Flat Feet (Fallen arches) – Pronation & Supination of your feet.
What are Flat Feet and Fallen Arches?
Flat feet also known as Fallen Arches, with pronation and supination are terms that are used to refer to the natural rolling movement of a foot while running or walking. Just as positioning your hand in the space is paramount for hand movement and the grip of the upper limb, pronation, and supination are responsible for providing mechanical benefits in the movement of a human being. It is a motion that at certain times is referred to as the running gait.
They are basically the unique combination of actions that your foot performs while trying to offer balance, cushion, and support to your body. Turning a key or a screwdriver, for instance, are the best illustrations of the functional movements that apply pronation and supination. For this movement to be successful, several muscles that work synergistically are involved.
Before we get to overpronation, it is equally right to get the exact meaning of the term pronation.
- Pronation can be best described as the inward roll of the foot during an ordinary motion. It takes place at the heel’s outer edge gives the ground a strike making the foot to roll inwards before flattening out.
- With a standard pronation, a foot would normally roll inward for about fifteen percent before it comes in a full contact with the ground. It is at this time that the foot is then able to offer your body weight the support it deserves without any problem.
- Pronation is very crucial for shock absorption, and it allows you to push off evenly all the way from the foot’s front right at the end of a gait cycle.
- The ability of the foot to roll can be affected by some factors despite the fact that it is the foot’s natural movement. One of these factors is the runner’s arch size, and this can result in either under pronation or overpronation. It is therefore very imperative to look for running shoes that offer the best support for your pronation tendencies and arch.
- Those who have a normal arch are definitely the normal pronators. These kinds of people will feel better in a stability shoe that provides medium pronation control. In most cases, runners who have flat feet pain, also overpronate, and therefore they tend to perform well in a type of motion control shoe, which can regulate their pronation.
- Runners who are high arched usually under pronate, and therefore they perform better in a neutral-cushioned shoe that promotes a foot motion that is more natural.
- As it is with the basic pronation sequence, the outer part of the heel is responsible for the first ground contact. But the foot rolls inward many times than the typical 15%, and this is what is referred to as overpronation. It basically means that the foot and the ankle have certain problems in making the body stable and therefore shock is not absorbed as it is supposed to be.
- Towards the end of the gait cycle, the front part of the foot pushes off the ground mainly using the second toe and the bigger one.
- Overpronation of the foot is not actually an injury on its own, but the fact is that if you overpronate, then you definitely must be more vulnerable to so many injuries.
- Despite the fact that overpronation is widely recognized as rolling in or flattening of the foot, it is not as easy as it may appear to be. Other factors like the timing when foot rolls must be carefully considered.
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The Connection of Overpronation and flat feet problems & Injuries
Overpronation usually results in overuse type injuries that mostly occur in runners. When a foot pronates during running or walking, the knee, lower leg and thigh all have an internal rotation. This, as a result, maximizes the stresses that are on the tendons, muscles, and ligaments of various parts like the lower leg and foot. The limb tends to rotate a bit far causing an injury.
You can easily tell if you have over pronated through these simple tricks.
- The first thing you need to do is to look at your feet while you are standing carefully. You should be able to tell whether you have a golden arch on the inside part of your foot. You will tell whether your feet are overpronated if there is no arch and the innermost section of your sole makes contact with your feet.
- The second thing you need to do is to check your running shoes carefully. If they are worn, especially on the inside of your foot sole, then you should know that pronation is not working right for you.
- The wet foot test is the other way of telling if you overpronate. This is simple, all you have to do is to wet your foot and take a walk along a paving, and then look at the footprints you leave behind. Those with a normal foot will leave a print on the heel that is linked to the front side using a strip estimated at half a foot’s width on the outer side of the sole. If you have pronated feet, then you will notice a little distinction between the forefoot and rear.
- But the best way to know if you overpronate is to pay your podiatrist a visit. If you can’t find a podiatrist around, then you can look for any professional who can be able to carry out a full gait analysis on a treadmill. These professionals mainly use force plates that measure the exact forces and angles of the runner’s foot while in action.
Some of the other things that must be assessed are the amount of overpronation as well as its timing at the gait cycle. Overpronation can cause the following complications,
- Shin splints
- Plantar fasciitis
- Anterior compartment syndrome
- Bunions, commonly known as Hallux valgus
- Tarsal tunnel syndrome
- Bursitis of the knee or hip
- Lower back pain
- Patella femoral pain syndrome, and
- Achilles’ tendonitis
Although several factors can bring these conditions, a large detrimental role is played by improper body biomechanics. Of all the biomechanical features that are involved, ankle and foot functions contribute most of these pains and aches.
During a standard gait cycle, the forward movement is usually as a result of the mass of the body being displaced. This movement places the body in a position that can be best described as forwarding falling. To prevent the fall, the lead foot then hits the ground immediately followed by the rear leg that swings forward quickly. The cycle keeps on repeating with all the steps. The first function of the foot the moment it hits the ground is to assist in dissolving the shock of impact.
To help efficiently accommodate the contour of the ground, pronation occurs just immediately. The ankle then goes into flexion and creates a chance for the knees to move ahead, followed y the entire body. Once the heel rises, the supination of the foot takes place, and this becomes a rigid lever that assists in pushing action eventually ending with a toe off. During this particular process, some other complexes and complex components of motion mechanics occur.
Before participating in a running exercise, the runners usually have some gait or postural analysis carried out by a professional coach or a healthcare provider. They are then fitted with stability shoes, costume made or off the shelf orthotics with the aim of preventing excessive foot pronation. Despite the fact that this is vital, it should not the case each time a runner’s foot overpronates. Doing this can eliminate one symptom and introduce another that could be more severe.
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Here is a brief reasoning why this process may be imperfect without a proper evaluation before using orthotics or modifying shoes.
- In a normal operating foot and ankle, there should be approximately fifteen to twenty degrees of ankle dorsiflexion. Ankle dorsiflexion simply refers to a process where the leg moves forward on top of the foot or the foot making a backward bend towards the side of the leg. There should also be approximately 60 to 65 degrees of the extension of the first toe.
- During the gait cycle, foot pronation and foot supination are very much needed for a normal function. To be able to minimize the forces that the body deals with during running or walking, all foot must have pronation and supination. This also creates the lever required for propulsion.
- In many of these referenced conditions, overpronation has been described as the greatest offender. It is what happens when the foot stays in pronation for an abnormally long period. It is the same thing that some people usually attempt to correct, but do it in an improper way.
Causes of Overpronation
Overpronation usually occurs at the rearfoot. Here are some of the causes.
- The rearfoot can pronate excessively as a result of a tight calf muscle. A tight calf muscle will make the ankle to reach its end range of motion earlier and unable to go any further.
- Another issue could be as a result of a proximal control. This is mainly caused at the pelvis and hip areas where the leg tends to rotate more or at a time that it is not supposed to. This internal leg rotation is responsible for overpronation at the rearfoot.
- Overpronation can also be caused by the weakness of the posterior tibial muscle. Tibial muscles are one of the most crucial pronation resistors on the rearfoot, and therefore any weakness in this area can cause a lot of problems.
- Forefoot varus – forefoot varus is one of the bony alignment problems that happen mostly at the forefoot. However, it is very common and makes just about one to two percent of osseous alignment problems that occur at the foot. A forefoot varus is the point when the forefoot is in varus (inverted) as a result of an osseous or bony problem. When standing with the vertical of the rearfoot, the forefoot’s inside, or medial is usually off the ground. The entire foot then has to pronate at the rearfoot so that the foot can stay on the ground. It has nothing to do with the strength of the muscle of soft tissues.
What You Can Do About It
- Have you ever visited your doctor or a therapist complaining about all manner of pain? If this has happened to you, then the first thing you will receive is a cursory evaluation and given orthotics or other shoes as a way of resolving your problem. But a few weeks later, you find yourself complaining of another pain somewhere else. This normally happens to athletes.
- The first thing you need to do is to properly evaluate whether an overpronation should be corrected using orthotics or a new pair of shoes. To do this, a structural and functional examination must be carried out. Such examination requires a thorough evaluation of various areas of the hips, pelvis, knee, and ankle. You should also have an assessment of the foot ranges of motion.
- Another thing that is equally important is a squat and a lunge test to examine various features of motion like force dissipation, force production, balance, stability, and proprioception.
- And to rule out any chances of inequalities, the lengths of both legs must be properly examined. The spine and pelvis must also be properly evaluated for proper alignment and joint motion, without forgetting the ratio of muscles’ strength and length that must also be assessed.
- These factors must be adequately put into consideration to avoid an occurrence of improper correction, which can cause ensuing pain and other dysfunctions.
One of the most frequent and common reasons for overpronation is the lack of range of motions in a normal ankle. If the ankle or foot is not capable of dorsiflexing properly, which is bending backward, then the knee will not be able to move forward enough to make the body move the center of mass on foot. This, in turn, makes the body’s forward motion very hard.
In such an instance, the foot is left with no choice but to pronate excessively making the knee to drift medially and the hip excessively adducting and internally rotating. This process goes on in the remaining kinetic chain and causes other abnormalities in various motion mechanics. Correction of overpronation through orthotics and shoes is not right in an instance of poor ankle mobility. The overpronation that happens, in this case, is a required compensation for lack of mobility in other areas of the body. This compensatory element should not be taken away without addressing and fixing the real underlying cause of the problem. Failure to do this may cause a forced compensation accompanied by pain in different body parts.
A Simple Test to Tell If You Fall Into This Category
- Be in a standing position and then put your feet in a shoulder-width apart.
- Ensure that both your feet and toe are both pointing forward and are not in any way turned away from the body’s midline.
- After that, see if you can be able to get into a squatting position that puts your knees below or at 90 degrees of bending without your feet rotating externally or your heels coming off the ground.
If you are unable to complete this particular exercise, there is a significant possibility that the pronation of your foot is as a result of your ankle inflexibility. You should, therefore, correct the rigidity of your ankle and not the pronating foot.
Can Running Shoes Prevent Overpronation?
The answer is yes. As indicated earlier, overpronation can cause additional tightness and stress to the muscle. What you can do once you have that feeling is a little extra stretching. The first sign of an overpronation will be noticed on your running shoe. You will notice an excessive wear on the inner section of your running shoe, and they will tend to tilt inward when placed on a flat surface.
Since knock-knees and flat feet shoes contribute more to overpronation, you should always wear shoes that have semi or straight, curved lasts. The best ones are stability shoes or motion control that have external control features and strong, multi-density midsoles that can minimize pronation.
Apart From Orthotic Inserts and Good Shoes, What Else?
To prepare your tendons and muscles for any sport or activity, you need a proper and correct warm up. Without this, the tendons and muscles will stretch around your feet, lower legs, and ankles will be stiff and tight. Following this, there will be limited blood flow especially to the lower legs and this will results in sufficient nutrients and oxygen for the muscles.
The other things you need are flexible muscles. These are very imperative in the prevention of most lower leg and ankle injuries. When tendons and muscles are supple and flexible, they can move and carry out duties without having to be overstretched. If by any chance your tendons and muscles are stiff and tight, then it would be very simple to push them beyond their natural range of motion. It is crucial to undertake a structured stretching routine to keep your tendons and muscles supple and flexible.
Before you actually decide to correct an overpronation, you should visit a qualified healthcare provider who will be able to carry out a completely functional and structural evaluation.
Before we get to over supination, it would be right first to get the meaning of supination. Supination is basically an ordinary component of the gait cycle and also a significant movement of activities like running or walking. Oversupination, however, brings problems that can easily lead to injuries. Supination mostly happens when the plane synovial joint makes three major moves that are:
- Moving into inversion, which is turning the sole inwards
- Plantar flexion, a process of pointing the toes far from you, and
- Adduction – pointing the toes across your body.
- When the foot moves outwards while the person is standing, supination then takes place. This action puts the majority of the mass to the foot’s lateral side and subsequently raises the arch.
A natural foot mostly rolls inwards in a process known as pronation and then outwards which is supination while walking or running. If your feet is not supported in the right manner, normal supination and pronation can be a nightmare for you. This action will cause inflammation of the soft tissues that are responsible for providing support to the joints in the back, hips, knees, and neck.
Over supination, which is also known as the high arches, is the most common issues that happen while walking and a person’s arch falls upon the bearing of weight. This collapse can then result in serious discomfort and even bring other foot problems. Pronation is just a normal part of the gait cycle. Too much pronation can bring a variety of issues. Oversupination, however, is less common than overpronation. It is a common thing with athletes like a runner. In an over supination position, the foot is unable to offer the right shock absorption and therefore resulting in an injury and pain.
The Mechanism of Injury during Over Supination
In most cases, over supination causes overuse form of injuries. This injury commonly affects numerous athletes like runners. The movement where the foot is in a position of absorbing shock and properly adjusts itself on the ground is known as pronation. In the occurrence of a foot over supination, there is much reduction in the absorption of shock, and this places more emphasis on the lower limb, which becomes absorbed by the foot.
Over supination can also result in other things like the increased external rotation of force on the thigh, knee, as well as the shin. It is this particular action that puts much focus on the ligaments, tendons, and muscles of the lower limb causing a deep pain.
Common Signs of Over Supination
- You will feel certain pain underneath our feet, or sometimes in the ankle.
- Frequent pains at the ankle
- Clawed hammertoes or toes
- Swelling of the foot, ankle, or heel. The toes may also be affected and end up developing bunions or calluses
- Non-adaptive musculoskeletal problems especially in the calves, ankles, knees or outer thighs
- A weakness of severe heart throbbing while walking, running, standing for a long time, or exercising
- Loss of functionality as well as a lowered range of motion in the lower body
How Over Supination Is Diagnosed
The good news with over supination is that you can actually watch certain common signs and know if you have the foot condition without visiting a doctor or therapist. These are some of the things you will observe:
- High arch on your foot’s inside while standing
- Your running shoes outside soles are more worn out particularly at the forefoot area
- Your wet footprint indicates that your forefoot and heel are not connected or may be connected with just a thin strip
How Do You Come Up With These Answers?
Here are some of the simple ways of doing it.
- Stand and then observe your feel while at that position. If you detect an arch that is higher than normal, then that is a full indication of over supination.
- Carefully observe the pair of your running shoes. If they are worn out on the outside part of the sole, especially at the forefront section, then that is an indication that you supinate excessively while on your running tracks.
- The other way of finding out if you have over supinated feet is through carrying out the wet foot test. This is a very simple test; begin by soaking your feet in the water and then make a few steps. Look back at the footprints. This is how you will tell a normal foot; the prints are always linked to the front side by a band that is nearly foot’s half width on the sole’s outside part.
- When you notice that the forefoot and the print of the heel are just connected by a thin band on the outside, then you’ll that is a case of over supination. In certain cases of over supination, the forefoot and the heel’s print may even fail to be connected at all.
Possible Over Supination Corrective Measures
- Gait analysis – You need to have a gait analysis carried out by physiotherapist, podiatrist, or someone who has excelled in sports therapy. They will check how you run and assist you in knowing the difference between an over supination, overpronation, and a neutral gait. They will determine the extent to which the condition has affected you and find the right solution for dealing with the situation at hand.
- Stretching Exercises – as a runner, you can actually benefit by putting in some time in stretching certain parts of the legs like hamstrings, calves, and quadriceps. These activities are supposed to be carried out before any physical activity or workout. It is a perfect way of preventing supination stress.
- Good Running Shoes – Running Shoes that have been adequately cushioned can also be used in case of over supination. The shoes should also be very flexible to assist in absorbing the shock efficiently.
- Orthopedic Insoles – In extreme cases of over supination, patients can go overboard and have orthotic devices fitted. There are a variety of orthotic insoles off the shelves that patients can purchase and use. However, other patients may require custom-made orthotic devices. For the right prescription of these devices, it would be imperative to visit a podiatrist or a sports injury therapist.
Flat Feet Treatment
Fix Your Form – Did you know that you could correct your stance using natural ways before it causes more problems later? Adjusting your stance is basically the groundwork for teaching yourself the right walking and running form. Apart from just helping you to stay away from conditions like over supination, you need proper posture and form to help balance your weight on the feet when running or lifting a weight. When walking or running at a fast speed, lower the feet with a soft landing, and focus on landing next to the mid-foot and not at the heel’s back. Increase your cadence slowly and shorten your strides potentially to keep proper form in your legs and feet. When running, always maintain an upright posture through your back, and remain relaxed.
For More Support, Strengthen the Leg Support-
- You can reduce the muscular weaknesses in the calves and ankles by performing the following natural strength building exercises:
- Lunges – there are various types of lunge twists, lunge dips, or side lunges.
- Squats – all manners of squats need a proper stability and mobility in the ankles and also add strength in almost all parts of the leg. You can try basic squats or squat while lifting up weight.
- Calf raises – you can do gentle calf rises by just lifting your heel off the floor and then lifting the toes towards the ceiling. You need to do it three times per leg for thirty seconds.
- Crab crawls can also be very beneficial.
Start Exercising Gradually – While you are exercising, you should remember always to take a rest and avoid any injury. There are vigorous natural exercises that you can adapt to help you stay away from effects of over supination. They include hiking, running, or walking uphill. You can also just spend quality time on your feet. Here are more tips.
- Always loosen your calves and ankles, it is very important
- Set a consistent practice goal but ensure that you give yourself a rest in between so that you do not add much stress to the connective tissue.
- If by any chance your ankle, leg or feet muscles become swollen or just tired, then you could develop scar tissues and be in an improper form.
- Incorporate both cross-train and burst training using various exercises to strengthen all over instead of just using particular leg muscles.
- Remember that simple ways of recovering after a workout are massaging, and icing your feet and calves. The other way would be foam rolling. These ways will assist you in preventing tightness and swelling in your body.
It is important to remember that your feet are the foundation of your whole body. So when this foundation starts to perform in a poor manner, the effects can be felt in the entire body.
- Close to 80 percent of the world’s population suffers from over supination or overpronation, yet a large number is not aware of their own foot types and its effects on the entire body.
- Learn how to support your feet in the proper manner, and your general body alignment will be improved. This will also alleviate pain and assist the body to have its natural healing.
The information references in this presentation have been cultivated from credible, reputable sources. Please consult your healthcare provider before utilizing any of this information. The following are the list of sources that were used to prepare this information. They are reliable sources from renowned professionals in the area of sports fitness and other healthcare services.
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- Over Pronation, Leading Edge Physiology ,
- Runners Understanding Pronation, ASICS ,
- Supination, Bone and Spine ,
- Oversupination, Doctor Orthotics ,
- Oversupination Corrections, Foot Solutions ,
- Oversupination of the Foor, E Pain Assist ,
- Supination, Dr. Axe Food and Medicine ,
- Foot Supination, Foot Smart ,
- Supination Foot and Heal Pain, Sports Clinic ,