Abnormal Pronation Research Articles

Relationship of Functional Leg-Length Discrepancy to Abnormal Pronation: Author's Response

Relationship of Functional Leg-Length Discrepancy to Abnormal Pronation: Author's Response

The Incidence and Risk Factors in the Development of Medial Tibial Stress Syndrome among Naval Recruits

Purpose To identify the incidence of medial tibial stress syndrome (MTSS) in a group of naval recruits undergoing a 10-week basic training period and to determine potential risk factors. Method One hundred and twenty-four recruits (84 men and 40 women) were followed prospectively during basic training. Anthropometric and lower limb biomechanical data were recorded at the start of the program along with injury history and previous sporting activity for the 3 months prior to enlisting. Recruits were monitored during training for development of medial tibial strees syndrome and were asked to complete an exit interview at the end of the program. Results Forty recruits (22 men and 18 women) developed medial tibial stress syndrome, giving an incidence of 35%. A significant relationship existed between gender and medial tibial stress syndrome (P= .012), with female recruits more likely to develop medial tibial stress syndrome than male recruits (53% vs 28%). A risk estimate revealed a relative risk of 2.03. The biomechanical results indicated a more pronated foot type (P= .002) in the medial tibial stress syndrome group when compared to the control group. A risk estimate established that recruits with a more pronated foot type had a relative risk of 1.70. Conclusion Identifying a pronated foot type prior to training may help reduce the incidence of medial tibial stress syndrome by early intervention to control abnormal pronation. Findings of a higher incidence of medial tibial stress syndrome among female recruits require further investigation.

A biomechanical basis for the prescription of orthoses in the treatment of common running injuries

Orthoses are beneficial in the treatment of common running injuries. They limit abnormal pronation and reduce injurious torque to the musculotendinous structures of the leg and knee. Recent kinematic research has disputed this mechanism. An alternative model is proposed.

Sensitivity and specificity of the functional hallux limitus test to predict foot function.

Functional hallux limitus is an underrecognized entity that generally does not produce symptoms but can result in a variety of compensatory mechanisms that can produce symptoms. Clinically, hallux limitus can be determined by assessing the range of motion available at the first metatarsophalangeal joint while the first ray is prevented from plantarflexing. The aim of this study was to determine the sensitivity and specificity of this clinical test to predict abnormal excessive midtarsal joint function during gait. A total of 86 feet were examined for functional hallux limitus and abnormal pronation of the midtarsal joint during late midstance. The test had a sensitivity of 0.72 and a specificity of 0.66, suggesting that clinicians should consider functional hallux limitus when there is late midstance pronation of the midtarsal joint during gait.

Effect of foot orthotics on calcaneal eversion during standing and treadmill walking for subjects with abnormal pronation.

Repeated measures analysis of intervention. To determine the effects of foot orthotics and shoewear on calcaneal eversion for standing and treadmill walking. Foot orthotics are commonly used as an intervention for treating lower extremity musculoskeletal pathology. Qualitative research regarding the benefit of foot orthotics tends to be favorable, while the results of quantitative studies often conflict. Eight men (mean age = 35.8 +/- 12.7 years) and 5 women (mean age = 30.4 +/- 10.6 years), who demonstrated abnormal pronation, walked quickly (average velocity = 1.9 m/s) on a treadmill with and without foot orthotics. Subjects were filmed using a 2-dimensional video system and plastic molds designed to indicate calcaneal position inside the shoe during static standing and treadmill walking. Paired t tests indicated that foot orthotics significantly reduced the mean maximum calcaneal eversion angle by 2.2 degrees and the mean calcaneal eversion angle at heel rise by 2.1 degrees during fast walking. Orthotic and nonorthotic conditions did not differ significantly for the remaining kinematic variables. A one-way ANOVA indicated that calcaneal eversion in standing was significantly greater for barefoot standing compared with standing in shoes with or without orthotics. ANOVA also indicated that the plastic molds provided reliable measures of calcaneal position. Foot orthotics have a significant effect on calcaneal eversion and shoes also should be considered in conjunction with foot orthotic prescription.

The Young tenosuspension in the treatment of abnormal pronation of the foot

The intent of this retrospective study was to evaluate the efficacy of the Young tenosuspension for the control of abnormal subtalar joint pronation. Two series of 15 feet of patients aged 10 to 16 years were selected. Patients in the first series had been operated on with a combination of tendo Achillis lengthening and subtalar arthroereisis, while those of the second series had these same procedures along with a Young tenosuspension. All cases had been reviewed in June and July of 1994, both clinically and radiographically. The follow-up period ranged from 1.5 to 8.6 years. The authors found at follow-up a statistically significant improvement in both series of patients. There were no significant differences, however, when comparing the results of the two series with the exception of the reduction in forefoot supination, which was statistically greater (p < 0.05) in patients on which the Young tenosuspension had been performed.

An electrodynographic study of foot function in shoes of varying heel heights

Forty-three female test subjects had electrodynographic gait analysis performed in barefoot, low-heel shoe, and high-heel shoe conditions. Comparisons of segmental foot function, actual pressures, and pressure durations were determined. The findings suggest that an increased duration of forefoot loading, rather than an increased actual pressure, is responsible for pedal pathology secondary to wearing high-heel shoes. Contrary to previous reports in the literature, evidence of abnormal pronation in high heels was not found in this study.

Peroneal tendon balance procedure.

The authors introduce the peroneal tendon balance procedure and discuss normal and hypermobile function of the first ray. The procedure is based on the theory that the peroneus longus tendon is a primary retrograde stabilizer of the proximal portion of the first ray. The theory emphasizes that abnormal pronation results in a positional weakness of the peroneus longus tendon, which induces first ray hypermobility. This surgical procedure involves an anastomosis of the peroneus longus to the peroneus brevis tendon. It is designed to increase the force of the peroneus longus tendon in order to reduce first ray hypermobility.

Painful Plantar Heel, Plantar Fasciitis, and Calcaneal Spur: Etiology and Treatment

Painful plantar heel is a relatively common clinical entity encountered by the health care professional who treats patients with foot complaints. Plantar fasciitis and calcaneal spurs are frequently associated with this condition. The most common etiology involves abnormal pronation with resultant increased tension forces developed in the structures attaching in the region of the calcaneal tuberosity. This article reviews the relevant anatomy, pathomechanics, pathophysiology, and clinical presentation of the painful plantar heel patient. A course of treatment is suggested. J Ortho Sports Phys Ther 1987;9(1):17-24.

Arthrorisis by Means of a Subtalar Polyethylene Peg Implant for Correction of Hindfoot Pronation in Children

A modified subtalar arthrorisis is obtained by implantation of an endoprosthesis manufactured from ultrahigh molecular weight polyethylene. It is fashioned into the shape of a peg and implanted into the dorsal surface of the calcaneus just anterior to the posterior facet of the subtalar joint and fixed with polymethylmethacrylate. The purpose of the implant is to eliminate abnormal pronation, correct heel valgus, and produce an increase of the medial longitudinal arch in the growing child.

Fresh ligament injuries at upper ankle joint and foot (author's transl)

Crush injuries and abnormal pronation and supination are the most common reasons for typical ligament tears in this region. Most of them should be treated conservatively by plaster of Paris and early weight-bearing after exact clinical and X-ray diagnosis. At upper ankle joint, suture of ruptured fibular collateral ligaments should be favoured. For dislocations and fracture dislocations of the Lisfranc type operative reposition and K-wiring is recommended. Our treatment results with fibular collateral ruptures and fracture dislocations of the Lisfranc type are presented.

Abnormal pronation in children. An hormonal etiology.

Abnormal pronation in children. An hormonal etiology.