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ABNORMAL PRONATION CONSISTS OF 2 TERMS. PRONATION CONSISTS OF "ION" WHICH DOES NOT MEAN A POSITION BUT INSTEAD THAT MOTION IS ACTIVELY OCCURING. ABNORMAL REFERS TO THE TIMELINE IN THE GAIT CYCLE THAT THE MOTION OF PRONATION SHOULD NOT BE OCCURING. BY PRONATION OF THE REARFOOT THE CALCANEOUS EVERTS AND DORSIFLEXES AS PER WHAT I WAS TAUGHT IN NYCPM. ALL THE ABOVE I WAS TAUGHT. BUT THE CONCEPT OF WHEN THE REARFOOT EVERTS, THE FOREFOOT SPLAYS DO YOU REALLY BELIEVE THE FOOT BECOMES MORE FLEXIBLE? |
I AM A LONG ISLAND PODIATRIST AND RIDGEWOOD QUEENS PODIATRIST THAT EVALUATES PODIATRIC BIOMECHANICAL FAULTS. Runners may find this particular web page of interest: I believe that a certain degree of pronation is normal, if the foot is it's optimum position during the gait cycle. If too much supination is present then the foot does not pronate, the heel does not evert when it should, and the internal rotation of the leg does not occur. If the leg does not internally rotate then the knee cannot flex. The knee flexion is needed to absorb shock. Thus abnornal foot function possibly can cause other problems in the body for which your medical doctor can examine, diagnose and treat. A podiatrist can treat the abnormal supination which I believe is the foot not pronating when it should. An example of "abnormal supination" which is also known by me as "hypersupination" or "hypopronation" can be found by the gait analysis of a patient and also from the findings of your static exam. ( Generally the findings of a static exam should confirm the findings of a gait analysis of biomechanics occuring in the foot. Please keep in mind that there are triplanal suprastructural influences that influence the foot and the foot can compensate either normally or abnormally. There is normal and abnormal compensation occuring in the foot). At the New York College of Podiatric Medicine I learned that when the subtalar joint is held in it's neutral position, and the longitudinal axis of the midfoot is maximally pronated especially in the frontal plane, then the first metatarsal phalangeal joint is relatively plantarflexed with regards to the other metatarsal heads. The abnormal compensation that occurs if this joint is rigid but not flexible causes the rearfoot to abnormally supinate ( a great deal of motion is occuring on the frontal plane during this abnormal supination) at that point in the gait cycle when it should be pronating. Again pronation of the rearfoot is where the calcaneous everts and dorsiflexes and the talar head is plantarflexing. With this in mind, the leg does not internally rotate as it normally should and the knee cannot flex and so there is a decreased ability for the knee joint to absorb shock. I believe the knee was the major shock absorber. I believe this could possibly lead to ankle and foot inversion sprains and injuries especially during certain sports. All this is only some of what I learned while I was a student at the NYCPM. I am very grateful to all my teachers at NYCPM for all that they taught me. All my teachers there were mostly podiatrists who have given me the biomechanical knowledge that enabled me to better treat my patients. Please understand that there are other theories in the orthopedic texts. For example, when the calcaneous everts, the foot becomes more rigid. This is totally the opposite of what I learned at NYCPM. (I believe theory in general can be very interesting. However, every runner, patient with a biomechanical fault is a seperate clinical patient. Through trial and error even the use of felt propperly placed in one's shoes or sneakers can dramatically affect gait.) I am now looking to see if certain sneakers, shoes or orthotics can help accomodate such abnormal supination. For some of my patients I have tried using an arch support as a temporary attempt to treat certain problems. Before any treatment is attempted I feel it is important to first see a podiatrist or other qualified licensed health care practitioner. |