Foot Structure and Pronation
Foot Structure and PronationSome people think that pronation is bad. Pronation is a necessary motion that allows the foot to accommodate to the ground in a way that ideally reinforces stability and allows for a broad transference of kinetic energy through the entire foot. It isn’t a bad thing. A lack of pronation can be just as detrimental as an excessive amount of pronation.
An efficient foot is structurally capable of pronating to accommodate the foot to the ground. This pronation occurs during normal weight-bearing activities. Pronation begins in, but must not be isolated to, the rearfoot (subtalar joint). It must continue as a splaying, or spreading, of the midfoot and forefoot joints. An efficient foot is a foot that, in weight-bearing, is broad and demonstrates equal weight-bearing between the front and back and the sides of each foot. It is not rigid.
Many people pronate too much, or too quickly due to a lack of neuromuscular control and/or areas of rigidity in the foot. More often than not the joints of the midfoot are rigid. This rigidity disallows the splay/spreading of pronation into the mid and forefoot and causes a compensatory over-pronation of the rearfoot structures and ankle. This is a problem in static standing, as too much weight is born on the inside of the heel. It is also a problem in dynamic function, such as walking or running, as the excessive and/or poor timing of pronation will decrease the force produced by the foot when pushing off of the ground. When pushing off during walking or running the foot needs to return to a supinated position to maximize force potential. When pronation is limited to the rearfoot, compensations occur, including abnormal rotation of the lower leg, which will then propagate dysfunction further up the chain into the knee, hip, and lower back.
It is important to have a balance of stability and mobility through the foot (and throughout the body for that matter). Pronation is necessary but must be dispersed throughout the foot. It is important to enhance the mobility of areas of the foot that are rigid, through soft tissue mobilization and joint mobilization. It is equally important to improve the neuromuscular control of the areas of the foot that over-pronate, through corrective exercises and motor control training.
-Pete Rumford, DPT, MS DPT, CFMT, FAAOMPT