Anti pronation, zero drop, bare foot….the choice of foot wear available is unlimited, and the flavour of the month changes like a David Beckham haircut. We are told that over pronation is bad and should be avoided by barricading the foot behind layers of foam cushioning, and that if left unsupported, will cause knee pain, back pain, neck pain and every other human ailment known to man. Well it is time to take a stance and stand up for pronation and unleash it from the shackles of insole imprisonment.
Biomechanics and pronation
The foot is a genius piece of engineering. As it hits the floor the bones unlock allowing it to blend to the rough terrain underneath (at least before the advent of pavements, carpets and hard soled shoes), where its intrinsic muscles can stretch like tiny trampolines ready to catapult our mass forward. As the foot melts a tiny bone with no muscular attachments called the talus, slides over the heel and the journey of pronation is transferred up through the knee, hip, back and into the arms and head. Each muscle that attaches over these joints is stretched and human locomotion takes place – a beautifully synchronised orchestra of anatomy that has enabled us to evolve into the creatures we are today.
Case history
So what happens when this all goes wrong? Today I had one such example walk through the clinic doors. This chap was a high level cricketer who on assessment was unable to pronate his left foot. He was suffering from long term back pain and had experienced disc prolapses between several of his vertebrae. When we analysed his cricket fast bowling technique we realised that his front foot never had the chance to pronate due to the follow through action of his arms and the need to abort to the left so he did not follow down the crease. A foot that does not pronate is a foot that does not shock absorb, and results in a spine which is most likely going to be loaded asymmetrically with every step it takes. The effect up through the body is equally immense, the buttock muscles do not get a chance to load, the stomach muscles switch off, the pelvic floor is only required to function in certain quadrants, even the eyes have trouble accessing certain positions. This gentleman could not look up and left without the muscle strength blowing out in his legs!
So is pronation bad? In one word no, however if we delve a little further this might need expanding upon. Pronation is essential for human locomotion however a difference between left and right is an issue and so is a lack of supination (pronation’s mirror image which is required for the foot to lock as we push off it). I would rather see in clinic two equally over pronated feet rather than one pronated and one supinated.
So how did the story end. We introduced the gentleman’s left foot to pronation using the Anatomy in Motion ‘flow motion’ model and a couple of yoga wedges and the body let out a huge sigh of relief. “My foot feels lighter and walking seems so much easier”. The buttock muscles sprang into life and when fully integrated, his body weight shifted forwards as his body found centre and the pain in his back reduced significantly – all from 5 minutes of pronation work.
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