Understanding Foot Pronation & How To Correct It

When the body has a loss of mobility, it can be due to the joints that are located on the foot. Foot pronation is when the foot is either rolled in or out causing the body to become crooked and that can cause some problems that are affecting the body. When there is foot pronation, the body can suffer from lower back pain, problems with the foot itself and many more complications. So by using custom foot orthotics can actually help correct foot pronation and aligned the body to walk correctly. When people are walking to their destination, they always seem to be walking on the outside of their foot instead of inside. This is due to the individual lifting their heel off the ground and bending at the middle of their arches, causing the toe joint to be immobile. This is known as functional hallux luminous and it can cause problems. By using custom foot orthotics, it can enhance the motion of the first MTP joint in the foot and can give the person proper arch support. These are customed to the individual and can help align the body, so that way when a person is walking, they can walk straighter, taller and not have to worry about their body becoming crooked or misaligned. Using foot orthotics can help a person feel good and be free of pain as well since they can almost retrograde foot pronation that can surely impact the entire posture and not just making the body rely on one side of the foot to make it crooked. Dr. Alex Jimenez explains to patients about the importance of how custom foot orthotics can help them walk a bit better and not having to deal with misalignment of the body and the complications that may come over time.

[00:00:19] The body represents a complex yet elegant system that used for simultaneous support, mobility, postural alignment, and forward advancement.

[00:00:29] Functional loss of mobility, at the toe joints can create havoc with the entire postural support complex.

[00:00:35] Is pronation really the etiology of the things we see when we look at foot and knee and hip them back? Or is it one of several manifestations of stress to the entire musculoskeletal system related to a suddenly different origin that happens to be foot related?

[00:00:53] Take a look at the foot you see in front of you.

[00:00:55] It’s pronated. There’s no doubt about it. But look at their shoe. The foot rolls in, but the shoe rolls out. How possibly can that happen? Here’s another example of the same phenomenon in a different patient. Look at the foot. Look at it from the front and the back. There’s too many toes sign. It’s clear that the foot is totally pronated. But now in the right slide and look at the shoe. The shoe is totally worn to the lateral side. How does someone pronate when they walk on the outside, not the inside? Now, if we look at this slide, this is a dynamic slide. What happens when she’s walking? You can clearly see that her heel is lifted from the ground. But where did she bend? In the middle of her arch. The toe joint doesn’t move. That is functional hallux luminous. And when you think about it, it equates to when pathologic or late midstance phase pronation occurs at the time of heel lift, not heel contact. And here, if you look head-on what you can see is that as the heel begins to lift, there’s a horizontal line right over the medial malleolus of the ankle joint.

[00:02:12] And you could see that as the foot starts to pronate at that time, the medial malleolus, which is the tibia, is not rising up. It’s staying at the same level. But if you look at the side view, which is in a little box on the left-hand side, you could see that the heel is lifted an inch or two off the ground already. Well, if the heel is rising, but the ankle not moving. What’s happening is that the leg is falling at exactly the same speed that the heel is being lifted off the ground. So that’s exactly what this is, is that the leg is falling at the same rate of speed, that the heel is rising. So when a lot of ways pronation, it’s an illusion that it seems to be contact related. But when we realize that the limb is falling at the time the heel is lifting, it gives us a picture that is not quite accurate. Think about looking at that from the back on the left-hand slide, it looks like the calcaneus has rolled out from under the heel. But when we realize that the tibia, which is what’s moving inward, is sitting on top of the subtalar joint and like I said earlier, works like a differential gear or like a screw as it drops, it’s going to internally rotate.

[00:03:31] As it internally rotates, it’s going to make it appear. And so the heel is rotated out from under the foot, even though the heel has not rotated at all.

[00:03:40] So why even bother with prefabricated orthotics? What’s the intent? Well, it’s a lot more than you might think. Now that we realized the effect of functional hallux luminous and how that can cause almost a retrograde pronation that can impact the entire posture and not one foot put the body above it.

[00:03:57] What we want to do with the foot orthotic is not so much control motion as much as we can enhance the motion of the first MTP joint. If we can do that, we get automatic arch support by the windlass. We get the ability to raise body weight and we also get the ability to advance forward all simultaneously. What the orthotic does, is it promotes proper first-rate function, which is playing a flexion, inversion, and we encourage motion to occur when the demand is the greatest.