This is a condition in which the fascia that surround the muscles on the anterior part of the leg appear to be tight, so that during exercise when the muscle tries to expand, it can’t. This can become painful and gets known as anterior compartment syndrome or chronic exertional compartment syndrome. Typical the only satisfactory treatment for this has been a surgical release of the fascia as conservative treatments never seemed to work very well. This topic has been generating a lot of interest lately due to the using of changing the running gait appearing to be very successful at managing this. The trend has been to use forefoot striking rather than heel striking and shortening the stride length and increasing the cadence. A non-controlled study show that this is to be very effective and a lot of good clinical experience is supporting it use.
This is a concept that has been getting increased attention in recent years in clinical practice. It is a concept and clinical test of determining how hard it is to supinate the foot based on the assumption that the harder the force is, then if a foot orthotic is needed for something like, overpronation, then more force needs to come from the foot orthotic; so a rigid firm and inverted type foot orthotic is needed. Similarity if the force is low, then not much force is needed from the foot orthotic, so a soft flexible foot orthotic is indicated.
There has been some research done on it, but not a lot. This is probably limiting its more widespread use in clinical practice. The test for supination resistance does correlate quite well with some pathologies and not others.
The windlass mechanism is an extremely important function in the foot. It is the foot’s own natural arch supporting mechanism, so any inhibition of this mechanism is going to affect the integrity of the foot and it biomechanics. The plantar fascia or plantar aponeurosis attaches to the bottom of the heel and the base of the toes, so spans the arch of the foot to support it. When the heel lifts off the ground the toes bend relative to the metatarsals, so they tighten this plantar fascia, giving stability to the arch and foot during the propulsive phase of gait.
If there is any issues that affect the integrity of the windlass, then there are often consequences. The arch of the foot will not be able to resist the forces that are applied to it during propulsion and will collapse. This can result in a range of different pathologies such as plantar fasciitis. Also while not being able to support the arch will also contribute to any overpronation and the consequences of that.
If there is any sort of dysfunction of the windlass there are a number of different types of interventions that can be used such as lowering the force to get it established or to get the windlass to initiate or start working earlier.
Overpronation is a term that is widely misused and abused outside the podiatry profession. This is especially true in running communities where is is often the basis that underpins the manufacture and use of running shoes. Running shoes are typically designed or mild moderate or severe pronators. The evidence that supports this concept is either very weak or nonexistent. The evidence that shows overpronation is a risk factor for injury in runners is that it is only a very small risk factor. The evidence that running shoes should be prescribed based on the amount of pronation, is that this is not supported.
Pronation is a normal health motion in which the ankle rolls inwards and the arch collapses. Overpronaton is obviously when there is too much of this. No one really knows how much is too much and there are plenty of people who have a lot and have no problems.
A lot has been written on the nonsense and myths. At the same time, there are many people pretending to be gurus on this topic when they clearly do not understand it.
Pursing information on ‘overpronation’ on the web means using your critical thinking skills. Check the source. Check the credibility of who is posting the information. Don’t just believe something because it supports your preconceived biases.
