Pronated Feet

Pronated feet can have devastating effects on the rest of the body, particularly the lower back, hips and knees.

Effects of over-pronation on skeleton

What is Pronation?

There should be some mild pronation with walking and running.  

It is a necessary motion that allows for the dynamic action of the foot and ankle to permit normal function and shock absorption, as well as weight distribution. It essentially reduces impact stress on the body with walking and running on normal surfaces.

The problem arises when there is excessive or over-pronation. This problem is compounded when one foot is more pronated than the other.

To begin with, the foot is often not normal in its structure and because of acquired or developed weaknesses it almost never is normal in its function.

Over-Pronation Left foot

Over-Pronation of Left Foot

The shoe is probably not normal in its design or has become abnormal due to breakdown.

In addition to that the surfaces you walk on, being flat and unyielding, are not normal either and certainly not conducive to normal foot dynamics. Therefore, due to one or more of these abnormalities the feet for all practical purposes never function in a normal manner.

Probably, the most common condition affecting the feet is over-pronation.

In order to understand overly pronated feet the normal structure and function of the foot needs to be understood.

Three Arches-Not One

The normal foot has three arches:

The human foot consist of 26 bones and 30 joints, all held together and functioning under the control of over 100 muscles, tendons and ligaments. 

3 Arches Of Foot

Three Arches

  1. The medial longitudinal arch-which is the primary arch that we are all familiar. usually easily visible to the naked eye and the one we are familiar with.
  2. The lateral longitudinal arch-this arch runs along the outside of one of the foot and is not as deep or as wide for as long as the medial longitudinal arch which runs along the outer aspect of the sole.
  3. The transverse arch-this arch runs across the bottom of the foot just proximal to the metatarsal heads. It traverses across the ball of the foot, at the front of the foot between the toes and the mid-foot.

Each of these arches, along with the bones, joints, ligaments, tendons, and muscles are designed to afford proper support and flexibility. They should allow for normal pain free function throughout our lives.

,Nature did not design your feet for standing and walking on hard, flat and unyielding surfaces such as concrete, wood, packed earth, or even carpeted floor.

Your feet were created to function on unpacked earth that gives with pressure and encourages normal stability and function of the bones, joints, ligaments, muscles, and arches. The earth is a natural arch support and shock absorber.

Just look at the foot imprint you leave in the sand when you walk on it. There is a deep indentation where your heel strikes (shock absorption), a little impression on the outer side at the midpoint (arch support) and again a deep indentation at the forefoot and toes as you push off or propel yourself forward (shock absorption).

What happens when you walk on a flat, rigid, and unyielding surface, such as concrete or wood floors?

Your heel strikes the surface, which does not yield, causing forces to be transmitted up your body and into the knees, hips, and lower back (no shock absorption).

As you go into mid-stance where the entire foot is flat on the surface, there is no upward support on the three arches causing them to collapse (flat feet) further than nature intended in order to meet the surface below.

Finally, when you toe-off, once again, there is no giving of the surface; so, forces are exerted into the toes and balls of the feet (no shock absorption).

Over time, your joints, ligaments, and arches undergo accelerated stress, or wear and tear, and eventually you have overly pronated feet or excessive pronation of one foot. This will lead to conditions such as metatarsalgia, plantar fascitis, sprains and strains, knee, hip and low back degenerative arthritis, stress fractures, and poor balance and coordination.

Identifying Excessively Pronated Feet

5 Signs Of Over-Pronation

Observe your ankles and feet from the back. With excessive foot pronation the ankle will move toward the inside causing the achilles tendon to bow or angle in that same direction. (See Diagram) This is another indication that you are over-pronated and would probably benefit from the use of orthotics.

With excessive pronation the foot will most often assume a flared out or out-pointing position with standing or walking. This may be more pronounced on one side as over-pronation is often more severe on one side compared to the other.

When one foot flares outward more and pronates more this is usually the result of that leg being structurally or functionally longer on that side.

If the leg lengths are equal an over-pronated foot on one side will cause your pelvis to drop on the over-pronated side. This will make the leg on that side "appear" to be shorter. Now, the body, in an attempt to level the pelvis, forces the opposite foot to turn outward and develop excessive pronation as well.

When both feet are over-pronated you will most often have abnormal lumbar and pelvic alignment in the form of a hyperlordosis.

With over-pronation of one or both feet there will be a severe sequence of actions by the body. This requires a definite, immediate correction in the form of orthotics and in the case of a short leg a need for possibly a heel lift on the short side as well.

Examine the shoe for wear that may indicate abnormally pronated feet. The heels will be worn down on the outer back edge and the soles may show more wear along the inside front. The reason is that you are walking or have been forced to walk with too much out-flaring and thus toeing-off with too much pressure on the large toe.

Overtime your shoes undergoes more wear and breakdown. This will lead to excessive wear and tear and breakdown of the feet as well. In other words, abnormal feet will result in abnormal breakdown of the shoes. An abnormal shoe or one that has worn down too much will promote foot breakdown also.

What is interesting, again by nature's design, is the pronated feet are usually the last body area to express pain. This allows you to continue to walk and function relatively pain-free. It is only in advanced stages that the feet will become too painful to walk or bear weight on.

But there are early warning symptoms such as plantar fascitis, achilles tendonitis, sore, achy or swollen feet, knee or hip pains, and of course lower back pain.

Unfortunately, while the feet are breaking down and remaining relatively free of significant pain the rest of the body is suffering the consequences. If correction to the pronated feet is not made your lower back pain will become recurrent and chronic and the damage will be devastating to not only your lower back but your overall health in general.

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