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Pronation (the movement of the rear foot inwards) is a naturally occurring movement that happens in the foot when we are walking or running. It allows weight to be transferred from the outside of the heel (contact phase of stance) to the inside of the foot and big toe before our foot leaves the ground (end phase of stance or toe off). Some of us naturally stand with our heels in a pronated position and are advised to buy shoes which have anti-pronation to correct this position and protect ourselves from injury however there is little evidence to suggest that a shoe can provide significant protecton from injury. Like any movement the risk of injury to soft tissue is greater when the movement is poorly controlled and pronation is no exception.  
Pronation which is well controlled allows structures of the foot to act like a spring which can store energy and then release it to assist our foot in propelling the body forward as we toe off. When pronation is poorly controlled, the foot moves quickly into a fully pronated position increasing loading of soft tissue, and making the foot act more like a club which increases compressive forces to the ankle, knee and hip. Increases in loading of soft tissue and compressive forces do increase risk of injury. 
Muscles that are involved in movement and strength of the foot, knee and hip all have an influence on how we are able to control pronation. Assessment of weakness and control of these muscles and joints is important to determine what may be causing poorly controlled pronation if it is suspected as being a source of injury.  
So in summary pronation is not a bad thing however like any other movement if it is poorly controlled it can become problematic. 
 
 
Craig Fowlie 
Senior Physiotherapist 
MSc Sports and Exercise Medicine (Distinction) BPHTY(Hons), MCSP, MAACP 
Member of the HCPC 
Colchester Physiotherapy and Sports Injury Clinic 
 
 
 
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