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Pronation | Analyze your feet | Analyze shoe wear | Products (insoles, orthotics) | Ankle flexibility | Foot Pain | Foot Anatomy

According to the literature only 20% of the population has "normal" feet. Others have non-standard feet which can cause problems with foot or boot fitting, or cause one to suffer from sore knees, hips and/or lower back.
30% of your body's joints are in your feet.

Every step you take puts 2 times your body weight on your foot.
Running puts 3 to 4 times your weight on each step you take.

If your feet become sore from running or walking, you might be tempted to try orthotics--custom-made shoe inserts that take the place of insoles. But orthotics can be expensive and might reduce a shoe's cushioning. Consider whether your problem could be solved with new shoes or a different category of shoe (cushioning, neutral, or stability and motion control).
See Athletic Shoes under products.

Pronation:
Many of the web sites and books are confusing. They lead you to believe that pronation is rotating inward with shoe ware on the inside and supination is rolling outward with wear on the outside of the foot. Here's what actually happens.
1. Almost everyone (98%) is a pronator and rolls inward. Normal is about 15%. Over Pronation is more than 15%. Under pronation (supination) is less than 15%.
2. Everyone's heal strikes first on the outside, in part because your normal running gait is narrower than your hips, so your legs are angled inward. So both under pronators and over pronators have heal ware on the outside.
Because under pronators typically have a high arch they may have less wear on the heel.

The outside part of the heel makes initial contact with the ground. The foot "rolls" inward about fifteen percent, comes in complete contact with the ground, and can support your body weight without any problem. The rolling in of the foot optimally distributes the forces of impact. This movement is called "pronation," and it's critical to proper shock absorption. At the end of the gait cycle, you push off evenly from the front of the foot.

See videos from medical motion and RunnersWorld.

If your feet pronate (roll inward) excessively, a stabilizing or motion-control shoe might minimize the problem. And if your feet don't pronate enough, a cushioning shoe that emphasizes shock absorption might be best. Overpronators typically have a low arch, underpronators (supinators), a high arch, and neutral runners fall somewhere in between.
Source: Athletic shoe guide from Consumer Reports

Analyze your feet:
Wet your feet and stand on a flat surface that will allow your footprint to be seen. Comparing the footprint with Figure below gives an idea regarding pronation.

There are machines with pads you stand on which will measure your arch type and foot pressure, shuch as Dr Scholl's FootMapping machine at stores such as Walmart and Road Runner Sports: Shoe Dog Shoe Finder.

Note: Both analysis are for my feet. ShoeDog's arch analysis did not agree with Dr Scholls and other analysis of my feet. However, ShoeDog has worked for other people.

Analyze shoe wear:
Some people will have neutral feet when standing and walking without weight, but will over-pronate when running greater than 3 miles or backpacking, so you need to examine your old shoes to see how they are wearing.
 
Source: Runner's World and DukeHealth.org

You can get off the shelf support insoles to replace the insoles that came with your shoes or boots such as Spenco or Superfeet. You generally use the same ones whether you are pronated, supinated or have other problems. Or you can get a podiatrist or chiropractor to measure you for custom orthotics at $400 to $500 per pair.

Foot Impression Techniques for custom orthotics:

One knowledgeable foot shop told me they don't actually mold an orthotic to the impression you send in, but look at it and select a pre-made one from a rack.
At Advanced Casting Technology they recommend a weight bearing impression method.


Products (insoles, orthotics):
Superfeet Premium Insoles $40-50
Spenco

Road Runner Sports will create a custom insole heat molded to your foot for $80.
Dr. Scholl's $50
Acor Prefabricated Orthotics (Prefab Orthotic)
eSoles - Custom footbeds at foot-locker's run stores

Boot Doctors:
Many popular ski areas or destinations have a boot doctor who will modify ski boots to make them fit better.
Jim Schaffner at the StartHaus, 10990 Donner Pass Rd Truckee.


Ankle flexibility:
Your foot should flex 15° up from 90° to have the mobility to run without causing problems to connecting tissues with distance running. If not you should start stretching exercises.
Limited dorsiflexion can be caused by soft tissue dysfunction, tissue adhesions or lateral ligament damage, usually caused by a sprain. Ligament damage can lead to Chronic Ankle Instability (CAI) and may also lead to increased risk of osteoarthritis and articular degeneration. Medical examination is recommended.
See:
Ankle Dorsiflexion and Positional Faults:
Boston Sports Medicine and Performance Group

Foot and Ankle Conditioning Program at American Academy of Orthopedic Surgeons


Foot Pain:
If you go to shoe stores they will try to find shoes to fix your foot pain, but this is usually not the answer.

In an article at Running Shoe Malpractice | Trail Running and Ultra Marathons a guy, who had been running for 8 years, vented on the practice of running store associates with little knowledge of anatomy can recommend shoes to fix your problems. His example was a store that had some sophisticated equipment to analyze his gate and then recommend a shoe what was 1 1/2 size too large. He says,
"I think back to when I first started running. My legs and ass always hurt from running when I first started. As did my feet, knees, hips, etc... I didn't go to a running store for a form analysis! I went to an athletic trainer who has a degree in the study of human kinetics. There is where I got my form analysis and the prescription was not a different pair of shoes or inserts. It was exercise. It was working out in the gym to strengthen the many muscles I had neglected in my training, that in turn, cause poor running form. AMAZING! So I ask again.. how are running store associates getting away with this?!"


An article Ask the Coaches: Foot Pain and Shoes | Running Times, recommends some shoes for under-pronators but goes on to say,
"I suggest you find a personal trainer who specializes in running or a local coach who might be willing to give you some drills to do."


Side of the Foot Pain at Steve Smith Chiropractic says,
Causes:
1. Stress fracture:
Try this test: Find the long bone along the outside of the foot and try to bend it by holding on the the ends and pushing up from the center of it with your thumb. If you feel pain in the mid shaft of the bone then you are probably in trouble and you'll need to rest it for the next 6 weeks.

2. Tendonitis at the insertion of the Peroneus tendon.
Cause:
Could be caused by over supinating, meaning you are running on the outside of the foot.

Mitigation:
Anti inflamatories can be a help. There are a few approaches to anti inflamatories. Use over the counter medicines called N.S.A.I.D. which mean, Non-steroidal anti-inflammatory drugs. Advil, Ibuprofen, Motrin are all pretty much the same.

Ice is the most powerful anti inflammatory. Use a good gel ice pack that has been kept in the refrigerator.

Epsom Salt soaks do a great job at reducing swelling and inflammation.

Standing on a step and doing calf raises and slowly lowering can be helpful in developing strength and flexibility. Similar to my heel raise (see below)

The stretches that we use on Saturday mornings are a good way to stretch the outside of the foot. Start with the toes in contact with the floor and slowing rotate the foot in large circles. Do this for 20 seconds every hour of the day to develop flexibility. Do not get orthotics as a first treatment. They often worsen the problem or caused it in the first place.

3. Contact pressure along the outside of the shoe it can rub along the wide bony area of the foot, causing an irritation.

The best way to handle this is by locating the show laces nearest to the affected area and simple re-lacing the shoe to skip that area. Sometimes the shoes are fine during short runs but as your foot swells on the long runs there is more pressure and the area can get irritated. Sometimes it is just the fit and you need new shoes.


Foot and Ankle Osteoarthritis Symptoms, Causes, Treatments

Symptoms of foot and ankle osteoarthritis often include:
Tenderness or pain
Reduced ability to move, walk, or bear weight
Stiffness in the joint
Swelling in the joint

Diagnosis
See a doctor

Tennis ball exercise: Roll a tennis or golf ball under your foot
See:
Sprains & Strains here
Ask the Coaches: Foot Pain and Shoes | Running Times
Tips to Ease Sore Runner's Feet and Prevent Injury
5 Exercises for Stronger, More Flexible Feet | SparkPeople (Stacey Lei Krauss)


Foot Anatomy:


Source: Foot And Ankle Bones, Ligaments, Tendons And More | Ryan Foot & Ankle Clinic
Links:
Athletic Shoes here under products.
Pronation, Explained | Runner's World
Understanding Pronation | Running | ASICS Ireland
Tognar Ski Snowboard Boot Fitting Fit Repair Tips
foot pain and ankle problems discussed by a podiatrist (foot-pain-explained.com)
Insoles : Shoe Insoles : Foot Supports : Foot Health : Footsmart.com
Standard Orthotic Adjustments & Foot Biomechanics - Orthotic Shop
Pronation, Explained: Info from Runner's World Magazine
- Motion Analysis, Video Motion Capture and Gait Analysis - Medical Motion

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last updated 2 Mar 2014