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Posted on 02-29-2016

  A total “hot-button” topic amongst those of you who run, or attempt to run.  Throughout this blog I’ll probably offend Podiatrists, running store owners, and those of you who have already had success with their “patches.”  Rest assured, I would never encourage fixing something if it ain’t broken.  This is just educational info which I think may help in making future decisions. 

First question… “Is pronation a bad thing?”  It is a necessary multiplanar movement of the foot.  Second question… “Is overpronation bad?”  Depends.  How was someone measured?  Actively or statically.  Most analysis is done in the standing static position.  This tells you what happens when your full weight is resting on one leg.  Not a very reliable method for determining the need for support.  Recent research has definitively shown that the amount of total pronation is not necessarily the critical measure, but more importantly the rate at which the foot pronates dictates arch dysfunction.  There are millions of so-called “overpronators” out there who control their rate of pronation well and have no significant dysfunctions to speak of.  

Here is most Podiatrists approach.  The foot is designed to move…a lot!  If you have foot pain, and we prevent the foot from moving as much, your pain may diminish.  Voila - orthotic.  Orthotics control and essentially prevent foot motion.  Now I’m not saying that orthotics are bad for everyone, however I believe them to be overprescribed for sure.  

The mechanism of pronation is a complicated action.  For simplification purposes, I will say that the motion is predominantly controlled by the Tibial Posterior muscle.  This essentially means that the Tib Posterior creates supination.  Which muscle then creates pronation you ask?  It would be the Peronei (generally speaking).  When we are looking for supination/pronation dysfunctions these two muscles are pretty high on our suspect list.  Now they could be tight and strong, or tight and weak.  Typical pronators will present with a weak tib posterior and tight-strong peronei.  With our sensitive muscle testing we can determine their function and give the corrective exercises to remedy the situation within a week or two.  

A side note about these two muscles.  If you have ever sprained you ankle, there is a good possibility that you may have a dysfunction.  These two muscles act like reigns on a horse.  They can either pull the foot out or in.  When you have good control over both muscles, you typically can find “TALAR NEURTAL.”  This is absolutely critical to normal foot function.  If you have ever had your ankle taped, you are always taped in talar neutral.  

The bottom line is before you invest in a pair of orthotics or stability shoes, get your lower extremity checked for these common dysfunctions.  The knowledge you gain will pay great dividends in your longevity and resilience.  

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