Over-pronation Hyperpronation


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The leading cause of musculoskeletal deformities is blamed on excessive hindfoot motion. This lecture

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Over-pronation Hyperpronation

  1. 1. Over-Pronation<br />
  2. 2. What is over-pronation<br />
  3. 3. We need to learn aboutpronation.<br />
  4. 4. Pronation is a normal motion of the foot during walking or running.<br />
  5. 5. Pronation<br />Helps to absorb <br />the normal forces <br />traveling <br />from the body above <br />to the ground below.<br />
  6. 6. Specifically<br />The ankle bone<br />slightly turns inward <br /> and <br />the rest of the foot<br />turns slightly outward.<br />
  7. 7. Ankle bone (talus) controls the motions of the hindfoot (calcaneus/navicular)<br />Talus<br />Navicular<br />Calcaneus<br />
  8. 8. Let’s get more technical<br />During pronation<br />Talus- slightly moves <br /><ul><li>Toward the mid-line of the body (medially)- transverse plane
  9. 9. The inner side (medial) lifts up-ward and the outer side (lateral) slightly drops downward- Inverts- frontal plane
  10. 10. Front of the talus slightly dips – sagittal plane</li></li></ul><li>The talus controls the motion occurring in the mid-foot.<br />
  11. 11. The mid-footcontrols the motions ofthe forefoot.<br />
  12. 12. Therefore:the talus ultimately controls the motions of the rest of the foot.<br />
  13. 13. The foot moves in the opposite direction of the talus during walking.<br />
  14. 14. Foot has to move in all three planes to pronate<br />Slightly turns away from the mid-line of the body – lateral (abduction) transverse plane motion<br />Sole of the foot slightly turns outward (everts) frontal plane<br />Foot turns slightly up-wards (dorsiflexes) sagital plane.<br />
  15. 15. Pronation<br />Also allows for adaptation while walking on uneven surfaces.<br />
  16. 16. The motions of the foot when walking.<br />Pronation<br />and<br />Supination<br />
  17. 17. What is supination?<br />
  18. 18. Supinated Foot<br />Over-Pronated Foot<br />
  19. 19. Supination - Pronation<br />Opposite movements between the ankle bone and the foot.<br />Think of it as a winding and unwinding of the foot mechanism.<br />A period of stability and less stability of the foot structures while walking.<br />
  20. 20. Pronation & supination are very important motions of the foot during the walking cycle.<br />
  21. 21. These complex motions of the foot consist of a locking and unlocking of the joints within the foot.<br />
  22. 22. Pronation unlocks the foot and turns it into a “Loose bag of bones”<br />We have to be very careful using this term when describing the stability of the bones of the foot during pronation as it seems like there is no stability within the foot during this period.<br />This is not the case, it is just that there is a period of slight joint motion as the foot is allowed to be a mobile adapter.<br />
  23. 23. Mobile Adapter<br />This is a very important aspect of the foot to allow slight accommodation to an uneven weightbearing surface below the foot. <br />During this time there is a normal amount of adaptation that is acceptable and built into the mechanics of the foot.<br />
  24. 24. What controls how much pronation or supination occurs in the foot?<br />
  25. 25. It is determined by the motion of the ankle bone (talus) on two hindfoot bones (calcaneus-heel bone and navicular).<br />
  26. 26. There is a specific point when the foot needs to be supinating.<br />
  27. 27. During the contact phase of walking the hindfoot lands supinated, quickly pronates, and re-supinates for toe-off.<br />
  28. 28. At mid-stance the foot transitions from its supinated motion into a pronating motion. <br />
  29. 29. Finally, in order for the foot to function as it was designed, the hindfoot must stiffen/limit joint motion and transition back into supination in order to prepare the foot for lift-off.<br />
  30. 30. So what is over-pronation/hyperpronation?<br />
  31. 31. Over-pronationsimply meanstoo much pronation.<br />
  32. 32. In other wordsit meansan extended amount/duration of pronation.<br />
  33. 33. When the foot is supposed to be in a supinated/locked state, it is in it’s pronated/weakened lax state. <br />
  34. 34. This means the secondary support structures (ligaments/tendons/fascia)are going to have an increased strain to lift the foot.<br />
  35. 35. However, medically, it is more appropriate to use:hyperpronation.<br />
  36. 36. Hyper- means excessive or too much.<br />
  37. 37. Think of the wordshypertension (high blood pressure)hyperglycemia (high blood sugar) <br />
  38. 38. We don’t sayover-tensionor over-glycemia.<br />
  39. 39. How does the foot end up with too much or a prolonged amount of pronation? <br />
  40. 40. Hind-foot stability has everything to do with the stability of the ankle bone on the hindfoot bones called the TaloTarsal Mechanism.<br />
  41. 41. TaloTarsal Mechanism<br />3 bones<br />Talus <br />(ankle bone)<br />Calcaneus <br /> (heel bone)<br />Navicular <br />(bone in front of the talus)<br />This mechanism has the most complex motion of the body.<br />
  42. 42. Talus sits on top of the back of the foot.<br />4 specific joints between the talus and the calcaneus and navicular bones.<br />4<br />3<br />2<br />1<br />
  43. 43. TaloTarsal Motion<br />There is a specific amount of motion that is supposed to occur between the talus on the hindfoot bones.<br />
  44. 44. Normally, there should be twice the amount of supination compared to the amount of pronation.<br />
  45. 45. Why is over-pronation or hyperpronation a bad thing.<br />
  46. 46. As the saying goes, too much of anything is usually not a good thing.<br />
  47. 47. A prolonged or excessive amountof foot pronation means there is instability of the ankle bone on the hindfoot bones. <br />
  48. 48. This leads to excessive forces acting on the structures of the foot.Specifically, there are increased strains placed on certain ligaments and tendons of the foot. <br />
  49. 49. A few conditions blamed on an excessive amount of foot pronation.<br />Bunions<br />Hammertoes<br />Posterior tibial tendon dysfunction<br />Plantar fasciitis/heel pain<br />Tarsal tunnel syndrome<br />
  50. 50. And then there is the rest of the body.<br />
  51. 51. Does over-pronation only happen in a low arched or “flat” foot?<br />
  52. 52. Answer<br />In most cases there is a lower than normal arch of the foot.<br />HOWEVER<br />What determines a low or high arch is the inclination of the heel bone.<br />
  53. 53. It is possible to have a high arched foot and still have hyperpronation?<br />YES<br />
  54. 54. Over-pronationis a result of the talus partially displacing off its normal position on top of the heel bone.<br />
  55. 55. The angle of the heel has little to do with the displacement of the talus.<br />
  56. 56. The bottom of the foot is notthe cause of over-pronation.<br />
  57. 57. How can we fix over-pronation?<br />
  58. 58. To fix something you have to eliminate the cause.<br />
  59. 59. Abnormal<br />
  60. 60. Internally Stabilized with HyProCure<br />
  61. 61. Abnormal<br />
  62. 62. Fixed internally with HyProCure.<br />
  63. 63. “Changing Lives, One Step at a Time”<br />To learn more please visit:<br />www.hyprocure.com<br />
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