HELP is this supination or pronation?
Question:
I’ve had bad ankle problems due to gout. But recently realized that another problem is that my feet tilt. When golfing, which a passion I love and cannot do walking anymore because of the pain, I noticed that I tend to severely tilt my left foot(my right foot does this too but not as bad) outwards. I’ve don’t this so excessively at times that the outside of my shoes near my baby toe wear out a lot. I also wear out the heal sole portion of my shoes on the outer half. The pain in my ankles today was unbearable it was near the outside portion of the back part of my ankle. My questions are is this supination or pronation and will inserts with high arches help me or hurt me? I am thinking that they will hurt me because it raises the inside of my foot. Thanks for any help, John
Response:
[[ This message was both posted and mailed: see the "To," "Cc," and "Newsgroups" headers for details. ]] – Hide quoted text — Show quoted text – I’ve had bad ankle problems due to gout. But recently realized that another problem is that my feet tilt. When golfing, which a passion I love and cannot do walking anymore because of the pain, I noticed that I tend to severely tilt my left foot(my right foot does this too but not as bad) outwards. I’ve don’t this so excessively at times that the outside of my shoes near my baby toe wear out a lot. I also wear out the heal sole portion of my shoes on the outer half. The pain in my ankles today was unbearable it was near the outside portion of the back part of my ankle. My questions are is this supination or pronation and will inserts with high arches help me or hurt me? I am thinking that they will hurt me because it raises the inside of my foot. Thanks for any help, John
Some things to think about before supination and pronation. A previous post from 2002:
Are you splay footed? / This causes the posterior tibialis to be stretched and the arch to start to drop inward so that after years of this the arch is no longer supported by the posterior tibialis. When this happens the stress is put upon the plantar fascia which is a sheath that inserts into the metatarsals and has its origin on the front of the calcaneus. The plantar fascia is not made take the stress when the three muscles that maintain the arch do not do their job because of faulty mechanics often caused by the way we run. ___ All through last year I suffered with a pain in the ball of the foot. Podiatrist and surgeon diagnosed it as Capsulitis and metatarselitis respectively. Neither of them studied my gait or stride for either walking or running. Interesting that you brought up splayed feet as mine are very noticeable. It tended to get worse as I started to walk on the side of my foot due to the pain in the ball of the foot. At the end of the year I started getting pain in the tendon on the side of the knee, but below the knee, along the calf and down to above the ankle. So my question is: Could these two injuries be related and could they stem from the same cause that being the splayed feet? Obviously you can’t diagnose me online, but is this within the realm of reason to take to a 3rd doctor? Thanks Ed, Some thoughts and some rec.running addenda: Summary: Your Piriformis May Effect Your Splay Feet and Your Bunions Splay Feet / and Bunions may have more to do with what you do unconsciously. The way you stand may have more to do with the muscles in your upper legs. And you never even thought about it. Until now. Thanks to Erik Sten for reminding me about Bunions. The bunion is usually a result of the feet / rather than | |. Keeps pushing out the cartilage out and the cartilage calcifies and voila, le bunion. You might want to take thee to a Rolfer or someone that does postural integration and the problem more often than not is in the hips that create the splay. Leroy Perry had people rotate the heels out first to straight the hips and then bring the feet together so they were aligned | |. Your Piriformis May Effect Your Splay Feet & Bunions: Thank You LeRoy Perry c. 2000, 2002 Austin "Ozzie" Gontang, Ph.D. Piriformis What it does: Piriformis rotates your thigh laterally (turns it outward). Piriformis abducts (ab(Latin) from/away from; duco lead, direct [ad=to or toward]) or turns the thigh away from the body when your leg is flexed. Piriformis is attached onto the front of the sacrum (origin) and inserts into the top of the femur (insertion) – sort of at the top and inward on the greater trochanter. Piriformis does most of the work when you turn your leg outwards. You now can see how the hyper-tense (overly tight) gluts which has as its job of laterally (outside) rotating the thigh. That rotation or turning the thigh outward So if the piriformis does most of the work when you turn your leg out along with the gluteus max which laterally rotates the thigh, when these muscles become hypertonic (overly tight) they assist in rotating the entire thigh…and the lower leg and foot also go along for the ride. So more than likely, you’ll often see that when you stand or walk or run through some water and look at your running foot prints they look like: ../ ../ and not | ..| | ..| and when you stand up brushing your teeth in the morning or standing around not thinking about how you’re standing and you look down at your feet, you will see / and not ||. Now to correct this you you’ll bring the front of your feet / together ||. But the problem is that, if you go back to what you’ve just learned from the info about the piriformis and the glut max, you’ll say to yourself: "Hmmmmmmmm, if I turn the front of the foot inward, I won’t have done (never good at English when I speak to myself) anything to the piriformis or the glut max. How can I best effect those muscles which may be a big part of my splay foot stance?" Ah now I see what Ozzie’s talking about. And you’ll say to yourself, "Oh, that’s why Ozzie thanks Leroy Perry to this day for showing him some of his chiropractic intuition and folklore at a workshop which helped Ozzie understand how to effect the foot at the origin of the splay footed problem" When you are standing / and want to get your feet to align | | 1. View your feet. Note if the feet are / evenly or more | or | / or some ankle between _ _ and | |. 2. If your feet are /, turn your heels outward so that if you were looking straight on into a mirror you would not be able to see the inside of your heel like you can when you look at your feet and you’re standing /. 3. Now that you can’t see your heels because you’re standing | |, lift one leg and bring it to a position so that it is directly aligned underneath your hip. Think of the legs as two columns upon which your pelvic is supported. 4. By turning out the heels first, you’re countered the lateral rotational tendency of the piriformis and the glut max. (Now isn’t that sweet.) Two more observations: 1. If you stand in front of a mirror and tighten your butt muscles you’ll see the thighs rotate to the outside. You don’t even know you’re using the piriformis since it’s so deep inside…just like you know know you’re using the psoas to kick a foot ball or kick your dog. 2. In "Preparation" in Tai Chi, you’ll notice that you start / and then to get into your "Beginning" stance you rotate the heels out to get into | |. When that happens your knees when they bend, bend straight ahead. Ahhhhhh. Well maybe you don’t say "Ahhhhhh" to yourself because you don’t know what the hell I getting at. Okay, Okay. If you chronically have a tendency to have hypertonic piriformi and glutei Maximi (Latin – nominative plural) you can now relate to why people call you "tight assed." Now trying to run like that /, and now ever thinking that your legs and feet are suppose to track | |, gives you some sense of the system upon which you stand, walk and run, and realize that those unnecessary torques and twists do have their effects over the seconds, minutes, hours, days, months and years because you’re doing it all the time….unconsciously. You’re practicing to stand in improper form and style and you’re not even thinking about it, let alone doing something about except when you consciously stretch and workout…and when you compare that to all the unconscious exercise you do by the way you walk, stand, sit and move….you realize that 7 or 10 or 20 hours a week of exercise is nothing. Because if you worked out 20 hours a week, slept 56 hours a week, you still have over 90 hours a week that you’re awake. Albeit unconscious, when you are sitting, standing, walking and moving without awareness: It’s not what you do that gets you in trouble. It’s what you do wrong and don’t know that you do wrong or incorrectly…all of those unconscious seconds…that gets you in trouble. Every injury, every overuse syndrome, every ache and pain you have related to physical movement started with a millisecond of unconscious improper movement…that you did but didn’t know that you did, because you never thought about it because you were unconscious thinking or worrying or daydreamsing about something else. It’s not what you know that gets you into trouble. It’s what you know that just ain’t so. Sometimes it feels good to be a pain in the cerebral glutei and piriformi of people who suffer from psychosclerosis (English: hard headedness). I know I suffer from it, doesn’t everybody? Never mind. —end of article—- A post to rec.running from Rich Barkan: been there, done that I’m picking up this thread in the middle. I read with interest Ozzie’s recommendations about foot position and had some flashbacks to my own nightmare. I had a piriformis issue back in 91-92; from what I recall, the muscle was essentially atrophying from underuse. The big muscles were doing all the work due to my logging heavy effort daily long runs without any real cross training, i.e., overuse leading to a breakdown in my form (which wasn’t that great to begin with). After a couple of months of no running and physical therapy (including guided stretching, ice, electrical stimulation and voodoo), I was able to begin running again, paying attention to foot placement. The key to prevention of a reoccurance has been a combination of awareness of my footfalls, my trusty leather orthotics, and, most important, consistent stretching (before or after the workout) and varied workouts. Mixing speed, hills, easy days and long runs. In short, proper training and the yoga-position piriformis stretch teamed with stretching of the other muscles in the area that the Dr. Maffetone doctor has indicated The proper … read more »
Response:
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Oz, why don’tcha just ANSWER THE QUESTION rather than repost your ‘wisdom of the ancients’ verses?
Response:
John, PLEASE trust me on this. You have a misaligned vertebrae causing your ankle problems. I have the same problem when my lower back is out. Go to a good, qualified chiro, whose been in business for many, many years (I recommewnd 20 minimum to avoid the new, young guys, who mainly go for adjusting your wallett)and I can promise you that you’ll return to 100% pain free after one or two visits. Also buy a pair od Asics 2090’s, and toss those nikes! Do these two things, and I can promise you that you’ll return to 100% pain free after one or two visits. TheBillRodgers – Hide quoted text — Show quoted text – I’ve had bad ankle problems due to gout. But recently realized that another problem is that my feet tilt. When golfing, which a passion I love and cannot do walking anymore because of the pain, I noticed that I tend to severely tilt my left foot(my right foot does this too but not as bad) outwards. I’ve don’t this so excessively at times that the outside of my shoes near my baby toe wear out a lot. I also wear out the heal sole portion of my shoes on the outer half. The pain in my ankles today was unbearable it was near the outside portion of the back part of my ankle. My questions are is this supination or pronation and will inserts with high arches help me or hurt me? I am thinking that they will hurt me because it raises the inside of my foot. Thanks for any help, John
Response:
P.S. Every nerve in your body runs through your spine, and a pinched nerve can cause pain in amy part of your body without your spine giving you even a small hint that it is involved. – Hide quoted text — Show quoted text – I’ve had bad ankle problems due to gout. But recently realized that another problem is that my feet tilt. When golfing, which a passion I love and cannot do walking anymore because of the pain, I noticed that I tend to severely tilt my left foot(my right foot does this too but not as bad) outwards. I’ve don’t this so excessively at times that the outside of my shoes near my baby toe wear out a lot. I also wear out the heal sole portion of my shoes on the outer half. The pain in my ankles today was unbearable it was near the outside portion of the back part of my ankle. My questions are is this supination or pronation and will inserts with high arches help me or hurt me? I am thinking that they will hurt me because it raises the inside of my foot. Thanks for any help, John
Response:
P.S. Every nerve in your body runs through your spine, and a pinched nerve can cause pain in amy part of your body without your spine giving you even a small hint that it is involved.
Hi, Wobbot. Still practicing your own personal brand of psychotic medicine I see. Tell me, friend of chiropractors everywhere, is there anything that they CANNOT cure? Gout? Toothache? STD’s?
Response:
I’ve had bad ankle problems due to gout. But recently realized that another problem is that my feet tilt. When golfing, which a passion I love and cannot do walking anymore because of the pain, I noticed that I tend to severely tilt my left foot(my right foot does this too but not as bad) outwards. I’ve don’t this so excessively at times that the outside of my shoes near my baby toe wear out a lot. I also wear out the heal sole portion of my shoes on the outer half. The pain in my ankles today was unbearable it was near the outside portion of the back part of my ankle. My questions are is this supination or pronation and will inserts with high arches help me or hurt me? I am thinking that they will hurt me because it raises the inside of my foot.
This is a biomechanical issue beyond typical supination/pronation. It deserves proper medical attention. You may be prescribed orthotics, certain exercises, or whatever. Find yourself a podiatrist. Cheers, — Donovan Rebbechi http://pegasus.rutgers.edu/~elflord/
Response:
I’ve had bad ankle problems due to gout. But recently realized that another problem is that my feet tilt. When golfing, which a passion I love and cannot do walking anymore because of the pain, I noticed that I tend to severely tilt my left foot(my right foot does this too but not as bad) outwards.
That is supination. I’ve don’t this so excessively at times that the outside of my shoes near my baby toe wear out a lot. I also wear out the heal sole portion of my shoes on the outer half.
Wear on the outside of the heel is normal even among pronators. People typically strike with the heel laterally, and then the weight is transferred to the medial side of the forefoot before toeing off. The heel blocks of shoes are often structured to reflect this: it’s quite typical to see a crescent-shaped section of the outsole at the heel separated from the rest of the outsole to create a kind of strike pad. That crescent faces slightly to the outside rather than straight back. The pain in my ankles today was unbearable it was near the outside portion of the back part of my ankle. My questions are is this supination or pronation and will inserts with high arches help me or hurt me?
Inserts with high arches will either do absolutely nothing because of your supination, or, if you have low arches, they will protrude into your arch and cause discomfort, and possibly bruising and blistering. Supinators should generally look for road training shoes that have lots of cushioning, like the Asics Gel-Nimbus.
Response:
I’ve had bad ankle problems due to gout. But recently realized that another problem is that my feet tilt. When golfing, which a passion I love and cannot do walking anymore because of the pain, I noticed that I tend to severely tilt my left foot(my right foot does this too but not as bad) outwards. That is supination.
Supination does not mean that your foot is tilted outwards in a supinated position, it means that one supinates during impact. Basically almost never happens. Actually, if impact is in a heavily supinated position, he’s more likely to be a heavy pronator. He could also have splayed feet or bowlegs (which could lead to impact in a heavily supinated position and wear on the outer perimeter of the shoe) But he possibly (based on what he’s said, almost certainly) has further problems with his biomechanics, that really need to get looked at. I’ve don’t this so excessively at times that the outside of my shoes near my baby toe wear out a lot. I also wear out the heal sole portion of my shoes on the outer half. Wear on the outside of the heel is normal even among pronators. People
But not wear on the baby toe. Indicates lack of pronation or splayed feet. Inserts with high arches will either do absolutely nothing because of your supination, or, if you have low arches, they will protrude into your arch and cause discomfort, and possibly bruising and blistering. Supinators should generally look for road training shoes that have lots of cushioning, like the Asics Gel-Nimbus.
I’ve worn the Nimbus and I can assure anyone that while it’s not a bad shoe, it is not miraculous enough to instantly cure this guys foot problems. He needs a podiatrist, not a cushion shoe. Cheers, — Donovan Rebbechi http://pegasus.rutgers.edu/~elflord/
Response:
I’ve had bad ankle problems due to gout. But recently realized that another problem is that my feet tilt. When golfing, which a passion I love and cannot do walking anymore because of the pain, I noticed that I tend to severely tilt my left foot(my right foot does this too but not as bad) outwards. He could also have splayed feet or bowlegs (which could lead to impact in a heavily supinated position and wear on the outer perimeter of the shoe)
Oooh, ooooh, tell me more! I’m not the OP, but I have splayed feet (had ‘em all my 45 years, kids used to make fun of me in the snow, / / /, and I have an unbelieveble amount of wear on the outer perimeter of my shoe (on the forefoot, not that much on the heel, though). I also think that I have a medium to low arch. Looks like it collapses when I put weight on it also. I use a SuperFeet footbed. (I’m also the Creed wearer, from another post). All that being said, though, I’m not in any pain. My shoes feel fine to me. From the other post, I’m thinking of moving to the 2090, but wonder also if I could use something well cusioned, something like a Mizuno, or another model of Asics. It’s been mentioned that the other guy needs a podiatrist, but I suspect I do not, since I’m not having any problems. Of course, it might be better to head things off at the pass. I’m currently at 30 mpw with no problems. Hmmmm. My running club DOES have a member who is a podiatrist too…
Response:
Tell me, friend of chiropractors everywhere, is there anything that they CANNOT cure? Gout? Toothache? STD’s?
Don
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