Supination... The lesser evil?

Supination as it pertains to the feet is the motion where the foot rolls outward, the opposite of pronation where the foot rolls inward. Supination is normal during the gait cycle, particularly during the push off phase when the heel leaves the ground. Supination of the foot lines up the joints of the foot into their most stable alignment, making for a rigid lever for the body to push off of to move to the next step.

Supination at the wrong time of the gait cycle or lack of sufficient pronation during the contact phase of the gait cycle can lead to foot leg and back problems. The primary role of pronation in the gait cycle is to absorb the shock of heel strike and allow for adaptation to the ground. Lack of adequate pronation causes shock to be transmitted up the entire leg to the rest of the body. With time this can lead to ankle, knee, hip and lower back pain. .

The high arch foot type tend to have a lack of adequate pronation. Also known as pes cavus, the high arch foot type can have several causes. The most common is genetic, some people inherit this foot type. The second most common cause is neurological conditions. Certain neurological conditions can cause weakness of certain muscle groups leading to muscle imbalances. Over time these muscle imbalances can lead to joint contractures, changing the shape of the foot.

What can be done about supinated feet?

The right foot wear and foot orthotics are the primary way we manage the supinated or high arch foot. This foot type tends to have a higher over all height of the foot and commonly has contractures of the toes, called hammer toes This foot type needs a shoe with extra depth and volume in the shoe. Also, a shoe with more cushioning and shock absorbing materials are needed to reduce the transmission of stress to the body from walking.

Custom foot orthoses are used to realign the foot in supinated feet that have some degree of joint mobility. Rigid high arch feet require accommodative orthotics to bring the ground to the foot to provide for balance and stability.

In rare instances surgical correction of the supinated or cavus foot can be considered. The procedures employed are usually a combination of bone and soft tissue procedures aimed at aligning the foot and reducing contractures for better bracing and shoe fitting.

We have all of the tools here in the office to manage all type of feet.

Let us know how we can help you!

Dr Paul "Supinator" Betschart

The Foot Book Doctor

Healthy Feet Happy Life

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