Top 100 Biomechanical Guidelines #14: Know the Symptoms Related to Excessive Pronation

Inward Collapse of Left Shoe with Over Pronation

There are many well known problems related to the abnormal motion of pronation or the abnormal position caused by pronation. Remember the post on the Weakest Link in the Chain. Some of these include:

1. Pain around the ball of the foot as the arch collapses: sesamoiditis, sesamoid fracture, first metatarsal phalangeal joint capsulits, bunions.
2. Pain around the arch of the foot with this arch collapse: anterior tibial tendinitis, midfoot capsulitis, peroneus longus tendinitis, posterior tibial tendinitis, arch strain.
3. Pain around the heel area with arch collapse and heel valgus: sinus tarsitis, plantar fasciitis, achilles tendinitis.
4. Pain in the legs: posterior tibialis shin splints, soleus strain or shin splints, tibial stress fractures, anterior tibial shin splints.
5. Pain around the knees: chrondromalacia patellae, lateral knee compartment compression syndrome, ilio tibial band tendintis.
6. Pain around the hips: external hip rotator strain, piriformis syndrome, sciatica, ilio tibial tendinitis, hip bursitis, hamstring strain.

When treating symptoms related to pronation, results can be seen from 10% correction of the pronation, or may need 110% correction of the pronation. Very different than treating excessive supination which normally needs 100% correction.

     Deciding on how much initial correction of this pronation can be difficult (and when to change corrections). I try to engage my patients in understanding the amount of correction they have. I like to give my corrections grades like the right is an A and the left is a B-. In the patient's mind, they know if they do not get better, that I can more to correct the pronation further.

The video below shows excessive pronation right worse than left. If the symptoms require complete correction of that pronation,  the right side will need more correction.