resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
January, 2007, Vol. 07, Issue 01
By Whitney Lowe, LMT
The foot provides dynamic stability for a person's entire body weight, while simultaneously maintaining flexibility for shock absorption and propulsion along uneven surfaces. As a result, there are unique biomechanical demands on the foot.One of the body's adaptations to these demands is through specialized movements in the foot, such as pronation. In order to fully understand pronation, let's look at some fundamentals of movement and mechanics.
Most joint movements of the body are described in one of the three cardinal planes: sagittal, frontal or transverse. While there are foot motions such as dorsiflexion and plantar flexion that occur in these standard planes, most foot and ankle motion is not adequately described by these planes. More commonly, motion of the foot at the ankle is in a diagonal or oblique plane. This oblique plane motion involves movement through all three planes. For example, pronation is a diagonal plane movement of the foot around an oblique axis that combines the primary cardinal plane movements of dorsiflexion, eversion and abduction of the foot.
The diagonal plane movement of pronation occurs normally during walking or running. Although the term pronation routinely is used to describe dysfunctional foot mechanics, a better description of the pathological problem is overpronation. Also called hyperpronation or excessive pronation, this biomechanical disorder involves too much pronation during gait. Overpronation results when an individual moves either too far, or too fast, through the phases of pronation, placing more weight on the medial side of the foot during gait.
Unless there is a severe, acute injury, overpronation develops as a gradual biomechanical distortion. Several factors contribute to developing overpronation, including tibialis posterior weakness, ligament weakness, excess weight, pes planus (flat foot), genu valgum (knock knees), subtalar eversion, or other biomechanical distortions in the foot or ankle. Tibialis posterior weakness is one of the primary factors leading to overpronation. Pronation primarily is controlled by the architecture of the foot and eccentric activation of the tibialis posterior.1 If the tibialis posterior is weak, the muscle cannot adequately slow the natural pronation cycle.
Another primary cause of overpronation is subtalar eversion, also called calcaneal valgus (Figure 1). When the calcaneus is everted, weight is forced onto the medial edge of the foot. The subtalar eversion of pronation is visible in a standing position and it's evident that increased weight is placed on the medial side of the foot (Figure 2). Obesity can cause overpronation because the additional weight produces subtalar eversion and forces the longitudinal arch to collapse.
Overpronation can be a contributing factor in other lower extremity disorders, such as foot pain, plantar fasciitis, ankle injuries, medial tibial stress syndrome (shin splints), periostitis, stress fractures and myofascial trigger points. Overpronation increases the degree of internal tibial rotation, thereby contributing to various knee disorders such as meniscal injury or ligament sprains. The effects of the postural deviation are exaggerated in athletes due to the increase in foot strikes while running and the greater impact load experienced. When running, three to four times the body weight is experienced with each foot strike.2 If overpronation exists, the shock force is not adequately absorbed by the foot and is transmitted further up the kinetic chain.
Overpronation is best viewed from the posterior while the individual is walking, such as on a treadmill. When viewed with the client in a standing position, the overpronated foot looks similar to calcaneal valgus, because subtalar eversion is a fundamental component of overpronation. Examine the shoes for evidence of excessive pronation. If the shoes have had sufficient use, there will be an exaggerated wear pattern toward the medial side of the shoe bottom.
Overpronation usually is corrected with orthotics and/or strengthening exercises for the tibialis posterior. Massage treatment can relieve myofascial trigger points in the tibialis posterior, and other muscles, and address any resulting neuromuscular dysfunction in the leg or foot. Biomechanical correction of overpronation might require orthotics, neuromuscular reeducation, or gait retraining methods, as well. Stretching the gastrocnemius and soleus muscles will reduce hypertonicity in these muscles and also is essential for effective treatment.1 Because of impacts throughout the remainder of the body, the detrimental effects of overpronation should not be overlooked.
Click here for more information about Whitney Lowe, LMT.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.