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A normal gait cycle consists of a stance phase and a swing phase. During the stance phase
of gait, the heel strikes the ground in a slight amount of supination, then quickly changes to
pronation for the extent of the entire foot on the ground. Finally the foot propels forward (or
pushes off) in supination. While the foot is in supination, it is a rigid lever creating a pulley
system with the muscles of the foot to control the amount of motion of the foot, and assist in
effective push off of the foot. This allows propulsion to occur without sending undue stress
up the leg. While the foot is in pronation, the foot can shock absorb effectively and help
dissipate ground reaction forces. Normal pronation allows the foot to become a mobile
adapter during the stance phase of gait. The foot can also adapt to uneven terrain and
assist in maintaining equilibrium while the foot is in pronation.
So pronation and supination are part of normal gait mechanics. It is only when there is
excessive amounts of one motion beyond it’s normal phase of gait. In general, there are
more injury related conditions correlating to pronation than supination.
At midstance normal pronation occurs, the foot acts as a shock absorber, and ground
reaction forces are dissipated. There is no rigidity at this time. When the foot pushes off the
ground, that rigid lever is necessary to propel the body forward. If the foot pushes off the
ground in pronation the ground reaction force is transferred up the body to the knee, hip
and back region, creating undue tension and strain. General complaints with excessive
pronation include feet pain, achiness in the knees or hips, low back pain and other lower
extremity ailments. including circulatory issues. Other biomechanical abnormalities may
occur with excessive pronation including bunion formation, hammer toes and neuromas in
the feet. Medical diagnoses related to excessive pronation include plantarfascitis, posterior
tibial tendonitis, anterior shin splints, meniscus wear and tear, hip joint pathology, and
sacro-iliac joint mal-alignment.


As the foot hits the ground, a variety of abnormal mechanics can occur. One of the primary
forms of abnormal biomechanics is excessive pronation. This occurs when the foot either
hits the ground at heel strike already pronated, or when the foot remains pronated at the
push off phase of gait. Excessive pronation can be congenital, neuromuscular or acquired.
Examples of acquired types of excessive pronation are tight calf muscles or de-conditioned
state of the lower limb. Other types of acquired excessive pronation include poor structural
integrity of shoes, over-training with high impact activities and chronic strain to the ankle
joint itself. All these acquired types of excessive pronation could have been prevented and
can certainly be treated.
Normal Biomechanics
Abnormal Biomechanics
The Problem with Excessive Pronation
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