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Tuesday, March 17, 2020

Problems Developed by Abnormal Foot Supination

     My practice of Podiatry is fairly injury or pain centered. I use mechanical, inflammatory, and neuropathic pain treatments to help these patients get ahead of their pain, and prevent reoccurrences. The list below is in my head as I listen to patients complaints. You are trying to see a pattern in the problems that they present with related to their past problems. Here is the pattern of injuries related to abnormal supination of the foot that occurs after heel strike when the foot should be normally pronating to absorb shock and adapt to the ground. You will only get a strong feel of this correlation by eliminating the abnormal supination and seeing what symptoms resolve. Symptoms related to all 20 of the problems below can get better or completely resolve with treatment.
     There are many aspects to any treatment you prescribe. How you strengthen a patient? How long do you send them to Physical Therapy? What do their return to activities work out look like? It is a definite art with a lot of variation. However, in controlling abnormal supination, you either do it all or it will not work. One of my unbreakable rules of practice is that Abnormal Rear Foot Supination has to be completely eliminated. We are so used to dealing with pronation, the opposite problem, where as little as 10% correction can help someone at times. But, abnormal supination is not like that. It needs your full attention.
     I have attached at the end of the post a video on all the orthotic bells and whistles to stop this motion. However, there are so many treatments from peroneal strengthening, ankle brace temporarily, taping (video also attached), valgus shoe wedges, shoe selection, single leg balancing, etc. There are very few that actually need surgery, but some do to tighten ligaments. I hope if you have this problem, or treat this problem, this post will help you. There are many more posts on this subject by going into the search engine on my blog. Rich

Checklist for Supination Produced Problems
1. Hammertoes
2. Lateral Metatarsalgia
3. Tailor’s Bunions
4. 4th/5th Metatarsal Stress Fractures
5. Cuboid Pain
6. Lateral Ankle Instability
7. Peroneal Strain
8. Haglund’s Deformity
9. Medial Ankle Impingement
10. Fibular Stress Fractures
11. Proximal Tib-Fib Sprain
12. Medial Knee Compartment
13. Knee Arthralgias
14. Lateral Knee Collateral Ligament Sprain
15. Lateral Hamstring Strain
16. Iliotibial Band Syndrome
17. Femoral Stress Fractures
18. Hip Arthralgias
19. Sacroiliac joint inflammation
20. Low Back Pain

This list is an excerpt from my book: The Inverted Orthotic Technique: A Process of Foot Stabilization for the Pronated Foot

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.