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30 May 2015 - 02:11:59 am

What Are The Primary Reasons For Overpronation

Overview


Over-pronation means flattening of the arches and inward tilting of the ankles when your child is standing (when your child's feet are viewed from behind) Pronated foot structure is often inherited. Before children reach the age of 3 or 4, it is normal for their feet to appear flat because of a normal fat pad under the arch. After age 4, the fat pad should decrease and inward tilting of the foot and ankle becomes more evident. When over-pronation is excessive, it can lead to pain in the feet, ankle, achilles tendons (heel cords), back and most commonly, the knee.Over Pronation


Causes


There may be several possible causes of over pronation. The condition may begin as early as birth. However, there are several more common explanations for the condition. First, wear and tear on the muscles throughout the foot, either from aging or repetitive strain, causes the muscles to weaken, thereby causing the foot to turn excessively inward. Also, standing or walking on high heels for an extended period of time also places strain and pressure on the foot which can weaken the tissue. Lastly, shoes play a very common factor in the development of over pronation. Shoes that fail to provide adequate support through the arch commonly lead to over pronation.


Symptoms


Overpronation may have secondary effects on the lower legs, such as increased rotation of the tibia, which may result in lower leg or knee problems. Overpronation is usually associated with many overuse injuries in running including medial tibial stress syndrome, or shin splints, and knee pain Individuals with injuries typically have pronation movement that is about two to four degrees greater than that of those with no injuries. Between 40% and 50% of runners who overpronate do not have overuse injuries. This suggests that although pronation may have an effect on certain injuries, it is not the only factor influencing their development.


Diagnosis


Firstly, look at your feet in standing, have you got a clear arch on the inside of the foot? If there is not an arch and the innermost part of the sole touches the floor, then your feet are over-pronated. Secondly, look at your running shoes. If they are worn on the inside of the sole in particular, then pronation may be a problem for you. Thirdly, try the wet foot test. Wet your feet and walk along a section of paving and look at the footprints you leave. A normal foot will leave a print of the heel, connected to the forefoot by a strip approximately half the width of the foot on the outside of the sole. If you?re feet are pronated there may be little distinction between the rear and forefoot, shown opposite. The best way to determine if you over pronate is to visit a podiatrist or similar who can do a full gait analysis on a treadmill or using forceplates measuring exactly the forces and angles of the foot whilst running. It is not only the amount of over pronation which is important but the timing of it during the gait cycle as well that needs to be assessed.Overpronation


Non Surgical Treatment


If you overpronate, you should talk with a foot and ankle specialist, especially if symptoms have not developed yet. Questions you may want to ask your doctor include what are the best running shoes on the market? Where can I find those shoes? If over-the-counter orthotics don?t work, how long should I wait before contacting you for custom-made orthotics? On my next visit, what type of diagnostic testing should I expect? If I limit the amount of time I spend running, will my overpronation symptoms disappear? What additional treatment options can we try?


Surgical Treatment


HyProCure implant. A stent is placed into a naturally occurring space between the ankle bone and the heel bone/midfoot bone. The stent realigns the surfaces of the bones, allowing normal joint function. Generally tolerated in both pediatric and adult patients, with or without adjunct soft tissue procedures. Reported removal rates, published in scientific journals vary from 1%-6%.
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