Last week, we talked about forearm supination and pronation. In addition, these movements happen to the most distal segment of our lower extremity, our foot. The foot is significant for weight-bearing, shock absorption, and maintaining balance, especially for a single-leg stance.
In a neutral gait, our foot effectively transits between pronation and supination for stability and adaptability to the ground. Foot supination occurs when the heels lift off the ground, and the weight is placed on the outside of the foot, and vice versa for pronation when the heels strike the ground. However, some people could have excessive supination or pronation during their gait. Any misalignment at the foot level could adversely affect the foot mobility and function, ultimately leading to pain in the knee, hip, and up through the kinetic chain.
Overpronation means that patients excessively roll their feet inwards. The inner part of the heels would contact the ground and the feet would flatten. It could cause stress to the big toe and strain on the posterior tibialis, resulting in knee pain and shin splint. Patients might also develop flat feet, in which the arch under the foot disappears and the entire soles contact the ground. On the contrary, excessive supination also refers to under pronation, which is characterized by a high arch and hypomobile midfoot. It would place much of the stress on the outer edge of the foot. Patients could also develop shin splint and plantar fasciitis.
There could be many factors leading to excessive pronation and supination, including genetics, lifestyle, footwear, injuries, and more. Not only it is critical to correct poor posture or improper walking techniques, but we should also ensure proper and suitable footwear. To prevent midtarsal joints from rolling inwards or outwards, we can stretch out the calf and plantar fascia regularly, keeping the tissues flexible and strong.
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