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 Concerned I Pronate When Running

Concerned I Pronate When Running

Ask the Experts:
Should I Be Concerned That I Pronate When I Run?

August 2011

I have been to three different shoe stores here in the Bay Area, and each store
person took a look at my current running shoes (I wear them during the day) and
said that I pronate.” One youngish guy (he had the look of an emaciated, longdistance
college runner) wanted to sell me some “anti-pronation”, “motion-control”
shoes and a pair of off-the-shelf orthotics. I politely declined his offer and later mulled
my options at a nearby Starbucks. I am still kicking tires, and it seems that the
minimalist shoe trend is less about the perils of pronation and more about the horrors
of heel-striking. So, inquiring minds (and feet) want to know: what is the straight story
about pronation?

by Dr. Steve Gangemi (aka Sock Doc).....

Pronation has gotten a bad rap.This has been going on for years. But it makes little
sense to point an accusing finger at pronation as the “cause” of many running
injuries.
We all pronate.
During a normal gait cycle the foot rolls inwards, everts (turns out on its axis), and
the arch flattens. This is pronation and the foot is very flexible and loose at this time,
or should be. Then the foot becomes more rigid and turns outwards a bit and uses
stored energy in the tendons and ligaments to push off the ground, hopefully as it is
rolling over the big toe. This is supination. Any variation to this normal cycle of
function can result in a problem.
These terms are often used interchangeably to diagnose why someone has a foot
problem or injury. What about overpronation? The reality is that it’s a symptom of a
problem and may correlate with an injury somewhere in the body or be the result of
overtraining. Overpronation (or lack of supination) as with most symptoms, is often
treated improperly as the root cause of a problem, especially by those eager to sell
runners orthotics or “anti-pronation” shoes.
Foot pronation is a necessary and important aspect of the gait cycle. It acts as a
major shock absorber for forces that are applied to the foot. During pronation, the
tibialis anterior and the tibialis posterior muscles are active in supporting the foot,
especially the main arch. If there are imbalances in the lower leg muscles,
particularly the tibialis posterior, then excessive pronation may result, or the failure to
resupinate.
Artificially reducing normal pronation with orthotics and many types of rigid footwear
decreases the foot’s ability to act as a shock absorber and adapt to the ground
underneath. This can result in stress and injury to the foot and other areas of the
body responsible for normal gait action – and that can even mean an opposing upper
body limb whose natural movement is necessary during a normal gait cycle. That
means if you don’t pronate and supinate correctly, you may end up with a shoulder
problem, for example. In such a case, orthotics or motion-control footwear can now
become the reason for a new injury as normal gait is disrupted and shock is
artificially altered.
How do you know if you really overpronate? There are a few things you can do as a
self test. First, look at the shoes you’ve been walking or running in for some time. If
the outside of the heels are excessively worn out, then that is a sure sign you
overpronate. Another test is to point your foot down as much as possible (plantar
flexion) and then inwards. So point down and twist your foot inwards like you’re
trying to point down to the ground with your big toe. If this causes some discomfort
on the inside of your calf muscle, especially behind your tibia bone (the main bone of
your lower leg), or in the arch of your foot, you may have excessive pronation. This
movement is actually one of supination, but many people have a weakness in
supination and therefore they excessively pronate. There is an imbalance between
the two. A third thing to observe is how you stand. If you catch yourself standing on
the outside of your feet (rolling one or both of your feet outwards while standing),
then that is a sign that you overpronate. One last test you can do is have someone
look at your Achilles Tendon. Normally the tendon should run straight down the leg
into the heel. If the foot is overpronated, it will turn inwards.
If you overpronate what do you do? Don’t treat it directly because you are merely
treating the symptoms and controlling your pronation will just land you another
problem eventually. Many runners are told they overpronate because their
podiastrist diagnosed it or some guy at the local running shoe store told them so
while recommending some trendy motion-control shoes.
You’re not going fix your overpronation with any orthotic, supporting
footwear,stretching, or any other gimmick out there. Always look for the source, and
since these common treatment regimens only treat the symptom, as overpronation is
just that – a symptom – look to why you are not pronating correctly.
Muscle imbalances of the lower leg and foot are the main reason for improper
pronation (and supination). Wearing over-supportive shoes and/or orthotics will
throw your body out of whack. Trying to control pronation and supination directly will
only disrupt normal gait, balance, proprioception, and muscle response resulting in a
new injury somewhere down the line. Correcting these muscle imbalances can be as
simple as transitioning out of your orthotics or non-minimalist shoes to minimalist
shoes and walking barefoot as much as comfortably possibly so your foot and leg
muscles, and tendons and ligaments begin to strengthen and heal.
Another significant and perhaps more common reason for muscle imbalances
resulting in pronation/supination problems is overtraining. Yup, too much stress will
have a dramatic effect on the lower leg muscles, particularly the tibialis posterior
muscle that supports the main arch of the foot. There is a common connection
between this muscle and the adrenal glands, which is where the major stress
hormone cortisol is produced. So high levels of stress result in high levels of cortisol
and tibialis posterior problems and then overpronation. Shin splints and plantar
fasciitis are two common injuries that accompany this problem too. Another adrenal
gland hormone, aldosterone, is necessary for sodium regulation and electrolyte
balance in the body.
If you’re training too hard and anaerobic too much then you’ll end up with cortisol
and aldosterone problems, and you will overpronate as a result. So, chill out on the
hard-core stuff for a bit, go back to more aerobic training, walk barefoot as much as
possible, and get out of those over-supportive running shoes.

Pronation & Barefoot Running

Pronation & Barefoot Running

June 19th, 2013 by: Steven Sashen

This piece by Steve Sashen of Xero Shoes, formerly known as Invisible Shoes, is very interesting and was brought to my attention through Barefoot Beginner "online magazine from Chris Fielding" http://www.barefootbeginner.com (Colin McPhail)

Over to you Steve,

Whenever we're selling Xero Shoes at a public event, a few people will come up to our booth, examine our barefoot sandals, and claim (with a strange tone of almost arrogance), "I can't wear these. I pronate."

Sometimes they'll pull out the third party endorsement, "My doctor says I pronate." Or the less-convincing, "The shoe store did gait analysis on my and said I pronate."
It's as if they expect me to say, "Oh, my gosh! That's horrible! I would never argue with an actual doctor or, even more, a 23-year old who works at a shoe store that sells 'motion-controlled' shoes! You totally can't wear Xero Shoes, then. In fact, I'm amazed you were able to walk over to our booth!"

Instead, I bite my tongue for a second (so I don't say something incredibly sarcastic), and then say,
Pronation is not an issue. First of all, many world-class runners pronate more than you ever will. Pronation is part of the natural spring-mechanism of the lower leg.
Now, hyper-pronation (showing weakness) *might* be a problem, but it rarely is. And…
When you run with barefoot style and land on your mid-foot or forefoot, it's much less likely that you'll pronate at all, since those ways of landing usually put the foot and ankle in a strong position when you land.

But now I have something else to add to my "pronation isn't evil" arsenal… SCIENCE!
Aarhus University in the Denmark just published a study in the British Journal of Sports Medicine called "Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe."

What I LOVE about this study, reported at ScienceDaily.com, is that it studied almost a thousand runners for an entire year. That's a good amount of data to work from.
And, in short, what they discovered is that putting runners in non-supportive shoes did not increase their chance of injury (and this is with them NOT switching to a mid-foot or forefoot landing, which arguably reduces their pronation).

Rasmus Nielsen, the PhD student who led the study says, "This is a controversial finding as it has been assumed for many years that it is injurious to run in shoes without the necessary support."

My addition to that would be, "Well it was 'assumed' for many years because the companies making motion-control shoes TOLD us that, and we believed it."

Now, admittedly, the study is not the be-all-and-end-all studies about pronation. Even the researchers say that they "still need to research the extent to which feet with extreme pronation are subject to greater risk of running injury than feet with normal pronation." And, I'm going to contact Mr. Nielsen and suggest he look at barefoot running in the future.

But, I'm never one to complain when another nail is added to the coffin of, well, foot coffins.

The foot coffin is another name for the sensory depravation chamber sometimes referred to as "Shoes"

Further Explanation to Pronation

Further Explanation to Pronation

During walking and running, pronation and supination normally occur in the foot.
Pronation is important for optimal movement and shock absorption. During foot
strike, many changes take place—the foot begins to roll inward, everting slightly, and
the arch flattens. This is called pronation. It is a normal action—one that occurs in
every step in every healthy foot. The purpose of this is to loosen the foot so it can
adapt to the surface, especially on uneven terrain.

Following pronation, as the foot continues through its gait, supination occurs. This
results in the foot turning slightly outward then changing from a flexible foot to
becoming rigid so it can propel the foot and push off from the ground. During this
phase the foot inverts slightly, and the arches become higher, thus enabling the foot
to properly roll over the big toe.
A number of factors can disrupt a person’s normal gait. The two most common
reasons are muscle imbalance and wearing stiff, over-supported shoes. Sometimes,
areas above the foot, such as the pelvis or spine, can abnormally influence foot
function. For example, too little or too much hip rotation can cause the foot to land in
an abnormal position. In addition, injury, pain, and other problems that affect blood
flow, cause inflammation, or disturb muscle function in the foot can abnormally alter
the gait.
Most shoes change the gait by causing the stride length to become abnormally
longer. This causes an abnormal heel strike—hitting the ground farther back on the
heel. It’s especially a problem during running, as the longer stride places more shock
through the foot and into the knee, and occurs despite shoe cushioning or what is
commonly called a “heel crash pad.” Barefoot movement does not cause the same
stress.
The notion that some people are “pronators” while others are “supinators” is a gross
oversimplification that fitness magazines, shoe stores, and footwear manufacturers
foist upon the public in an attempt to sell shoes. It’s mostly all marketing
hype. Everyone pronates and supinates. The reason some people excessively
pronate or supinate is more often from wearing over-supported shoes, which cause
muscle imbalance. This is especially a problem in children whose feet need to
properly develop without shoes.
More importantly, an attempt to “help” a poorly functioning foot with a particular type
of shoe or orthotic insert is an example of treating symptoms; most cases of foot
dysfunction are usually due to muscle imbalance. Keeping the foot in a rigid,
immobile position can actually promote foot imbalance by not allowing the body to
naturally correct the problem.

--by Dr. Phil Maffetone

The 10 Myths about Barefoot Running Explained

The 10 Myths about Barefoot Running Explained

In the following essay, which appears in the current issue of Podiatry Today, Dr. Nick
Campitelli, a health and medical advisor to the Natural Running Center in ShepherdsTown WV, who is
board-certified by the American Board of Podiatric Surgery, addresses a hotly
debated topic in professional foot-treatment circles.

Tackling The 10 Myths Of Barefoot Running
by Nicholas A. Campitelli, DPM, FACFAS

Barefoot running, minimalist running and natural running are all terms that describe
running in a manner that allows our foot to function the way it was designed (or has
evolved). This happens through the use of little or no shoe at all. Many runners
suffering from chronic injuries are adopting this way of running and are experiencing
relief of symptoms to find themselves running with enjoyment and a more relaxing
form.
I too have been cured of a running injury, which I suffered from for over eight years
after transitioning my gait to that of a “barefoot” runner. Without further ado, here are
the 10 myths of barefoot running.

1. Barefoot running leads to stress fractures. Without a doubt, the most common
concern with barefoot or minimalist running is the development of a stress fracture.
While there have been documented cases of this in the literature, stress fractures
occur as a result of a change in activity without gradual adaptation and are not
directly related to the shoegear or lack thereof.1 We actually should see a decrease
in the likelihood of stress fracture given the change in stride and cadence that one
acquires while running barefoot.2
Stress fractures occur secondary to overuse without the body having adapted
adequately as proven by Wolff’s Law.3 In fact, if we adhere to Wolff’s law in theory,
we should see weaker bone trabecular patterns on those wearing cushioned running
shoes due to decreased intrinsic muscle strength, resulting in a proportional
decrease in the force acting on the respective bone.4

2.I have flat feet and I need support. Lees and Klemerman have demonstrated that
there is no correlation between foot type and running injuries, specifically with a pes
planus deformity.5 During barefoot running, we avoid heel striking and land more on
our forefoot or midfoot. Once the forefoot strikes the ground, pronation of the entire
foot begins (not isolated pronation of the subtalar joint) and continues until the point
where the heel touches the ground. Arch height becomes irrelevant as does the
commonly described concept of pronation with the heel striking the ground first. With
a forefoot/midfoot strike, pronation is very beneficial and helps to absorb shock.

3. I weigh too much. While this is a common excuse to not run, being overweight is
not reason enough not to run barefoot or in a minimalist shoe. In 2010, Leiberman
and co-workers were able to demonstrate that habitually unshod runners were able
to generate smaller collision forces than shod heel strikers.6 In other words, by
forefoot striking, we decrease the force that transmits through the lower extremity,
thereby reducing torque forces to the ankle, knee and hip joints.7 Clearly, we can
see that if people weigh 250 lbs, they would be placing more force through their
joints by heel striking then by landing on their forefoot.

4.I have bad knees. Osteoarthritis of the knee is a common concern among many
runners, especially older individuals who have run the majority of their lives. There
are many theories as to why running is bad or even good for your knees. So many in
fact that elliptical machines were invented to be used as a form of exercise similar to
running without causing excess pressure to the joints.8 However, these elliptical
machines do not reproduce anatomical motions and an in vivo force analysis reveals
there is less force with walking than with an elliptical trainer.9-11
As I noted previously, we know that ground reactive forces are greater with heel
strike in comparison to unshod or barefoot runners who adapt a more forefoot strike
pattern.6 Numerous studies have demonstrated higher ground reactive forces and
mechanical stresses to the knee while running in traditional running shoes as
opposed to barefoot.12-13 A recent study published in the British Journal of Sports
Medicine looked at patients with knee osteoarthritis over 12 months and found no
difference between wearing a lateral wedge orthotic versus a control flat insert.14
Similarly, a systematic review of literature demonstrates that external knee adduction
moment and pain associated with knee osteoarthritis is higher in individuals wearing
sneakers in comparison to those who do barefoot walking.15

5. I can’t do barefoot running because I need to wear my orthotics. Orthotics have
become more overutilized in the practice of podiatry then ever before. It is very
common for me to see runners present in my office with plantar fasciitis, a normal
arch, cushioned running shoes and orthotics they have worn. When running barefoot
or in a minimalist shoe, we do not need to control motion at the rearfoot because
heel striking is not occurring and “excessive pronation,” as described by Root, does
not occur. While we have numerous studies that do not support the use of orthotics
for running injuries alone, it becomes a challenge to convince the patient they are not
needed.16-20

6. I have plantar fasciitis so barefoot running would be too painful. This article was
not intended to discuss the pathomechanics or treatment options of plantar fasciitis.
However, we are anecdotally seeing resolution of symptoms in those who adopt this
style of running. One potential explanation is the development in strength we see to
the intrinsic musculature, specifically the abductor hallucis muscle, which is a
primary supporter of the arch.21-25 Another overlooked phenomenon is the fact
that the majority of running shoes place your ankle into plantarflexion. This forces the
body to compensate by increasing lumbar lordosis and increasing pressure to the
heel as opposed to having more even distribution throughout the foot.

7. An atrophied fat pad would prohibit barefoot running. This is another common
myth that patients acquire from various sources, including medical professionals.
Most, if not all, of us have treated a patient who complains of forefoot pain or
calluses, and then simply blames the problem on a lack of adipose tissue or
cushioning below the metatarsal heads. While this seems to be a possible etiology,
there is no evidence to date that the fat pad of the sole of our foot actually atrophies
on the forefoot or the heel region.26,27 With common forefoot pathology such as
hammertoe deformities, we do see the fat pad migrate distally producing more
prominent metatarsal heads but typically, this is in severe cases, such as rheumatoid
arthritis.28 Patients at this stage of a deformity are typically not runners.

8. Barefoot running causes severe calluses. Calluses on our feet form as a result of
shear force on the plantar surfaces of the skin that produces excess friction. Shear
force that occurs in the horizontal plane is the key to understanding this concept.
Direct pressure does not produce calluses or we would see a high preponderance of
heel calluses in runners as the majority of runners heel strike.
Root discussed the formation of forefoot calluses secondary to shearing forces
associated with propulsion as well as to the central metatarsals due to increased
loading for an excessive period of time and abnormal shear.29 Root’s observations
hold true for someone who heel strikes when running as we see increased force
placed upon the forefoot during what he described as the propulsion phase.
Observation of the gait of a barefoot runner or one who strikes with the
forefoot/midfoot demonstrates that the propulsion phase as described by Root
becomes very minimal in existence, if it even occurs at all.
Good Form Running provides training to adopt this
style of running and we can see that by developing forward momentum, we carry the
contralateral limb forward instead of having forefoot propulsion.30 By doing this, we
decrease the force present to the forefoot, especially the shear force. Not only is this
beneficial for reduction of the shear force but we see a decrease in the ground
reactive forces acting on the first metatarsophalangeal joint, which can reduce
sesamoiditis.

9. I run long distance and cannot do that barefoot. What many of us fail to realize is
that we have been running for thousands of years and we know that early runners
began running either barefoot or with very minimal shoegear such as moccasins.31
In 1960, Abebe Bikila won the Olympic Marathon in a record time of 2:15:16.2 while
running barefoot. Zola Budd recorded numerous middle distance world records
while running barefoot in the 1980s. Ken Saxton (well known among the subculture
of barefoot runners) finished 14 marathons in 2006 unshod and has since completed
a total of 56 marathons, including the Boston Marathon, all while running barefoot..

10. You could step on glass. This is my favorite excuse for not running barefoot.
Numerous times, people ask me the question of “what happens if you step on
glass?” There is debate on this topic among medical professionals as well as early
adopters to this style of running. What is my answer? “Don’t step on glass.” This
concept of “barefoot running” is not about what you are wearing on your foot. It is
about how you are running and allowing the foot to perform the way it was designed
and intended to perform. Once the form is perfected and the runner abandons heel
strike (which runners can typically learn on a treadmill barefoot), the next step is to
protect the skin of our foot while not compromising the proprioceptive feedback from
ground.

There are numerous options available that have recently become known as
minimalist shoegear. FiveFingers (Vibram), Minimus (New Balance) and the Trail
Glove (Merrell) are just a few of these shoes.FiveFingers has quickly become the
market share leader due to its ability to allow the toes to function individually and
allow full range of motion of the forefoot as well as the midfoot and rearfoot joints
with a zero drop. Nike as well was one of the very first to introduce a less
supportive shoe in 2004 known as the Nike Free. While this is a very flexible and
non-supportive shoe, it does have a considerable amount of cushioning, which can
interfere with feedback and increase muscle recruitment to provide control.
In Summary
Barefoot running is about learning to run the way our body was intended to using the
foot as an ideal shock absorber and not relying on a shoe that compromises the
anatomical position of the foot and places one at risk for injury. Using a true
minimalist running shoe can achieve this and still protect the foot from the
environmental dangers.

References
1. Giuliani J, Masini B, Alitz C, Owens BD. Barefoot-simulating footwear associated
with metatarsal stress injury in 2 runners. Orthopedics. 2011 Jul 7;34(7):e320-3. doi:
10.3928/01477447-20110526-25. 2. Edwards WB, Taylor D, Rudolphi TJ, Gillette
JC, Derrick TR. Effects of stride length and running mileage on a probabilistic stress
fracture model. Med Sci Sports Exerc. 2009 Dec;41(12):2177-84. 3. Stedman’s
Medical Dictionary, 28th edition. Lippincott, Williams and Wilkins, Philadelphia, 2005.
4. Wolff J. “The Law of Bone Remodeling”. Berlin Heidelberg New York: Springer,
1986 (Translation of the German 1892 edition). 5. Lees A, Lake M, Klenerman L.
Shock absorption during forefoot running and its relationship to medial longitudinal
arch height. Foot Ankle Int. 2005;26(12):1081-8. 6. Lieberman DE, Venkadesan M,
Werbel WA, Daoud AI, D’Andrea S, Davis IS, Mang’eni RO, Pitsiladis Y. Foot strike
patterns and collision forces in habitually barefoot versus shod runners. Nature.
2010;463(7280):531-5. 7. Kerrigan DC, Franz JR, Keenan GS, Dicharry J, Della
Croce U, Wilder RP. The effect of running shoes on lower extremity joint torques.
PMR. 2009 Dec;1(12):1058-63. 8. http://en.wikipedia.org/wiki/Elliptical_trainer <Actinic:Variable Name = '6'/> 9.
Burnfield JM, Shu Y, Buster T, Taylor A.Similarity of joint kinematics and muscle
demands between elliptical training and walking: implications for practice. Phys Ther.
2010;90(2):289-305. 10. Lu TW, Chien HL, Chen HL. Joint loading in the lower
extremities during elliptical exercise. Med Sci Sports Exerc. 2007;39(9):1651-8. 11.
D’Lima DD, Steklov N, Patil S, Colwell CW Jr. The Mark Coventry Award: in vivo
knee forces during recreation and exercise after knee arthroplasty. Clin Orthop Relat
Res. 2008;466(11):2605-11. 12. Franz JR, Dicharry J, Riley PO, Jackson K, Wilder
RP, Kerrigan DC. The influence of arch supports on knee torques relevant to knee
osteoarthritis. Med Sci Sports Exerc. 2008 May;40(5):913-7. 13. Burkett LN, Kohrt
WM, Buchbinder R. Effects of shoes and foot orthotics on VO2 and selected frontal
plane knee kinematics. Med Sci Sports Exerc. 1985;17(1):158-63. 14. Bennell KL,
Bowles KA, Payne C, Cicuttini F, Williamson E, Forbes A, Hanna F, Davies-Tuck M,
Harris A, Hinman RS. Lateral wedge insoles for medial knee osteoarthritis: 12 month
randomised controlled trial. BMJ. 2011 May 18;342:d2912. doi: 10.1136/bmj.d2912.
15. Radzimski AO, Mündermann A, Sole G. Effect of footwear on the external knee
adduction moment – A systematic review. Knee. 2011 Jul 4. [Epub ahead of print]
16. Stackhouse CL, Davis IM, Hamill J. Orthotic intervention in forefoot and rearfoot
strike running patterns. Clin Biomech (Bristol, Avon). 2004;19(1):64-70. 17. Fields
KB, Sykes JC, Walker KM, Jackson JC. Prevention of running injuries. Curr Sports
Med Rep. 2010;9(3):176-82. 18. Gross ML, Napoli RC. Treatment of lower extremity
injuries with orthotic shoe inserts. An overview. Sports Med. 1993;15(1):66-70. 19.
Kilmartin TE, Wallace WA. The scientific basis for the use of biomechanical foot
orthoses in the treatment of lower limb sports injuries–a review of the literature. Br J
Sports Med. 1994;28(3):180-4. 20. Razeghi M, Batt ME. Biomechanical analysis of
the effect of orthotic shoe inserts: a review of the literature. Sports Med.
2000;29(6):425-38. 21. Jung DY, Kim MH, Koh EK, Kwon OY, Cynn HS, Lee WH. A
comparison in the muscle activity of the abductor hallucis and the medial longitudinal
arch angle during toe curl and short foot exercises. Phys Ther Sport. 2011;12(1):30-
5. 22. Headlee DL, Leonard JL, Hart JM, Ingersoll CD, Hertel J. Fatigue of the
plantar intrinsic foot muscles increases navicular drop. J Electromyogr Kinesiol. 2008
Jun;18(3):420-5. 23. Wong YS. Influence of the abductor hallucis muscle on the
medial arch of the foot: a kinematic and anatomical cadaver study. Foot Ankle Int.
2007;28(5):617-20. 24. Fiolkowski P, Brunt D, Bishop M, Woo R, Horodyski M.
Intrinsic pedal musculature support of the medial longitudinal arch: an
electromyography study. J Foot Ankle Surg. 2003;42(6):327-33. 25. Emmerich J,
Wülker N, Hurschler C. Influence of the posterior tibial tendon on the medial arch of
the foot: an in vitro kinetic and kinematic study. Biomed Tech (Berl). 2003;48(4):97-
105. 26. Waldecker U. Plantar fat pad atrophy: a cause of metatarsalgia? J Foot
Ankle Surg. 2001;40(1):21-7. 27. Waldecker U, Lehr HA. Is there histomorphological
evidence of plantar metatarsal fat pad atrophy in patients with diabetes? J Foot
Ankle Surg. 2009;48(6):648-52. 28. Mickle KJ, Munro BJ, Lord SR, Menz HB, Steele
JR. Soft tissue thickness under the metatarsal heads is reduced in older people with
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Weed JH. Normal and Abnormal Function of the Foot -Volume 2. Clinical
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<Actinic:Variable Name = '7'/> 31. http://en.wikipedia.org/wiki/Shoe <Actinic:Variable Name = '8'/> 32.
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Enhancing Natural Pronation Control

Enhancing Natural Pronation
Control

Your Feet Were Designed
to Do Just That!



This piece is from Dr Mark Cucuzzella from “The Natural Running Centre .com” see
our link in the partners links section
The human foot is "a remarkable engineering feat."
When customers enter Footworks / Barefootworks, questions always arise about pronation. Many
of them in the past have been labeled pronators by well-meaning employees at other
running stores. Some claim that they have classified as supinators. They want
shoes that fit. They want to run injury-free. Yet it’s not something as simple as
asking them to walk or jog ten steps across the store floor, and come up with an
instant diagnosis.

This kind of evaluation won’t help the runner find the right shoe.
So the first thing we do with these customers is have a conversation. We explain
what pronation is. Then, we discuss the shoe-fitting process. We don’t rush through
this either. Every runner is unique. Some will need shoes with greater or lesser
support and mobility control, depending on his or foot strength.
Pronation is a normal function in the gait cycle, just as bending the knee or extending
the hip. Pronation control can be achieved with your foot (ideally), with a shoe/insert
(maybe), or both. Maximum pronation actually occurs when your heel is off the
ground, so the foot’s role in this is critical.
Let’s start with the foot itself, a remarkable engineering feat as described by
Leonardo DaVinci: 28 bones, 4 arches, and the accompanying muscles and
ligaments make the foot the “quarterback” of all motion. The foot is not locked in
place to hand the ball off to other parts of the kinetic chain, but rather dynamically
moves to balance, stabilize, and propel one forward. The actions are controlled by
our muscles and our brain, hence the term neuromuscular control.
Your arches are mobile, absorbing shock and then stabilizing the foot when you walk
and run. In normal pronation the arch flattens (notice I did not say collapse) in
midstance as a natural shock absorption mechanism. The foot unlocks and splays to
spread out the load. Two structures are at work here. The plantar fascia is a tendon
(it cannot actively shorten or lengthen) and provides restraint to maintain structural
support to the foot. The critical muscle is the Flexor Hallicus Brevus (FHB) which
contracts to stabilize the arch throughout the stance phase. During toe off the plantar
fascia and FHB assist supination, or locking of the foot, to allow takeoff on a rigid
lever.
Children running barefoot naturally feel the ground and reflexively their muscles work
to provide the pronation control. Runners (with or without shoes) who have strong
feet have the ability to control the motion just fine. The foot works best when it
receives sensory information on where it’s landing, and a firm surface is best for
feedback. Overly soft shoes delay the feedback Remember that a runner’s foot is
on the ground for only .15 to .17 seconds, so the pronation control must be
immediate and strong.
For most modern-day runners, spending a lifetime in stiff, overly cushioned, and
supportive shoes has diminished their natural pronation control. The shoe has
assisted or determined their pronation control.
To see for yourself. Try standing on one foot on the ball and balancing. Can you
hold the position for a second? Ten seconds? Thirty seconds? Can you pop off the
ground with springy recoil while jumping rope? If you are having difficulty, then you
may need to take certain measures if you want to transition to more natural pronation
control and run in a true minimalist shoe.
Why is natural pronation control better? The foot is the magic spring that adds
elastic recoil to our stride. This is free energy. When the foot is constricted by a rigid
shoe, it cannot work as a spring and you need to apply more muscle to the
stride. More muscle use is equated to more fatigue; and consequently there’s
potential for more injury.
So my recommendation to all runners is to make a gradual transition if you want to
strengthen your feet. Do plenty of walking barefoot and in minimalist shoes. Start
the running transition slowly and remember your muscles, tendons, ligaments, and
bones are adapting and do not have the capacity for the added load yet. Think it as
if a farmer had given you a calf when it was born. Every day you lift the calf. Within
two years you are lifting a cow. Do supplemental foot strengthening through the day.
Stand on one foot, balance on the ball, walk barefoot in the house and outdoors
where you can. This can only help your running. You may have a little soreness like
with any new training. Tissues are lengthening and strengthening. Extreme
soreness means you are progressing too quickly and asking the tissues to do too
much too soon.