SPORTS MEDICINE: There are many sports injuries that have their origin with over pronation or supination

Your feet form the foundation of the body. It is from these 52 bones, 66 joints, 214 ligaments and 38 muscles that we are able to propel ourselves through our daily lives. Further, the average person takes 8,000 to 10,000 steps per day. It is no wonder that when the foot begins to hurt, we take notice and want it resolved quickly.

In the work and sports world, the foot takes the brunt of the everyday stresses on the body. Think about the role the foot plays in hockey, especially on synthetic surfaces. Players may often think that it is normal to have sore feet. However faulty foot mechanics can cause extensive foot ailments. It is therefore important that hockey players have base knowledge when it comes to foot mechanics to identify any major foot inefficiency that may result in a number of foot injuries if left unattended.

The foot offers the body two very important functions. The first is stability. It provides a solid base of support (keeps us up against gravity) and a rigid lever for moving the body forward. This is called supination. Supination is a normal part of the gait cycle (walking/running) which allows the foot to form a rigid structure for propulsion. The second function is mobility. This allows for shock absorption, maximum contact with the ground with uneven terrain and allows unusual forces in the hips and knees to be absorbed. This called pronation. Pronation is a normal part of the gait cycle which helps to provide shock absorption at the foot.

The anatomy of a normal foot allows for both to occur at the same time. Approximately 30% of the population have a normal foot. The remainder of people either overpronate (95% of abnormal feet) or oversupinate (5% of abnormal feet). The important thing to know is that all feet pronate and supinate, but abnormal feet do one of these things too much or at the wrong time.

When the foot overpronates or oversupinates, several foot ailments can develop.

  1. plantar fasciitis (heel spurs)
  2. hallux valgus (bunions)
  3. achilles tendonitis
  4. corns, calluses and hammer toes
  5. navicular apophysitis
  6. shin splints
  7. fractures in the 1st and 2nd toes
  8. medial knee pain and patellofemoral dysfunction (improper tracking of the knee cap)
  9. hip pain
  10. low back pain.

How can I tell if I over pronate? How can I tell if I over supinate?


Over pronation wear on hockey shoes

A simple test for over pronation is to look at your hockey shoes. If they are worn on the inside of the sole in particular, then pronation may be a problem for you.


Over supination wear on hockey shoes

A simple test for over supination is also to look at your running shoes. If they are worn on the outside of the sole, especially on the forefoot area, then supination may be excessive when you run

However the best way to determine  if you over pronate or over supinate is to visit a sports therapist who can do a full gait analysis on a treadmill or using force plates measuring exactly the forces and angles of the foot whilst running. It is not only the amount of over pronation or over supination which is important but the timing of it during the gait cycle as well that needs to be assessed.

Correcting over pronation and over supination

If you over pronate, get an extra medial support. Many sports shoes have a harder material on the inside of the midsole (the thick hard foam part of the running shoe). This means the inside of the shoe will be compressed less under load and support the inside of the foot preventing it from rolling in or flattening. For over supination you need a highly cushioned and flexible sports shoe to make up for the lack of shock absorption at your foot. Visit a specialist running shoe shop where they can look at your feet and running style and advice on shoes for over pronation and over supination.


orthotic

For people with considerable over pronation or over supination, another option is to have an orthotic device fitted. Orthotic insoles come in many types and prices. Some are pre-molded and can be bought off the shelf. These can be inserted into your hockey shoe. The alternative is a customised orthotic made specifically for your feet condition. Specialist sports therapists, e.g., podiatrists can assist with this requirement.

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