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Showing results for tags 'pronation'.
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We have had many students start our classes (stretching and strengthening) with 'flat feet' and most have had the form and function of the feet improved significantly. One young man had ankles that pronated so much that he had developed bunions (painfully enlarged joints of both big toes), and the big toes had deviated over 45 degrees away from the midline of the body. Now, three years later (using Five Fingers and a lot of kettlebell work), he now has perfect arches, the swelling and enlargement of the joints has diminished, and he has run two 10km fun runs on asphalt and concrete in his Five Fingers. His feet are perfectly aligned; his arches are developed and supple, and all his toes separate voluntarily. An aside: most people who have been identified (or "diagnosed") with "flat feet" really have pronating ankles, and not the medial displacement of any of the bones of the feet (talus and navicular, usually that the term properly applies to). True flat feet are rare. When most people (and too many experts, IMHO) use the term, they mean pronating ankles: the whole leg has internally rotated in the hip joint; as this happens, the arch of any foot will flatten, and some collapse. Speaking generally, the pronated ankle is a lower energy configuration of the foot, and this is why exercising barefoot (or in FFs) on gravel or similar sharp surfaces has such a strong effect on foot placement: the body is doing all it can to unweight the sole of the foot—and creating the arch is part of what happens when the weight is spread from the inside border of the foot (pronation) to the whole of the foot (good alignment. What follows is the first drill: If you stand, and close your eyes, ask yourself 'where do I feel the weight going through my feet?' If you are like most people, most of the weight goes through the big toe side of the foot, and the heel. Now, lift the toes off the floor, and deliberately put a bit more weight on the outside of the front of the foot, and look down at your feet: notice how the ankle and arch are better aligned? And notice how that realignment takes no muscular effort? Now stand in front of a mirror and repeat the exercise (adding weight to the outside of the foot, and follow that with letting the foot roll in. If you watch, you will see that this is a whole-leg movement, mediated by the external rotators of the hip joint and the movement does not come from the foot itself. In fact, as you externally rotate your thighs, the weight moves to the outside of the foot, and the arch forms. If you have pronating ankles, somewhere in the past, the body has made a choice about where to position the foot (on the internally–externally rotated axis); and the foot adapts to this. The main reasons for the body to make this positional choice (alignment of the femur in the hip joint) are two: tight hip flexors and insufficient stimulation of the soles of the feet during childhood and adolescence. All babies have flat feet; most adults have some pronation, especially under load; and if the pronation is controlled well by the body, it is part of the shock-absorbing mechanism we need for walking and running, as well as the critical mechanism for weight distribution (and obstacle avoiding!). So: step two is to stretch the hip flexors—not easy to do on your own. We recommend a partner exercise, to begin with: And step three, last for today, is to do a foot-strengthening/hip–leg alignment exercise. All you need is bare feet and a set of stairs: put the ball of one foot on the edge of the step, place the other behind this leg, and hold a rail. Straighten the supporting leg's knee. Slowly let the heel move below the level of the stair tread (so, a soleus and gastrocnemius stretch). If your calf muscles are tight, then do small contractions with the calf muscles, and then press the heel lower as you relax and breathe. This is part one. Part two is the strengthening–realigning part: this time as you lower, deliberately let the ankle pronate. Feel where the weight is going through your foot: all on the inside, and under the joint of the big toe. Now, as you press the ball of the foot into the tread to lift the body, transfer some weight to the the outside of the foot so that as you pass the neutral point (normal standing position for the foot and leg): now the ankle will be perfectly alighted, with weight evenly spread across the front of the foot. Pause. Then, as you rise, transfer slightly more weight to the outside (this activates the peroneal tibialis posterior (thanks to slizzardman from Coach Sommer's forums for the correction) muscles strongly, in addition to the two calf muscles). At the top, plantar flexed, position, hold, and feel where the weight is: more will be on the outside than the inside (but don't exaggerate this); and press harder until the muscles spasm momentarily, then lower the heel to stretch that cramp out. Just shot the video today: The suggestion to let the muscles cramp might sound a bit intense, but an involuntary cramp activates the largest numbers of the involved fibres, and the strengthening/realigning effect is maximised. You only need a few repetitions. Once you have done both legs, walk around on a surface that gives you feedback (I like gravel!); you will immediately feel that the feet are contacting the floor differently. This is enough to go on with, and if there's interest, I will add some intrinsic foot muscle–toe spreading drills, too. Regards KL
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A bit of background to why I'm asking the question: I've had problems with the arches of my feet for most of my life and especially the left main arch - Extremely sharp pains I now believe from too much collapse. In the past year or so I found out my left leg is the longer leg. I injured my big toe of the left foot several times around 3 years ago which led to the end joint not moving. I've managed to get a little passive movement back and lately a tiny bit of active movement. I hadn't had that arch pain for about 10 years but it came back a couple of weeks ago. The compensations were huge as I guess my CNS really didn't want it to happen again? I started bearing weight on the outside of my foot and got outside knee pain. I just couldn't walk naturally at all, all the memories of over 10 years ago came flooding back. What I believe contributed to the pain returning was I bought some new minimal shoes and unlike the rest of my shoes I forgot to put a 4mm heel raise in the right shoe. I had been wearing these a lot and had been on my feet more than usual. Also I had been trying to gain some flexibility in the dorsiflexion of my toes so perhaps overstretching my weak arch? So getting onto the subject question, I noticed my left foot is a lot weaker at 'scrunching' the toes/pushing through the toes. When walking, should I be pushing through the big toe (or any toes)? At the moment I don't with either foot, my toes are pretty much passengers that just get walked on. The ball of the foot behind my big toe is baby soft on each foot and looks like I've never walked on them, wheres behind the middle 3 has a fair bit of callusing - Collapsed front arch I guess. I feel that if I were to more actively use my toes / big toe I'd actually bear some weight behind the big toe and not so much weight through the ball of the foot behind the middle 3.
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Very interested to see this new video - primarily for myself rather than my students (though I'm going to have a close look at foot pronation in the class in case it would be useful for anyone - and we'll do something similar anyway if I can fit it into the space available). As Kit may know, I pronate on both feet, on one so badly that the tendon of the tibialis posterior ruptured. A surgical repair would mean reconstructing the foot - taking tendons from elsewhere and redirecting them. The surgeon (thankfully) did not want to do this - in fact they were impressed that I had as much function as I have. I ascribe this to doing calf rises in ballet (though it was ballet that was the last straw in screwing it up in the first place). These are rather like faster versions of the exercise illustrated, though it starts from a flat foot and the rise was not usually held. However I am pleased to find that doing a few slower ones has led to a rapid improvement. Thank you! A couple of questions: 1. How important is it that you hold it till the muscle cramps? I can hold it quite a long time, and it gets tired, but does not cramp. Or am I just a wimp (i.e. giving up too soon)? Are a few repetitions held for a long time best, rather than the multiply repeated rapid "bobbing up" that I have been doing? 2. What then is the function of the posterior tibialis? It is often said that it is to "hold up the arch". However, I do not understand this from the geometry. As the p.t. tendon goes round the ankle, it runs forward horizontally (so at that point can only pull back) and then turns inwards to run almost horiztontally towards the midline of the foot. So here if anything it would seem to pull the arch medially - or I think more likely, the overall effect is instead to pull the ankle laterally in relation to the arch (rotating it laterally over the heel), helping to keep the arch and ankle in one line which is how they should be (i.e to stop the ankle collapsing inwards - to the body's midline). Could this be right? 3. What are the points that Kit mentioned in the video about alignment at the hips affecting pronation? How should we be aware of errors here? Please can we have more details on this point? Anyway, greetings, many thanks, and best wishes, Jim.