Defining Abnormal Foot Pronation - Treadmill Analysis

The definition of abnormal foot pronation does not refer to the amount of pronation.  Abnormal foot pronation refers to the timing of pronation.  That is, the foot is pronating when it should be supinating.  To the left is a 4 frame video of the left foot during stance phase.  Note that at mid-stance (Frame 3) the left foot pronates and continues to pronates (Frame 4) through heel off.  This is occurring when the ipsilateral (same side) hip is externally rotating. 

Any foot pronation that occurs when the ipsilateral (same side) hip is externally rotating is defined as abnormal pronation (Rothbart and Esterbrook 1988 Journal Physiological Therapeutic Manipulation).

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The Preclinical Clubfoot Deformity (Calcaneal Talar Supinatus)

Etiology:  torsional development of the foot ends before the 9th week post-ovulation, calcaneus and talus remain in supinatus (See Figure 1).


Figure 1 - Preclinical Clubfoot Deformity (PCFD): Calcaneal - Talar Supinatus


Clinical Findings: micro wedge measurements between 30 and 60 millimeters.  Weight bearing, knees extended, the feet are pronated (See Figure 2).


Figure 2 -  Weight bearing, Knees Extended


Differential Diagnosis: weight bearing, knees extended, the PCFD foot is pronated, the Primus Metatarsus Supinatus foot is not pronated.

Treatment:  rearfoot and forefoot proprioceptive activators