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·Excessive Pronation Villain To Leg, Knee, .Ankle
~R. GABE MIRtiN
·~·rAt~A.RSHALL HOFFMAN <>J978, C3be Mirkin and Marshall Hoffman ·
When you run, you land first. on your ;1eel; as·the foot moves forward, your weight transfers tO the outsl• :e part of your foot. Then your foot nlls inward so that all your weig~· t Is shifted to the inside bottom r-·ut of your foot. It ls this roll .. ing inward, called pronation, that distributes the force of a footstrike thr.oughout the entire foot and leg. J><Ot that appear to be flat usual. 'ly roll inward excessively. This is caur..t excessive pronation and it's this e.:mdltion that is the villain be-. hin.ct many injuries to the ankles, kne~s. hips, bones and muscles. The major purpose of athletic . shoes is to limit pronation._ To acc;o'llplish this, a good shoe should hn"e n fl:1red heel for sta.bllity and a
• sparISIDed•ICIOB '
cookie to support the arch. A stiff Achilles counter, a tight collar and a good saddle help to stabUize the foot in the shoe. To limit pronation, it must fit like a glove. Thick socks prevent the shoe from fitting snugly ' and should never be worn. THE MOST common injury caus-
ed by excessive pronation is runmer's knee, sometimes also known as basketball knee, characterized by pain bel1ind the knee during exercise. Excessive pronation exaggerates the normal twisting inward of the lower leg. This, in turn, causes the kneecao to r~b painfully against the long bone of the thigh.
Runner's knee has been mistakenly te~med Patella Chrondromalacia, which means a softening of the cartilage behind the kneecap. 'ORTHOTICS
An orthotic is a special-shoe insert made from a cast of the patient's foot. It looks like an arch support. Acry,llc posts under the heel restrict the foot from rolling inward excessively. By preventing the arch from going flat, most painful injuries can be eliminated. · Besides knee problems, orthotics are used to treat certain back, hip, ankle, arch and foot conditions. Orthotics can be obtained from a podiatrist or ari orthopedist for $75 to $150. To save money, you may want t!) try a1,1 arch support first. HIGH-ARCHED FEET
People with high-arched feet
don't pronate enough to distribute the footstrlke throughout the entire leg. / The treatment is to cushion the toot with thick-soled shoes fitted wlth an arch support made from soft, pliable material. People with limited pronation should also run on soft ground and avoid running .on concrete. Because orthotics will further restrict pronation, they usually are ineffective in treating a high-arched f~t. BOWLEGS, KNOCK-KNEES
Stand up straight with your heels together. If the space between your knees is greater than the width of two fingers, 'you are bowlegged and susceptible to low-back pain. If you are bowlegged, your illopsoas muscle, which runs from your , pelvis to the upper inner part of
your thigh, is usually shortened. When you run, it tilts your pelvis forward. This increases the curvature of your spine and can cause low-back pain. The treatment is to stretch the Ulopsoas muscles. Stand up straight with your knees together. Do you have trouble putting your heels ~gether? If you do, you have knock-knees and are more susceptible to pains on the inner part of your knees. UNEQUAL LEG LENGTHS
A difference as little as a r:
quarter-inch between the length of each of your legs can cause pain in; the hlp, low back and back of the , leg. When one leg,is shorter than other, your.pelvis tilts laterally$ ... ward the shorter leg, creating pre"t-:·· sure and pain on the hip joint of the longer leg. The tilted pelvis also twists the spinal column and short_. ens the space between the vertebral bodies, which pinches U).e nerves that pass between them. The ligaments that hold the vertebral. bodies in place can be strained and cause pain in the back.