Over-Pronation

What is over-pronation

We need to learn about

pronation.

Pronation is a normal motion of the foot

during walking or running.

Helps to absorb

the normal forces

traveling

from the body above

to the ground below.

Pronation

Specifically

The ankle bone

slightly turns inward

and

the rest of the foot

turns slightly outward.

Ankle bone (talus) controls the motions of the hindfoot

(calcaneus/navicular)

Talus

Calcaneus

Navicul

ar

Let’s get more technical

During pronationTalus- slightly moves

Toward the mid-line of the body (medially)- transverse plane

The inner side (medial) lifts up-ward and the outer side (lateral) slightly drops downward- Inverts- frontal plane

Front of the talus slightly dips – sagittal plane

The talus controls the motion occurring in the mid-foot.

The mid-footcontrols the motions of

the forefoot.

Therefore:

the talus ultimately controls the motions of the rest of the foot.

The foot moves in the opposite direction of the

talus during walking.

Foot has to move in all three planes to pronateSlightly turns away from the mid-line of the body – lateral (abduction) transverse plane motion

Sole of the foot slightly turns outward (everts) frontal plane

Foot turns slightly up-wards (dorsiflexes) sagital plane.

Pronation

Also allows for adaptation while walking on uneven surfaces.

The motions of the foot when walking.

Pronationand

Supination

What is supination?

Supinated Foot Over-Pronated Foot

Supination - Pronation

• Opposite movements between the ankle bone and the foot.

• Think of it as a winding and unwinding of the foot mechanism.

• A period of stability and less stability of the foot structures while walking.

Pronation & supination are very important motions of the foot during

the walking cycle.

These complex motions of the foot consist of a locking and unlocking of the

joints within the foot.

Pronation unlocks the foot and turns it into a

“Loose bag of bones”

We have to be very careful using this term when describing the stability of the bones of the foot during pronation as it seems like there is no stability within the foot during this period.

This is not the case, it is just that there is a period of slight joint motion as the foot is allowed to be a mobile adapter.

Mobile Adapter

This is a very important aspect of the foot to allow slight accommodation to an uneven weightbearing surface below the foot.

During this time there is a normal amount of adaptation that is acceptable and built into the mechanics of the foot.

What controls how much pronation or supination occurs in the foot?

It is determined by the motion of the ankle bone (talus) on two hindfoot

bones (calcaneus-heel bone and navicular).

There is a specific point when the foot needs to be supinating.

During the contact phase of walking the hindfoot lands supinated,

quickly pronates, and re-supinates for toe-off.

At mid-stance the foot transitions from its supinated motion into a pronating

motion.

Finally, in order for the foot to function as it was designed, the hindfoot must

stiffen/limit joint motion and transition back into supination in order to prepare

the foot for lift-off.

So what is over-pronation/hyperpronation?

Over-pronation

simply means

too much pronation.

In other words

it means

an extended amount/duration

of pronation.

When the foot is supposed to be in a supinated/locked state, it is in it’s

pronated/weakened lax state.

This means the secondary support

structures (ligaments/

tendons/fascia)are going to have an increased strain to

lift the foot.

However, medically, it is more appropriate to use:

hyperpronation.

Hyper- means excessive or too much.

Think of the words

hypertension (high blood pressure)hyperglycemia (high blood sugar)

We don’t say

over-tensionor

over-glycemia.

How does the foot end up with too much or a prolonged amount of pronation?

Hind-foot stability has everything to do with the stability of

the ankle bone on the hindfoot bones

called the TaloTarsal Mechanism.

TaloTarsal Mechanism

• 3 bones– Talus

(ankle bone)– Calcaneus

(heel bone)– Navicular

(bone in front of the talus)

• This mechanism has the most complex motion of the body.

Talus sits on top of the back of the foot.

4 specific joints between the talus and the calcaneus

and navicular bones.

1

2

3

4

TaloTarsal Motion

There is a specific amount of motion that is supposed to occur between the talus on the hindfoot bones.

Normally, there should be twice the amount

of supination compared to the amount of pronation.

Why is over-pronation or hyperpronation a bad thing.

As the saying goes, too much of anything is usually not a good thing.

A prolonged or excessive amountof foot pronation means there is instability of

the ankle bone on the hindfoot bones.

This leads to excessive forces acting on the structures of the foot.

Specifically, there are increased strains placed on certain ligaments and tendons of the foot.

A few conditions blamed on an excessive amount of foot pronation.

• Bunions• Hammertoes• Posterior tibial tendon dysfunction• Plantar fasciitis/heel pain• Tarsal tunnel syndrome

And then there is the rest of the

body.

Does over-pronation only happen in a low arched or “flat” foot?

AnswerIn most cases there is a lower than normal arch

of the foot.

HOWEVER

What determines a low or high arch is the inclination of the heel bone.

It is possible to have a high arched foot and still have hyperpronation?

YES

Over-pronationis a result of the talus partially displacing off its

normal position on top of the heel bone.

The angle of the heel has little to do with the displacement of the talus.

The bottom of the foot is not

the cause of over-pronation.

How can we fix over-pronation?

To fix something you have to eliminate the cause.

Abnormal

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Abnormal

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