Functional Asssessment – Foot and Lower Leg

Pronation

Necessary – not a bad thing
I don’t treat pronation. Instead, I treat the possible causes.
Possible Causes
Ligament Laxity
Weakness in:
Tib anterior & tib posterior
Intrinsic foot muscles
Shortness in peroneals
Shortness in ankle plantar flexors (Gastroc & Soleus) causes pronation to allow knee to pass forward over toes

Pronation Assessment

From my years performing clinical running analysis, I no longer believe in any static assessment. In fact, I don’t believe anything except a slow-motion video of a foot in motion. Standing is different from walking & walking is different from running.

I have seen more than one client present with strong supination when standing still and walking. But once they ran for me, I saw some of the worst over-pronation I’ve ever seen. Due to the way they stood, they were recommended a neutral running shoe. One of these clients even stood on a high-tech force plate at the shoe store & it recommended the WRONG shoe. Why? Because standing is different from walking is different from running!

One Simple Pronation Assessment

Ok…One assessment I do find helpful is to have the client stand with their feet shoulder-width apart and rotate their hips back and forth without moving their feet. When the hips rotate toward one side, it should invert the calcaneus and raise the arch on the side the hips are facing.

If the arch rises, the structure of the foot is solid and the muscles of the foot and ankle may just need strengthening. If the arch does not rise, it probably means the foot has ligament laxity and this person would benefit from orthotics.

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