PT on the Net Research

Over Pronation and Running


Question:

I have a client who likes going for regular long runs. He is 28 years old, 5 feet 7 inches and weighs 11 stone (154 pounds). He likes doing hypertrophy training. He over pronates too much on his left foot, but his right foot is in much better alignment. He has bought a pair of proper running trainers to support the flat arch but complains of soreness on the tibialis anterior. I have used stretching to try and relieve the muscle soreness. It works for a while then comes back a few days later when he is at light active rest. Is there any way of stabilizing and correcting his heavy pronation on the left foot through weight training as I feel the imbalance may start causing injuries elsewhere on my client. Please help.

Answer:

Thanks for your client concern. An “over pronation” distortion pattern is tough to analyze unless seen with the exact task at hand, unless his over pronated foot is structural. The point is, there is a difference between a structural and functional over pronation or a rigid versus flexible flat footed appearance. For the sake of your question, let’s assume his problem is more functional or flexible, which means his foot in non weight bearing and displays a normal arch yet in weight bearing the arch collapses. I would first recommend changing his shoe wear to an Asics DS Trainer if his foot is not too wide (the shoe is narrow) or an Asics Nimbus or Asics 2110 with a Power Step by Pinnacle insert. In addition, I would strongly recommend following the following tips while running. Many people who experience over stress while running neglect to understand what running is: a controlled fall. This means if you want to run more efficiently (decrease stress), you must learn to fall correctly (not face plant). Follow the below tips:

  1. Change support quickly from one leg to another.
  2. Raise the ankle straight up under the hips.
  3. Make your support time short.
  4. Retain your support easy, effortlessly, light.
  5. Keep your support and body weight on balls of your feet (midfoot).
  6. Don’t touch the ground with heels; keep them slightly above the ground.
  7. Don’t move your weight to toes, pull your ankle up, when weight is on ball of feet.
  8. When on support, keep your feet behind vertical line going through the knees.
  9. Don’t try to increase stride length or range of motion to increase your speed.
  10. Don’t move your knees and thighs too far apart, forward and backward, during stride.
  11. Don’t point toes and don’t land on them.
  12. Your legs should land themselves without any muscle activity, just by the pull of gravity.
  13. Keep shoulders, hips and ankles along one vertical line.
  14. Don’t push off or toe off, LIFT only.
  15. Keep your body leaning forward and FREE FALLING.
  16. Adjust the volume of training based on monitoring his adaptation.

To answer your question: “Is there any way of stabilizing and correcting his heavy pronation on the left foot through weight training as I feel the imbalance may start causing injuries elsewhere on my client?” Yes, help his structure and teach him proper technique relative to the EXACT task; in his case, running. If you attempt to stretch and “strengthen” in a non specific manner (strengthening muscles as opposed to exact tasks), then the results are questionable. In addition to the above, I would recommend looking into Gary Gray’s Functional Video Digest on Running.

Good luck!