I remember vividly a family coming in to see us with a chubby 11year old just over four years ago, and they were quite frustrated . . . the problem? His shoes were wearing down on the inside and he was getting pains and couldn’t function properly. As well, shoes had to be bought every two to three months because they were so badly worn! This is what is going to be dealt with in this part of the series – pronation.
With this condition, unlike supination, it is where there is an inward rolling of the feet after the heel strikes the ground. While pronation is normal, the degree of pronation varies.
When standing, pronation occurs as the foot rolls inwards, and the arch of the foot flattens. It is a normal part of the gait cycle (walking/running) which helps to provide shock absorption at the foot, and could be excessive which is referred to as over-pronation. This can cause you to shift your weight to other areas of the foot while walking, causing intense pain.
Appearance of Over-Pronation
1. When standing, your heels lean inward.
2. When standing, one or both of your knee caps turn inward.
3. Conditions such as flat feet, fallen arches or bunions may occur.
4. You develop knee pain when you are active or involved in athletics. The knee pain slowly goes away when you rest.
5. You abnormally wear out the soles and heels of your shoes very quickly.
Symptoms of Over-Pronation
Symptoms can manifest in many different ways. The individual lifestyle of each person contributes to the associated conditions, some of which are as follows:
2. Arch Pain
3. Plantar Fasciitis
4. Metatarsalgia (ball of the foot pain)
5. Ankle Sprains
6. Shin Splints
7. Achilles Tendonitis
8. Knee Pain
9. Corns & Calluses
10. Flat Feet
11. Hammer Toes
What causes it?
The causes vary; however, it is in most instances as a result of strain on the foot. Excessive pressure/weight on the arch of the foot can contribute to the arch flattening, weakening, collapsing, and the soft tissue stretching. Woman may be prone to developing this condition if they wear high heels for long periods of time. Also, shoes that lack proper arch support are also a factor that leads to pronation.
If pronation is left untreated, serious problems can arise. A fallen arch will cause misalignment and can throw the alignment of the foot, ankle, and knee off, leading to strain in overall posture. This strain may cause not only discomfort, but also pain throughout the foot, ankle, knee, hip, and lower back. Ligaments and tendons could become deformed as well, if left untreated.
As stated earlier, we pronate out of necessity, in order to adequately adapt to uneven ground surfaces. In short, our ability to walk, stand, and function with a normal gait is largely dependent upon our capacity to pronate. For example, a 200lb man standing on his feet all day on cement floors, with two poorly supported ankles due to excessive pronation, is predictably waiting for clinical problems to occur.
How can I tell what Degree of Pronation occurs when I walk/run?
• Firstly, look at your feet while standing; have you got a clear arch on the inside of the foot? If there is not an arch and the innermost part of the sole touches the floor, then your feet are over-pronated.
• Secondly, look at your running shoes. If they are worn on the inside of the sole in particular, then pronation is occurring.
• Thirdly, having a foot imprint test done is key in knowing the type of arches you have, and in some instances it also shows the area where your pressure is placed, whether it is rolling inward or outward. A normal foot will leave a print of the heel, connected to the forefoot by a strip approximately half the width of the foot on the outside of the sole. If your feet are pronated, there may be little distinction between the rear and forefoot; in other words, there would be a full footprint, which suggests flat or flattened arches.
How is Pronation treated?
Early treatment of children who pronate excessively is very important, especially in young athletes. As the child develops, by controlling pronation we can eliminate many of the conditions before they get a chance to start.
Arch Supports or orthotics are the most effective way of treating this condition. It controls pronation by adding support and stabilizing the arch and heel of the foot, neutralising the effects of pronation. Most times it is the only treatment necessary for a lot of foot conditions.
Your feet mirror your general health . . . cherish them!