The Runner’s Gait, Part 2: MidStance and Single-Leg Support
A runner may tolerate the first few steps yet struggle as repeated loading exposes pain, fatigue, or declining control. Mid-stance helps practitioners examine that challenge: the body moves over the supporting foot while the hip, knee, ankle, and trunk coordinate support and movement.
Understanding the Midstance Phase connects regional anatomy with the runner’s ability to tolerate repeated single-leg loading. This article examines relevant muscle and joint contributions, explains how observations can guide examination, and identifies MSR treatment priorities. The objective is to connect useful changes from manual care with strength, endurance, and progressive running so the runner can sustain the distances and activities that matter to them.
Article Index
Understanding Mid-Stance
For this series, mid-stance refers to the middle portion of ground contact, when the body passes over the supporting foot. It provides a useful landmark within a continuous movement rather than a separate action.
Knee flexion, ankle dorsiflexion, and arch compression help accommodate loading, but their peaks do not necessarily coincide. Muscles generate force while tendons and other elastic tissues deform and recoil. Ground-reaction forces vary with speed and running conditions; they should not be described as having a universal maximum of three times body weight.
Anatomical Structures
Glutes:
Anatomical involvement: Gluteus medius and minimus contribute to hip abductor force and control of the pelvis over the supporting limb. Gluteus maximus contributes to hip extension and control according to limb position and running demands. Some pelvic movement is expected.
Clinical interpretation: Contralateral pelvic drop, hip adduction, or inward knee movement may prompt assessment of hip strength, endurance, pain, and coordination. Observe whether the pattern changes with fatigue. These findings do not independently establish gluteal weakness.
MSR treatment priorities: Consider gluteus maximus, medius, minimus, and relevant hip restrictions when findings affect single-leg loading. Connect manual care with progressive hip loading and single-leg tasks, then reassess running.
Research in runners with patellofemoral pain supports examining relationships between hip capacity and movement, particularly during prolonged running. It does not support diagnosing gluteal weakness from pelvic position alone.
Quadriceps:
Anatomical involvement: The quadriceps generate a knee-extension moment that contributes to support and controls knee flexion during loading. Their contribution changes as the runner progresses through stance.
Clinical interpretation: Painful loading, abrupt knee motion, or apparent buckling warrants assessment of knee symptoms, mobility, and extensor capacity. A more flexed knee does not automatically indicate weakness; it may reflect speed, technique, or an adaptation to symptoms.
MSR treatment priorities: Consider the vasti, rectus femoris, and relevant knee restrictions when symptoms or limited movement affect support. Pair treatment with progressive knee-extensor exercise and reassess a suitable single-leg loading task.
Hamstrings:
Anatomical involvement: The hamstrings can contribute to hip extension, knee flexion, and control across the hip and knee. Their contribution varies through the gait cycle and with speed; their important terminal-swing role is examined in Part 6.
Clinical interpretation: Posterior-thigh pain, painful loading, or limited hip movement may justify focused hamstring assessment. Shortened steps or an uneven running pattern cannot identify hamstring dysfunction by themselves.
MSR treatment priorities: Consider biceps femoris, semitendinosus, semimembranosus, and relevant hip findings when examination supports their involvement. Connect manual care with progressive knee-flexor and hip-extensor loading suited to the runner’s presentation.
Calf Muscles:
Anatomical involvement: The ankle plantarflexors contribute substantially to support as the body advances over the foot. The calf–Achilles complex develops force and stores elastic energy during loading, contributing to the transition toward propulsion.
Clinical interpretation: Painful calf loading, restricted ankle dorsiflexion, or difficulty sustaining repeated heel raises may reveal relevant limitations. Ground-contact duration and apparent “spring” depend on several factors, including speed, and cannot diagnose calf weakness.
MSR treatment priorities: Consider gastrocnemius, soleus, and relevant talocrural restrictions when they affect loading or ankle movement. Combine manual care with straight-knee and bent-knee calf loading, progressing toward repeated elastic loading when appropriate.
Trunk Muscles and Pelvic Coordination
Anatomical involvement: Erector spinae, multifidus, obliques, rectus abdominis, and other trunk muscles coordinate spinal and pelvic movement during single-leg support. Running requires controlled movement rather than a rigid torso.
Clinical interpretation: Observe trunk lean, rotation, and pelvic movement in relation to symptoms, speed, and fatigue. Forward lean changes lower-limb loading and may be an individual strategy. Posture, pacing, or fatigue alone does not establish a weak core.
MSR treatment priorities: Consider relevant spinal extensors, quadratus lumborum, obliques, and thoracic or lumbar restrictions when examination identifies a symptomatic limitation. Connect treatment with appropriate trunk endurance, rotation control, and running tasks.
Foot Muscles and Joint Coordination:
Anatomical involvement: Plantar intrinsic muscles, including abductor hallucis, flexor digitorum brevis, and quadratus plantae, contribute to arch control under load. Tibialis posterior and other extrinsic muscles also contribute, alongside the plantar fascia and joint structures.
Clinical interpretation: Observe arch compression and rearfoot movement as the body passes over the foot. Pain, restricted motion, or declining tolerance across repeated steps may justify examination of foot strength, ankle mobility, and loading capacity.
MSR treatment priorities: Consider relevant plantar muscles, tibialis posterior, and foot-joint restrictions when findings affect support. Pair treatment with progressive foot and calf loading and reassess an appropriate weight-bearing task.
Mid-Stance: Observation and Clinical Interpretation
Observe several strides from the side and behind. Compare similar speeds and record whether symptoms or movement change as the run continues.
Pelvis and hip: Does pelvic drop or hip adduction coincide with pain or declining control? Examine hip capacity and relevant mobility, then compare findings with single-leg tasks.
Knee: Is loading painful, abrupt, or associated with giving way? Assess joint symptoms, movement, and quadriceps capacity before attributing the pattern to weakness.
Ankle and calf: Does the runner tolerate the body moving over the foot? Restricted dorsiflexion or painful loading may direct examination toward ankle mobility and calf strength or endurance.
Foot: Does arch or rearfoot movement accompany local symptoms or reduced loading tolerance? Assess relevant muscles and joints rather than classifying pronation alone as a fault.
Trunk: Does a change in lean or rotation emerge with symptoms or fatigue? Examine whether it reflects a useful strategy or a limitation requiring attention.
Motion Specific Release
MSR Midstance Treatment Demonstration
Use the accompanying demonstration to study the procedures presented, relating their application to the runner’s examination findings. Relevant targets may include the gluteals, quadriceps, calf, plantar muscles, and associated joint restrictions.
Establish a baseline such as painful ankle movement, a single-leg loading task, or running at a reproducible speed. Adapt the demonstrated procedures to the presentation, then reassess and connect useful changes with progressive exercise and running exposure.
These treatment priorities draw on anatomical reasoning and clinical application. The biomechanics studies explain running demands; they do not directly test MSR treatment effects.
Conclusion
Manual care can address relevant symptoms or movement restrictions, while progressive loading develops the capacity to sustain the task. Reassess whether changes carry into single-leg exercise, running, and recovery between sessions. When progress stalls, reconsider the findings alongside training volume, speed, recovery, and diagnosis. This keeps treatment directed toward the runner’s participation and goals. Part 3 examines propulsion and the transition from ground contact into flight.
References
Abelson B, Abelson K, Mylonas E. A Practitioner’s Guide to Motion Specific Release: Functional, Successful, Easy to Implement Techniques for Musculoskeletal Injuries. 1st ed. Rowan Tree Books; 2018.
Dierks TA, Manal KT, Hamill J, Davis IS. Proximal and distal influences on hip and knee kinematics in runners with patellofemoral pain during a prolonged run. Journal of Orthopaedic & Sports Physical Therapy. 2008;38(8):448–456.
Hamner SR, Delp SL. Muscle contributions to fore-aft and vertical body mass center accelerations over a range of running speeds. Journal of Biomechanics. 2013;46(4):780–787.
Hamner SR, Seth A, Delp SL. Muscle contributions to propulsion and support during running. Journal of Biomechanics. 2010;43(14):2709–2716.
Kelly LA, Lichtwark G, Cresswell AG. Active regulation of longitudinal arch compression and recoil during walking and running. Journal of the Royal Society Interface. 2015;12(102):20141076.
Novacheck TF. The biomechanics of running. Gait & Posture. 1998;7(1):77–95.
Teng HL, Powers CM. Influence of trunk posture on lower extremity energetics during running. Medicine & Science in Sports & Exercise. 2015;47(3):625–630.
DR. BRIAN ABELSON DC. - The Author
Dr. Brian Abelson is a chiropractor, author, and educator with more than 30 years of clinical experience in musculoskeletal care, rehabilitation, and sports performance. His educational work focuses on musculoskeletal conditions, human movement, sports biomechanics, and evidence-informed approaches to treatment and rehabilitation.
He is the developer of Motion Specific Release (MSR) and Clinical Director of Kinetic Health in Calgary, Alberta, Canada.
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