Is Over-Pronation

Overview


When standing, pronation occurs as the foot rolls inwards and the arch of the foot flattens. Pronation is a normal part of the gait cycle which helps to provide shock absorption at the foot. The opposite movement to pronation is supination. This is also a normal part of the gait cycle just after the heel strike however over-supination is also not good.Foot Pronation


Causes


You do not have to be a runner or athlete to suffer from overpronation. Flat feet can be inherited, and many people suffer from pain on a day-to-day basis. Flat feet can also be traumatic in nature and result from tendon damage over time. Wearing shoes that do not offer enough arch support can also contribute to overpronation.


Symptoms


Because pronation is a twisting of the foot, all of the muscles and tendons which run from the leg and ankle into the foot will be twisted. In over-pronation, resulting laxity of the soft tissue structures of the foot and loosened joints cause the bones of the feet shift. When this occurs, the muscles which attach to these bones must also shift, or twist, in order to attach to these bones. The strongest and most important muscles that attach to our foot bones come from our lower leg. So, as these muscles course down the leg and across the ankle, they must twist to maintain their proper attachments in the foot. Injuries due to poor biomechanics and twisting of these muscles due to over-pronation include: shin splints, Achilles Tendonitis, generalized tendonitis, fatigue, muscle aches and pains, cramps, ankle sprains, and loss of muscular efficiency (reducing walking and running speed and endurance). Foot problems due to over-pronation include: bunions, heel spurs, plantar fasciitis, fallen and painful arches, hammer toes, and calluses.


Diagnosis


Look at the wear on your shoes and especially running trainers; if you overpronate it's likely the inside of your shoe will be worn down (or seem crushed if they're soft shoes) from the extra strain.Foot Pronation


Non Surgical Treatment


Overpronation is a condition in which the foot rolls excessively down and inward. The arch may elongate and collapse (or ?fall?) and the heel will lean inward. Overpronation should not be confused with pronation. Pronation is a normal motion of the foot during weight bearing and allows the foot to absorb shock as it contacts the ground.


Prevention


Wear supportive shoes. If we're talking runners you're going to fall in the camp of needing 'motion control' shoes or shoes built for 'moderate' or 'severe' pronators. There are many good brands of shoes out there. Don't just wear these running, the more often the better. Make slow changes. Sudden changes in your training will aggravate your feet more than typical. Make sure you slowly increase your running/walking distance, speed and even how often you go per week. Strengthen your feet. As part of your running/walking warm up or just as part of a nightly routine try a few simple exercises to strengthen your feet, start with just ten of each and slowly add more sets and intensity. Stand facing a mirror and practice raising your arch higher off the ground without lifting your toes. Sit with a towel under your feet, scrunch your toes and try to pull the towel in under your feet. Sitting again with feet on the ground lift your heels as high as you can, then raise and lower on to toe tips.

Physical Therapy And Severs Disease

Overview


Sever's Disease, otherwise known as calcaneal apophysitis is an inflammation of the growth plate in the heel of growing children, typically adolescents. The condition presents as pain in the heel and is caused by repetitive stress to the heel and is thus particularly common in active children. It usually resolves once the bone has completed growth or activity is lessened.


Causes


Sever's Disease typically affects boys and girls between 8-15 years of age. Risk factors include. Athletic activity that involves heel contact with hard surfaces, as in gymnastics, track, soccer, basketball, ice skating, ballet and aerobics. The wearing of ill-fitting shoes. Well-made shoes that fit properly are a must for every child. Prolonged periods of standing. If a child complains of heel pain after choir practice, doing dishes, standing in lines or other activities that put pressure on the heel bones, pay attention.


Symptoms


Symptoms of Sever?s disease, mostly pain at the back of heel, usually occur during and after sporting activity, and usually disappear with rest. In some cases, children may find it difficult to place pressure on their heels, and begin walking on their toes to gain relief. For some children, the heel pain will persist until the next morning, causing some stiffness or hobbling on first arising. Some children may experience mild swelling at the back of the heel.


Diagnosis


Sever's disease is based on the symptoms reported. To confirm the diagnosis, the clinician will examine the heels and ask about the child's activity level and participation in sports. They may also squeeze the back part of the heel from both sides at the same time to see if doing so causes pain and also ask the child to stand on tiptoes to see if that position causes pain. There may be tightness in the calf muscle, which contributes to tension on the heel. Symptoms are usually worse during or after activity and get better with rest. X-rays generally are not that helpful in diagnosing Sever's disease, but they may be ordered to rule out other problems, such as fractures. Sever's disease cannot be seen on an X-ray.


Non Surgical Treatment


Podiatrists have an important role in the provision of orthotics to young sufferers of Severs? disease. Orthotics are specialised insoles designed to accommodate problems with the foot. In this particular condition?s case, orthotics are an effective way of making sure that the heel is cushioned in such a way as to reduce a child?s discomfort and alleviate some of the pressure of walking, thereby facilitating the recovery process. Young athletes can benefit from a visit to a podiatrist to learn about prevention and to have orthotics fitted to prevent Severs? disease from developing. Regular stretching to keep joints supple and loose are a great preventative measure, as is making sure that appropriately fitted and supportive shoes (often equipped with orthotics) are used to prevent future injury.


Recovery


It may take several weeks or months for the pain to completely stop. In most cases severs disease goes away on its own with a little rest and time. However if you ignore the pain and play through it, the condition may get worse and may be more difficult to treat. When the pain is completely gone, you can slowly return to your previous level of activity. With future growth spurts the pain may return therefore keep up with the stretches and follow the advice given.
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Marlys Vandekamp

Author:Marlys Vandekamp
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