What Does Over-Pronation Of The Feet Mean

Overview

Flat feet or foot pronation is common and often people with flat feet never have any problems. However, it can lead to over pronation when walking and running, this is a biomechanical problem when the arch of the foot collapses during weight bearing. This can have a knock on effect up the leg causing the knee to roll inwards, the hip and pelvis to rotate and even torsion in the lower back. Subsequently, over pronation can lead to lots of different injuries from plantar fasciitis to lower back pain. Therefore, assessment and correction of over pronation is a crucial part of any rehabilitation program. This can be done with orthotics.Over-Pronation

Causes

Over-pronation is very prominent in people who have flexible, flat feet. The framework of the foot begins to collapse, causing the foot to flatten and adding stress to other parts of the foot. As a result, over-pronation, often leads to Plantar Fasciitis, Heel Spurs, Metatarsalgia, Post-tib Tendonitis and/or Bunions. There are many causes of flat feet. Obesity, pregnancy or repetitive pounding on a hard surface can weaken the arch leading to over-pronation. Often people with flat feet do not experience discomfort immediately, and some never suffer from any discomfort at all. However, when symptoms develop and become painful, walking becomes awkward and causes increased strain on the feet and calves.

Symptoms

Symptoms can manifest in many different ways. The associated conditions depend on the individual lifestyle of each patient. Here is a list of some of the conditions associated with Over Pronation. Hallux Abducto Valgus (bunions). Hallux Rigidus (stiff 1st toe). Arch Pain. Heel Pain (plantar fascitis). Metatarsalgia (ball of the foot pain). Ankle sprains. Shin Splints. Achilles Tendonitis. Osteochondrosis. Knee Pain. Corns & Calluses. Flat Feet. Hammer Toes.

Diagnosis

If you cannot afford to get a proper gait analysis completed, having someone observe you on a treadmill from behind will give you an idea if you are an overpronator. It is possible to tell without observing directly whether you are likely to be an overpronator by looking at your foot arches. Check your foot arch height by standing in water and then on a wet floor or piece of paper which will show your footprint. If your footprints show little to no narrowing in the middle, then you have flat feet or fallen arches. This makes it highly likely that you will overpronate to some degree when running. If you have low or fallen arches, you should get your gait checked to see how much you overpronate, and whether you need to take steps to reduce the level to which you overpronate. Another good test is to have a look at the wear pattern on an old pair of trainers. Overpronators will wear out the outside of the heel and the inside of the toe more quickly than other parts of the shoe. If the wear is quite even, you are likely to have a neutral running gait. Wear primarily down the outside edge means that you are a supinator. When you replace your running shoes you may benefit from shoes for overpronation. Motion control or stability running shoes are usually the best bet to deal with overpronation.Overpronation

Non Surgical Treatment

Overpronation is usually corrected with orthotics and/or strengthening exercises for the tibialis posterior. Massage treatment can relieve myofascial trigger points in the tibialis posterior, and other muscles, and address any resulting neuromuscular dysfunction in the leg or foot. Biomechanical correction of overpronation might require orthotics, neuromuscular reeducation, or gait retraining methods, as well. Stretching the gastrocnemius and soleus muscles will reduce hypertonicity in these muscles and also is essential for effective treatment. Because of impacts throughout the remainder of the body, the detrimental effects of overpronation should not be overlooked.

Prevention

With every step we take, we place at least half of our body weight on each foot (as we walk faster, or run, we can exert more than twice our body weight on each foot). As this amount of weight is applied to each foot there is a significant shock passed on to our body. Custom-made orthotics will absorb some of this shock, helping to protect our feet, ankles, knees, hips, and lower back.

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How You Can Treat Calcaneal Apophysitis?

Overview

Sever’s disease, or calcaneal apophysitis, is a common cause of heel pain among active children between 10 to 13 years old. This spontaneous heel pain results from injury to the heel bone?s growth plate which is caused by overuse rather than specific injury or trauma. The condition is common among athletic children, particularly those active in soccer, football, and baseball. Treatment is available to reduce pain and discomfort associated with Sever’s disease, but the condition usually resolves on its own once feet stop growing.

Causes

There are several causes of heel pain in the young athletic population with the most common being calcaneal apophysitis (also referred to as Sever?s disease). Sever first reported calcaneal apophysitis in 1912 as an inflammation of the apophysis, causing discomfort to the heel, mild swelling and difficulty walking in growing children. The condition usually manifests between the ages of 8 and 14 with a higher incidence in boys than girls. In reality, however, calcaneal apophysitis is being diagnosed more frequently in girls due to their increase in participating in sports such as soccer, basketball and softball.

Symptoms

Symptoms include heel pain related to sports activities and worsen after those sport and exercise activities. However, some children who are not in a sport may also get this if they are physically active. If you notice that your child is ?walking on their toes? this is a sign of possible heel pain. The pain is usually on the back of the heel, the sides of the heel, the bottom of the heel, or a combination of all of these. We typically don’t see swelling with this, however if pressure is applied to the sides of the heel pain may be reported. Sometimes the pain is so bad the child will have to limp, or take a break from sports activity either for a few days or few months.

Diagnosis

This condition is self limiting, it will go away when the two parts of bony growth join together, this is natural. Unfortunately, Sever’s disease can be very painful and limit sport activity of the child while waiting for it to go away, so treatment is often advised to help relieve it. In a few cases of Sever’s disease, the treatment is not successful and these children will be restricted in their activity levels until the two growth areas join, usually around the age of 16 years. There are no known long term complications associated with Sever’s disease.

Non Surgical Treatment

The initial treatment is rest, relieve the pain and treat the underlying cause. The foot and ankle should be rested so that the apophysis it is not being continually ?injured?. A small heel (sorbothane heel insert) raise can used to raise the heel and take the stretch off the Achilles tendon. It may be sufficient to stop your child playing sport but some children require a short period of bed or couch rest. Some children find resting very difficult and require the use of braces or plasters or boots to slow them down. Using crutches is advised. Severs is usually caused by tight muscles. A stretching program should be followed usually supervised by a physiotherapist. The stretching program may need to be undertaken up to 5 times a day. If flat feet are a problems orthotics (insoles) should be used. The pain should be controlled by rest (limiting activity) and ice (icing the painful area 3-4 times a day – making sure the skin is not burnt), Simple pain killers can be used such as paracetamol as well as anti-inflammatory tablets and cream. Severs disease usually goes away with time. When your child stops growing, the pain and swelling should go away because the growing (weak) area fuses and becomes solid bone which is very strong.

Exercise

For children with Sever’s disease, it is important to habitually perform exercises to stretch the hamstrings, calf muscles, and the tendons on the back of the leg. Stretching should be performed 2-3 times a day. Each stretch should be performed for 20 seconds, and both legs should be stretched, even if the pain is only in one heel. Heel cups or an inner shoe heel lifts are often recommended for patient suffering from Sever’s disease. Wearing running shoes with built in heel cups can also decrease the symptoms because they can help soften the impact on the heel when walking, running, or standing.