Pronation and overpronation in running

Foot pronation consists of the physiological rotation of the foot inwards while walking or running to reduce joint tension. It is a natural movement that helps the feet to cushion the impact with the ground. The opposite movement is called supination. So, despite what is commonly believed: first, foot pronation is not a disease, second, we are all pronators.

When the physiological rotation of the foot inwards becomes excessive, we speak of over-pronation, which however is very often a secondary situation and adaptation to non-physiological situations of the function/structure of the foot (e.g. flat foot), as well as adaptation to descending non-physiological situations (e.g. valgus knee). In this case too, however, the term "overpronation" is not the identification of pathology but the description of an attitude of the foot.

Anti-Pronation shoes and insoles

Runners with pronounced pronation tend to put more bodyweight on the inside of their feet and therefore, tend to "crush" the midsole more on the inside. With the passage of time and miles the soft, cushioning midsole gets more squeezed in and the shoes tilt out. This effect becomes an amplifier of the natural pronation of the athlete who, due to the shoes inclined inside, tends to increase the angle of rotation of the foot on the longitudinal axis inwards, becoming, despite himself, an overpronator.

Almost all shoe manufacturers try to remedy this failure of the inside of the shoe. The idea is to put a denser material on the inside of the midsole to prevent the shoes from "collapsing" (unfortunately shoes are made by engineers and not by biomechanics). This way you get your shoes to stay flat and not become over-prone.

Having said that, we can make two considerations:

• First, anti-pronation shoes are not "medical devices" that correct one of our defects, but they are shoes that adopt a technological system to remedy one of their defects, that of tilting inside. The old shoes without midsoles, they didn't tilt because they didn't have soft materials that could crush.
• Second and most important consideration; there is no system that, in fact, prevents the foot from continuing to pronate (fortunately) or over-prone inside the shoe.

Another very popular practice in recent years, namely the analysis of running on a treadmill using a camera that films from behind-bass and which in fact films only the feet and calves. This is the system that is normally used by running shoe retailers to decide (very broadly!) whether you are a "pronator" or not.

What could be the solutions to solve the problem? The first and most important solution is to start thinking that there is no "problem" and that foot pronation is a purely physiological act and rarely is itself the cause of pathology or an Algic/inflammatory situation.

In these rare cases, the person who can give us a solution is certainly not the shoe manufacturer. The study and knowledge of how we are made and how we really work, i.e. it is by studying the functional anatomy and physiology of our limb-my-fascial systems that we can begin to make reasoning that can untangle us in the world of "false myths" that often fill blogs and magazines.

Biomechanics of foot support

The plantar vault is an architectural ensemble that harmoniously combines all the osteoarticular, ligament and muscular elements of the foot. Thanks to its curvature changes and its elasticity, the vault can adapt to all the roughness of the ground and transmit the stress and weight of the body to the ground in the best mechanical conditions according to the various circumstances.

Anything that contributes directly or indirectly to altering this ability to adapt will have negative repercussions both during static (upright station) and dynamic (walking, running, jumping, etc.).

And here we must necessarily mention and focus on what, more than anything else, is affecting the adaptability of the plantar vault in a negative way.

We are talking about the motor impoverishment we are experiencing in this age of well-being, which has created a new species of the human being: the city man.

We could sometimes simply call it sedentariness, but this for the uninitiated might mean nothing and not make sense of the connection between this and the problems connected with excessive pronation; that it would perhaps be better to start calling it motor disability of the foot.

The city dweller, in fact, always walks on a smooth, uniform and resistant ground with their feet protected (I would say shielded) by shoes. Their insoles have to make minimum adaptations and the muscles that are the main support, end up atrophying or lose it (use or lose it).

The flat foot is the price to pay for all this civilized progress and the rampant motor impoverishment of children - adolescents of this century. But we are fortunate because we know that we can do much to break this vicious circle created by sedentariness and progress.

Rediscovering the naturalness of walking barefoot, on the sand as well as on a nice grassy lawn or on big stones, will allow us to awaken the functionality of the plantar vault which, by rediscovering its adaptability, will work well again. Walking on the tips, or orthogonally to a transverse slope, or even going uphill and downhill will stimulate the foot to seek that functional adaptation that will ensure efficiency and effectiveness that will allow the various functional structures to operate at their best and strengthen themselves.

We have to start thinking of our foot as a complex and almost perfect functional system, extremely "dynamic" and totally interconnected with the rest of the body.

We need to approach a re-education of our foot both by locating attention to the foot itself but also by providing stimulation on a global level to improve our overall human movement. Also, speaking of running, we will work on all those specific exercises to improve the technique. The pronation, in running, is not a static fact but a "rotation" that takes place in each time.

There are many exercises, jumps, and gaits that can help us to improve the motor qualities that underlie an optimal general human movement, which will also benefit our race that will be more elastic, responsive and fluid. In short, effective (doing the right thing), efficient (doing it in the best way) and economical.

All this will make us talk about pronation only and exclusively for what it really is, which is a physiological and functional event of our foot. Nothing "pathological" or "not physiological" to even must correct with a shoe made specifically for anti-pronation.