Do I need a biomechanical assessment before custom orthotics?
Yes — a proper custom orthotic prescription is written against measured biomechanics, not a foot impression alone. Off-the-shelf insoles don’t require one; bespoke orthotics do.
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What should I bring?
Your current running shoes, any older pairs (wear patterns are diagnostic), shorts, and any prior imaging or reports. Athletes should bring their sport-specific footwear as well.
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Is it useful if I don’t run?
Yes. Gait analysis matters for walking mechanics, orthotic prescription, return-to-sport after injury, and workplace posture — running is one of several use cases.
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Who delivers the assessment?
A musculoskeletal podiatrist or a sports physiotherapist with formal biomechanics training. The written report should be produced by the clinician who ran the assessment.
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When is a biomechanical assessment not the right test?
When there are red flags — foot drop, new neurological gait, a Charcot foot or post-op malalignment. Those need neurology, diabetic-foot services or the operating surgeon first.
Sources
What this page draws on.
Reviewed 2026-07-30. Next review 2027-07-30.
Related
Related conditions and tests.
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Cavus foot
A high-arched foot type that concentrates load on the lateral column.
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Adult flat foot
Progressive flat foot from posterior tibial tendon dysfunction.
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Plantar fasciitis
Insertional heel pain from plantar fascia overload.
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All tests
Browse every test and procedure we arrange.
Learn more
In practice, in London
What biomechanical assessment looks like on the ground in London
With biomechanical assessment, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. On the NHS, biomechanical assessment typically sits behind a triage step and a wait that can stretch from a few weeks into months. In London’s private sector, the same appointment often lands within days. That speed matters when symptoms are disrupting work, sleep, or a plan you’d already committed to — and it’s the single most common reason people call us in the first place.
The mechanics are straightforward: a consultant appointment, any tests done at a nearby CQC-registered site, and a written report back within a few days. London’s density of private diagnostics — Marylebone, the City, Chelsea, Canary Wharf — means most patients can find something that fits around work without a cross-town trek. For biomechanical assessment specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
The value of going through a concierge for biomechanical assessment isn’t access — anyone with an insurer or a credit card can get a private appointment in London. The value is knowing which consultant reads this particular presentation best, which unit turns reports around fastest, and which pathway won’t hit a dead end if the findings point somewhere unexpected.