Pronation---A Troublemaker in the Foot

     When the inside of your foot drops inward toward the floor when you’re standing, it’s called “pronation.”  It is often seen in combination with fallen arches, or “flat feet.”

     If you stand behind someone who “pronates,” or has pronation in their feet, it is easy to see how the inside of the foot falls in and down. You may also notice an inward curving of the Achilles tendon in the back of the ankle on the involved foot (feet).

     Pronation can cause foot pain and fatigue, but it also negatively affects the knees, and can reverberate upward to cause abnormal stresses in the hips and pelvis.

     Watch the legs of someone who pronates as they stand facing you, and have them lift and hold the inside of their feet out of pronation. Now focus on their knees and have them relax their feet back into their usual pronation.  

     See what happened? The dropping back into pronation caused a rotation of the knees. This shows how much stress pronation causes on the knees. These abnormal stresses cause wear and tear that can lead to osteoarthritis.

     Pronation should be corrected by proper orthotics, and they don’t necessarily have to be custom. My treatment plan includes precise adjustments of lower extremity, hip, and pelvic joints with Activator Chiropractic, orthotics, and exercises to strengthen the muscles that support the ankle and foot. 

Over-The-Counter Orthotics

Patients who have fallen arches or who pronate need to support their feet with orthotics, not just for comfort, but also because these conditions in the feet reverberate up into the knees, hips, and pelvis and cause problems. Some may need prescription orthotics, but many people will find over-the-counter orthotics can do the job.

I commonly recommend a patient try one of two types that they can buy “off the rack.” One is softer, made of foam, with a mild arch support, that is easy to get used to. The other is a harder, molded orthotic appropriate for people who need more support. Either should be appropriately fitted by a staff person at the store who knows how to size them.

It’s not a bad idea to start with an over-the-counter orthotics and see if they will be sufficient. Certainly they are kinder on the patient’s wallet. If it turns out more fine-tuned or specialized support is needed, prescription orthotics are the next step.