is pronation really understood?

PRONATION

I played rugy from my 20th to 35th year of life. My place was winger for which you had to start quickly and run very fast. What I did. Someone once told me that I was sprinting like an Indian runner. Without heel contact, only on the fore-/midfoot; untrained only on the short distance. Now,  after being ‘foot-active’ for almost a whole life, I question the general naming and definition of pronation as an abnormality or illness.

posturology since early nineties

THE RELATIONSHIP BETWEEN  SEEING AND THE HUMAN POSTURE

by Peter W.B. Oomens (posturologist)

relationship seeing and posture

Introduction:

More then twenty years I had a practice in podopostural therapy, during which I have treated patients with posture related disorders, often chronic or asymptomatic. After a thorough, physical examination I provided my patients with very thin insoles on which I glued pieces of cork at a thickness of 1 à 2 mm. These subtle insoles have a disproportionate influence on people’s posture, immediate, objective, measurable and repeatable. The cork elements are placed under plantar intrinsic foot muscles. During stance and walking these elements trigger the baroreceptors in the glabrous skin of the foot sole. This therapy is practiced in the Netherlands from early eighties. During that time, I was more and more consulted by parents for their children.

 

Leg length discrepancy: not always implicate a shorter leg!

Leg length discrepancy: not always implicate a shorter leg!

Numerous articles and comments have been written on leg length discrepancy (LLD).  How to measure it, how to test it, how to treat it.

I have often been consulted by patients who, according to their physician or therapist, should have a leg length discrepancy. Which was not seen before or even ignored. The majority had no medical history of broken legs or complicated fractures. Testing them  both laying and standing I measured indeed this LLD.

Seeing  back  many of them the before measured length  not only seemed to be changed, but also the leg itself!  At that time we made so-called podograms on which you could see the pressure of the feet. Today this registration is all ict.

These length changes  were so frequent that there must be a pattern. As manual therapist and posturologist I am used to think 3 D (threedimensional).

laying

In many cases I then noticed a pelvis rotation around the longitudinal body axis. I asked the laying patient to bend both knees, resting the feet, leaving the knees free to move. Almost always one or both knees moved to one side.   A lumbar support under the loins towards the pelvis was rotating, made, nine out of ten times, makes the LLD disappear. In my experience this was not a ‘real’ LLD but a ‘physiological’. Many professionals, for instance hairdressers, stand their whole working life most on one leg. The muscles of the foot/leg/hip at that side contract and a ‘created LLD’ is born! Do not start to treat this as a shorter leg by means of heel orthotics because the pelvis will rotate even more!! the pelvis has to be corrected by a contra-rotation.

June, 2019.

PRONATION  really understood?

Imagine,

  • you walk barefoot on, for example, sand
  • you leave visible footprints of the heelstrike and caput metatarsalia behind
  • you expect a (pronation) impression at the medial length arch 
  • you see the opposite, the lateral impression is deeper
  • the medial arch is most of the time not even visible at pronation 
  • pronation is a natural and therefore normal phenomenon and no illnes
  • that the anti-pronation does not make sense and may even be a contra-indication