What is it?
The term pronation is actually
a description of directional movement that can be used in reference to
various body segments. For instance, a tennis player should pronate the hand
while serving and a pitcher should pronate the hand during delivery. In the
foot, pronation describes an in-rolling or collapsing of the longitudinal
arch during weight bearing. Some pronation is good because it allows our
foot and ankle to function correctly and makes it possible for us to walk
effectively on an uneven ground surface and absorb the shock our body gets
while walking or running. Pronation only becomes a problem when it exceeds
the normal range. If the foot remains in-rolled or collapsed for a longer
time period then it should, then we have an unstable foot, which can lead to
a wide variety of clinical problems. Bunions, corns, calluses, heel pain,
shin splints, knee pain and the list goes on and on, can all be caused
directly or indirectly by excessive pronation. It should be noted that as we
increase our gait from walking to running the pressure increases on our foot
to increase pronation. In a sense, excessive pronation is one of the chief
reasons of chronic foot pain and is directly related to secondary conditions
that can get worse without treatment.
What causes it?
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 throughout
normal gait is largely dependent upon our capacity to pronate. However, in
some instances, our mechanics or functioning capabilities become abnormal
and excessive pronation is a common result. A two hundred-pound 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 do you treat it?
The treatment of excessive
pronation is more difficult than what it might seem. A thorough examination
by a foot specialist is necessary in order to identify not only the degree
or extent of pronation but also the source of the excessive motion.
Orthotics or supportive functional devices are the chief means of treating
this condition. The foot specialist will prescribe and utilize a specific
product to address the particular needs of the patient. Controlling
pronation can many times be the only treatment necessary for a lot of foot
Early treatment of
children who excessively pronate 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. There are now
available small implants that go into the joint that moves the most in
pronation to eliminate excessive pronation. These are used if conservative
treatments have failed.