Pronation in Running & Walking

It’s all in the feet 

Pronation in Running.  When is it good, when is it not so good and what can you do about it.

You may have heard that pronation (your foot rolling inwards and flattening your foot’s inner arch) is bad for your foot – you could be forgiven for choosing footwear with arch support for this reason. Pronation is a movement that is absolutely necessary for the normal functioning of your foot. Pronation is one of the movements that lets your foot access the ground and provides a stabilising factor that assists your foot to transfer load throughout your whole foot. This is a good thing for your foot, so it’s not a bad thing to have pronation.  It’s just a matter of whether it is controlled or not.  A lack of pronation can be equally as bad as too much pronation.

Don’t stop reading here as there is a lot more of the story to know if your feet need some help or not and how this relates to pronation in running and walking

Is your foot structurally efficient?

Let’s break it down

Pronation – What is it good for?

1. It allows your foot to accommodate to the ground
2. Is essential for normal weight-bearing activities like walking and running
3. Starts in the back one-third of your foot (rearfoot), then move to the middle one-third of your foot (midfoot) and finish off in the front one-third of your foot (forefoot)

Supination – What is it good for?

1. allows your foot to push off of the ground efficiently
2. creates height in your foot arch

A foot that is efficient is one that has all of the following capabilities

1. It is broad
2. It is elastic
3. It can weight-bear equally between the front and back and the inside and outside parts of each one of your feet
4. It is not stiff or rigid

One of the most common issues we see with feet is that they are quite immobile in the midfoot section of a patient’s foot joints. Foot stiffness or immobile midfoot joints can occur in patients with either a higher arch foot position (supinated foot) or a lower arch foot position (pronated foot). Any stiffness present in your midfoot joints will create limited pronation in your mid-foot resulting in

1. Too much rearfoot pronation
2. Timing inefficiencies in pronation
3. Higher rate of pronation

Why is Midfoot stiffness a problem?

If your rearfoot has to compensate with excess pronation due to midfoot joint stiffness you can create a chain effect higher up into your lower limb and into your spine. You will have compensation in movement in your leg and spine – this will be seen as an increased internal rotation of your knee and hip which can create issues in either of these areas or be a culprit in lower back pain.

Timing inefficiencies of Pronation – what does that mean?

Stay with me here it will all make sense soon

If your foot starts pronating at the wrong time – ie when you are supposed to be in supination for pushing forwards in activities such as walking and running, you will run into some issues down the line. Propelling yourself forward during a run or walk requires a stable base from which to initiate movement. So, pronation in running or walking at the wrong time creates an inefficiency of energy and movement and may place greater strain on structures of your foot that are designed to help keep you stable. The structures that are under excess strain are your tibialis posterior muscle, your plantar fascia and your plantar ligaments of your foot.

Higher Rate of Pronation

This is the last one I promise

If your midfoot is too stiff or perhaps you’ve injured your ankle in the past or even in recent times it is possible that you may not have good neuromuscular control of your foot, this could lead to pronating too quickly.

Some recent scientific research showed that injured runners often pronate approximately twice as fast as non-injured runners. Pronating too quickly increases the demand on all the muscles and joints of your foot and lower limb. An interesting finding in the research was that the injured runners complained of knee pain.

How do you know if you have a foot that is inefficient?

City Physiotherapy & Sports Injury Clinic can assess your foot dysfunction or foot pain by looking at your biomechanics and how your muscles and joints are working, especially in single leg activities such as single-leg standing, walking or running. If we detect stiffness in your foot joints, we can address this with physiotherapy treatment such as hands-on manual therapy and corrective exercises. If we detect you have muscle imbalances that are contributing to your foot issues, including pronation in running, we will give you specific corrective exercises that will improve the intrinsic muscle strength of your feet as well as strength and endurance exercises for muscles that need to help keep you supported in single leg activities. This could be your glutes, core muscles or lower limb muscles. Neuromuscular control of your foot muscles is vitally important and if this is found to be inefficient, we will help you train your foot muscles with appropriate exercises for this component of rehabilitation.

Everyone is unique and therefore which exercises are right for you will depend on what we find on our assessment.  What is important for you is that your foot functional, that it has b both mobility and stability because after all your feet are your base of foundation from which all of your movement occurs.  And if this isn’t enough of a reason, it will improve your running and prevent overuse issues from occurring due to dysfunctional pronation or midfoot stiffness.

References:

Hosl M, Bohm H, et al. Does excessive flatfoot deformity affect function? A comparison between symptomatic and asymptomatic flatfeet using the Oxford Foot Model. Gait and Posture 2013

Rodrigues P, TenBroek T. Evaluating runners with and without anterior knee pain using the time to contact the joint complexes’ range of motion boundary. Gait and Posture 2013

Rodrigues PA, TenBroek T, Hamill J. Runners with anterior knee pain utilize a greater percentage of their available pronation range of motion. Journal of Applied Biomechanics 2013;29(April (2)):141–6

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