The biomechanical effects of pronated foot‐function on gait

Science ⋅ August 10, 2020

This brand new study has just been published

It just goes to show that what we thought we new, we really did not, or, at least a researcher somewhere is willing to propose an opposing point of view.

Which, is the whole point of science and research!

One of the REALLY interesting things about this study is that they define foot pronation (FP) as a whole of foot motion.. quite right, but for many of us we have been trapped into thinking is it all about the subtalar joint and rearfoot motion!

The primary aim of this study was to determine whether FP function modifies lower  limb kinematics during gait. Secondary aims were to describe the kinematics of the foot and plantar pressure distributions in FP function.

Based on previous studies, the researchers hypothesized that there would be increases in 1) knee and hip internal rotation and anterior pelvic tilt, 2) hindfoot eversion and forefoot supination and 3) pressure underneath the medial heel and the medial forefoot would be increased in FP.

154 subjects were included in the study which revealed

that pronated foot-function alters lower limb and foot kinematics and plantar pressure distributions during gait

The diagnosis of FP was robust since two methods were used to determine foot-function type (the The Foot Posture Index and the Center of pressure Excursion Index.)

This study has important clinical implications relating to the understanding of both foot and lower limb movement in individuals with pronated foot-function.

This work

confirmed the importance of studying transverse plane forefoot motion in pronated foot-function

We have discussed this previously, particularly in the context of Professor Benno Nigg having very similar thoughts..

The results suggest that individuals with pronated foot-function, though asymptomatic, may have a greater risk of lower limb MSD due to the increase in forefoot abduction.

This is an experimental study, and a LOT more work is required. There remain fundamental issues with the way we view, analyse, measure and talk about “foot pronation”.

However, although the  result  of this study requires confirmation, pronated foot-function could alter lower limb and pelvic kinematics and increase constraints on the knee and the lumbar region.

The authors therefore suggest that foot-function should be evaluated as part of a holistic assessment in the case of knee injury or low back pain.

 

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Simon Bartold