Five Red Flags of Pronation

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There are Five Red Flags or signs of Pronation. If these signs are ignored and left untreated, foot problems can adversely affect the entire body.

This is a perfect example of how pronation can affect the entire body. Moving from the ground up, a person who shows signs of pronation can have imbalances throughout the body including internal knee rotation, pelvis tilt, and dropped shoulder. This imbalance can lead to larger issues like pain.

Foot Flare

All pronators walk with foot flare or toe out. The reason for this is that pronation is developed slowly over a period of years, where the everters become dominant over the inverters.

Internal Knee Rotation

When the feet are flat on the floor the lower extremity has its greatest distortion with the feet bilateral and asymmetrically pronated internal tibial and femural rotation. Therefore if the foot, knee, and hip were in their optimal alignment, one could drop a plum-bob from the middle of the patella and it should hit the second toe. But in an excessively pronated foot, that plum-bob is medial, to the medial longitudinal arch.

Bowed Achilles Tendons

From a p-to-a view, the ankle and foot appear to roll inwards, causing a bowing of the Achilles tendons. These tendons will plastically deform over time.

Flat Foot

At mid-stance, where the heel and toe are both in contact with the floor, the patient will demonstrate the greatest degree of pronation. At mid-stance, all three arches of the foot have decreased their height, creating a longer, wider, and flatter foot.

Uneven Heel Wear

In the typical, bi-laterally asymmetrically pronated foot, the heel strike will be uneven, creating uneven or asymmetrical heel wear.

Start looking for these 5 Red Flags in all your patients; they’ll be glad you did as you address problems causing them discomfort or pain.

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