Supination and Pronation - does it really matter?
When we see a new patient part of the process of diagnosis is to take a look at the patients posture to see how they stand at ease. This is to get an idea of how the body is adapting to pain or an injury and to try and get an idea why that particular area became injured in the first place! Your body is always adapting so you constantly have the optimal posture for the present time.
Patients are often surprised when we look at how their feet are positioned and will often say things such as 'I know my feet are flat - I've been told that I over-pronate in the past'.
But what does that actually mean? So what if you over-pronate? Does it affect your diagnosis or treatment?
With pronation, when you walk the foot rolls inwards. This is actually a perfectly normal part of the gait cycle. The problems occur when your foot rolls inwards too far (over-pronation), or does not roll inwards enough (supination).
With over-pronation the foot arch flattens out and stretches the muscles, tendons and ligaments underneath the foot. The arch acts as a shock absorber and if it is not able to do this the force may travel to your legs, knees, hips, and spine. Your foot rolling inwards can cause your leg to twist inwards too, putting extra stress on the inside of your knee.
With supination there is more of an outward roll of the foot and forces of impact are concentrated on the outside edge of the foot and are not distributed as efficiently.
This places a large strain on the muscles and tendons that stabilize the ankle, and can lead to additional strain to the lateral ankle ligaments and lateral knee.
So, if you have knee, ankle or hip pain or injury then yes, how you walk and your arches could be very important and if you were presenting with back pain then it could also be of relevance. If you were on your feet a lot during the day or were a runner or keen walker then how your body deals with force from the ground is of particular importance and you will be asked about what shoes you wear whilst doing activities and at work.
Ultimately an osteopath is concerned with your biomechanics - how you move and ensuring its efficiency. Your posture is a very important part of this and so yes, the fact that you over-pronate is of interest to us!