- What your eyes can't see
The ceiling of visual assessment
Two experienced physiotherapists watching the same slow-motion footage of the same runner will often reach different conclusions. Not because one is wrong. Because visual assessment has a structural ceiling. Jay Dicharry, MPT, SCS, has assessed over 7,000 runners using 3D gait analysis. He puts it plainly: “You can’t see forces.” This paper is about that ceiling. Where it shows up in clinical practice, what gets missed when decisions are made in the gap, and what becomes possible when objective gait data fills it in.
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What’s inside? Five clinical gaps where the eye runs out of resolution:
- Impact load: Why footfall sound isn’t a reliable proxy for measured force, and why high impact with good absorption is a different clinical picture from moderate impact with poor absorption.
- Symmetry: How to distinguish protective asymmetry from overloading asymmetry. Two patterns that look identical on video but require opposite interventions.
- Dynamic stability: Why inadequate hip control passes visual screens, and how it drives ITB syndrome, MTSS, and the re-injuries that surface six weeks after return-to-sport.
- Tracking outcomes: A practical framework for showing clients measurable progress, instead of relying on observation to confirm an intervention is working.
- The report problem: Why post-session reports take so long to write, why they often fail to land, and what changes when the report generates automatically the moment the session ends.