Pronation and supination are commonly heard terms, often in association with fallen arches, high arches, flat feet etc. This article explains the meaning of these terms and looks in particular at the problem of over-pronation. You will read about the following:
1) What do the terms Pronation and Supination mean?
2) What exactly is over-pronation?
3) What are the consequences of over-pronation?
4) What can we do to fix the problem of over-pronation
What do the terms 'Pronation' and 'Supination' mean?
To understand the terms 'Pronation' and 'Supination', firstly we need to look at the gait cycle - that is the way we walk, or our 'walking pattern'.
The gait cycle is broken down into 3 different phases:
1) Contact phase: Firstly the outside of your heel hits the ground. This is entirely normal and it's the reason why most people's shoes wear out faster on the outside heel area of the soles. Just after the heel strikes, pronation occurs. I.e. the foot flattens out and the ankle rolls inwards. At the same time, your lower leg rotates inwards from the knee down. The pronated foot is flexible and loose, allowing it to adapt to the ground you've just stepped on. Pronation is your natural 'shock-absorbing mechanism'.
This contact phase continues until the foot is completely flat on the ground.
2) Midstance phase: The foot is flat on the ground and in this part of the gait cylce your body weight passes over your foot as the body comes forward. This is where your foot supports your body weight. The midstance phase is the part of the gait cycle where an abnormally functioning foot such as an over-pronated foot (fallen arches) or an over-supinated foot (high arch foot) will manifest its problems.
This phase ends as your body weight passes forward eventually forcing your heel to rise off the ground. At this stage supination occurs and the opposite to pronation happens: the muscles tighten and the foot becomes a rigid lever for the leg muscles to pull against. Rigidity in the foot should occur as the foot is propelled forward towards the next step. With supination, the foot rolls outwards and the lower leg rotates externally.
3) Propulsion phase: this is where the foot pushes off the ground to propel the body forward. Body weight is picked up by the ball of the foot and lastly the weight is absorbed by the big toe as you push off with that foot.
It is important to understand that both pronation and supination are part of a normal, healthy walking pattern! Pronation (rolling inward) acts as a shock absorbing process and supination (rolling outward) helps to propel our feet forward.
What exactly is over-pronation?
Over-pronation occurs when we pronate too deep and for too long, not giving the foot a chance to 'recover' and supinate. The foot stays flexible at all times. Over-pronators use a lot more energy when walking. Worse, over-pronation causes an imbalance throughtout the entire body, putting excessive strain on the feet, legs, knees and lower back.
Other terms for over-pronation are 'fallen arches', 'dropped arches' or 'collapsed arches'. The term 'flat feet' is also often used. However, a true 'flat foot' is very rare. In fact, less than 5% of the population have completely flat feet (Pes Planus) with no arch present whatsoever. Most of us (90%) have a normal to low arch and only 5% have a high arch. People with a high arch (Pes Cavus) are also called 'over-supinators'. This means that the foot stays rigid at all times and lacks its natural shock-absorbing mechanism.
It's important to appreciate that you don't have to be flat-footed to suffer from over-pronation! In fact, the vast majority of people with a 'normal- to-low arch' suffer from over-pronation. Interestingly, the arches may appear quite normal when sitting (or even standing up-right), but when we start to walk the problem of over-pronation becomes evident...with every step we take the arches collapse and the ankles roll inwards.
Over-pronation can be caused by a number of factors. Weak ankle muscles, being over-weight, pregnancy, age or repetitive pounding on hard surfaces (like pavements and concrete floors) can all lead to over-pronation. Over-pronation is also very common with athletes, especially runners.
What are the consequences of over-pronation?
Whether you have a true flat foot or have a normal-to-low arch and suffer from over-pronation (like 70% of the population), in both cases your poor walking pattern may contribute to a range of different complaints.
Many people over-pronate, however there are no clear symptoms, no aches or pains or complaints - especially in younger people (under 40's).
When people reach 40 or 50, poor foot function will start to show and over-pronation will take its toll. Many years of over-pronation will result in wear and tear in the feet, ankle and knee joints and lower back. People will simply accept these common aches and pains as a sign of ageing. Very few people realise these complaints have a lot to do with their fallen arches!
So what are the most common complaints related to over-pronation?
Plantar Fasciitis is a very common condition caused by over-pronation. As the feet flatten, the Plantar Fascia (fibrous band of ligaments under the foot) is being overly stretched, leading to inflammation in the heel, where the fascia attach to the heel bone. Plantar Fasciitis causes chronic heel pain and sometimes a heel spur develops (bony growth at the heel bone).
With over-pronation the foot continues to roll inwards, when it should be pushing off and outwards. When the foot rolls inwards the lower leg will follow and rotate internally and stay in this position (instead of rotating externally with supination).
This puts a lot of strain on the leg muscles (especially the calf muscles), causing aching legs and shin splints. Also, the twisting of the lower leg displaces the patella (knee cap). The knee is a hinge joint, designed to flex and extend (like a door, if you like). It's not designed to rotate!
Furthermore, when the legs rotate inwards the pelvis is forced to tilt forward. This results in constant strain and stress on the lower back muscles.
What can we do to fix the problem of over-pronation?
There is no real cure as such for over-pronation, however a lot can be done to prevent it. The most effective way to minimise over-pronation and its effects on the body is by wearing orthotics inside the shoes.
An 'orthotic' (orthotic insole, shoe insert or orthosis) is a device placed inside the shoes with the purpose of restoring our normal foot function. Different types of foot orthotics are available, from special custom-made devices (prescribed by a Podiatrist) to so called 'off-the-shelf' orthotics which can be purchased from pharmacies, good quality shoe stores or specialty websites.
Orthotics correct the problem of over-pronation and they re-align the foot and ankle bones to their neutral position, restoring our natural foot function. In turn, this will help alleviate problems not only in the feet, but also in other parts of the body!
In addition to wearing an orthotic, it is recommended to wear supportive shoes with some degree of built-in 'motion control'.
Motion control shoes incorporate support features into the shoe. Shoes with adequate arch support and firm heel counters help control over-pronation and will stabilise the heel and ankle during walking. Some shoes also have side posts for extra lateral support. Firm midsoles reduce pronation and protect the ankles and knees from lateral stress. The inner side of the midsole may be made of a denser material (dual density midsoles) to reduce the amount of pronation. A heavy person who overpronates will need a heavier, more supportive shoe than a light person with the same degree of pronation.
Too many shoes these days are using soft materials all-around the shoes and are very 'floppy' giving no support or stability whatsoever. In summer, many people wear open footwear such as sandals and flip-flops which are even worse in biomechanical terms.
When you are going to be playing basketball the right type of shoe is very important. When you are choosing basketball shoes ankle support and fit are the two main things when it comes to getting a good pair of basketball shoes. If you don't have the right type of basketball shoes then you could either sprang an ankle or even break it. Even though you can play basketball in any kind of shoes you will be injury prone if you do not get a good pair of shoes.
There are many important things to remember when getting a new pair of basketball shoes to play in. the most important rule when you are buying a new pair of basketball shoes should be ankle support. Support is the main thing you should be looking at when buying a pair of these shoes.
Every player has their own type of shoe they may like every year. Players that play really hard and run up and down the court a lot will need the best ankle support you can buy. The lower top type of shoes is for players that are not very heavy and can run fast.
When you are buying a pair of new basketball shoes you want them to last a long time. You should look for the best brand when it comes to buying a good pair of basketball shoes. It wouldn't be very good if you were playing and your shoe fell apart you would probably hurt yourself and be out a pair of shoes.
After looking for the shoe with durability, be sure to also look for the shoe with the best or most traction. The whole idea of traction is to be able to run fast and stop without sliding. Traction is needed when playing the game of basketball.
When you are buying a new pair of basketball shoes you want a pair that fits and feels good on your feet. Buy a shoe that feels good on your feet and fits firm and feels like you could play really good in them. You also need to have room so your feet can breathe if you feet can't get air they will stink really bad.
When you are buying a new pair of shoes you need to buy a pair that fits the way you dress and your style. When you buy a new pair getting the right shoes is the key to stepping up your game. You need to be careful when choosing the pair of shoes for you. If you choose the wrong pair it could cost you your money and injury to your feet.
Everyone feels some discomfort from their shoes from time to time, but what if you have foot problems all the time you are wearing shoes? Pain can become a part of everyday life as high heeled shoes create problems in your toes, feet, and ankles. Stiff or cheap dress shoes can cause an unnatural gait that leads to problems that go beyond the feet. Doctors are often pressed to find a solution to problem feet. Orthopedic shoes are one solution.
If you can shed your ill-fitting shoes for pairs that are an appropriate size and shape for your feet, you may not need orthopedic shoes. As long as your shoes are properly sized and constructed, they will protect your feet from damage. Not only will the shoes help you avoid damage from the environment such as sticks or glass on the ground. They will also stop any foot problems that have been starting to happen due to poor shoe choices as long as it is not to late to recover that easily.
For people who just cannot find shoes that are shaped to fit their feet, no amount of breaking in will change the fact that the shoes are not appropriate for their feet. Perhaps, they simply have feet that are not shaped the same way as the feet that average shoes were designed to fit. These and other foot problems can be addressed with a good pair of orthopedic shoes.
Orthopedic shoes are ideal for people who have overly wide feet. Many times, people with feet that are somewhat wide can find shoes in the regular shoe stores that come in wide or extra wide widths. Men's shoes and women's shoes alike can be purchased from catalogues that specialize for people with wide feet. However, you might have feet that are exceptionally wide. It may be a natural state or it may be due to any number of medical conditions. In any case, orthopedic shoes can be made especially for you based on the measurements of your feet.
Arch support is a tricky subject. Many people with flat feet do not like the feeling of wearing anything with arch supports. Yet, proper arch support will make them feel stronger and cut down on the pain they experience as they walk and stand throughout the day. Orthopedic shoes can be fitted to provide just the right arch supports that will not feel unnaturally high to the person with flat feet. At the same time, the arch supports will add strength to the foundation the person stands on. Orthopedic shoes can be fitted to any height of arch from flat to high. Everyone needs good arch support.
If your problems with your feet are very painful, it is best to see a doctor to rule out serious conditions that would require medical treatments or surgeries. If the doctor determines that you need orthopedic shoes, you will be sent to get them. Doctors sometimes go into great detail on a prescription for the orthopedic shoes, and other times, they give a simple note and a referral to an orthopedic shoe store. At that point, it is up to you to follow through and get the orthopedic shoes that you so need.