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Defining excessive, over, or hyper-pronation: A quandary
Andrew M. Horwood, Nachiappan Chockalingam
The Foot; Article in Press

 

oh, ok .... @Griff

 

oh wow :eek::eek:

 

Welcome back to 1987 y'all. Lets take this quote as a discussion point:

"HP of the hindfoot can be defined as: A range of motion of the subtalar-ankle joint complex that is driven primarily by moments of plantarflexion, abduction, and eversion of the subtalar joint complex and, dorsflexion, abduction and eversion of the ankle joint. These motions are greater than that required by the individual to balance morphology, or deal with the forces placed on the musculoskeletal system by kinetic and kinematic events within gait or another given motion."

Spot the problems...

 

Just seeing the word "hyper-pronation" in the title of a paper would make me reject it for publication....:mad:

 

I'll give it a bash.

As control of subtalar joint motion, for the vast majority of us, for the vast majority of the time, takes place at a subconscious level, all pronatory movement that occurs while dealing with actual or potential kinetic events is required?

I like the idea of extending STJ motion beyond the required amount. Why would someone do that? For aesthetic reasons? Maybe there is something more poetic or artistic about the extended flow of motion? More likely they are just being perverse and bloody minded? Of course if it is any of these things the answer is simple, no need for orthoses, a good dressing down is undoubtedly the answer. Something along the lines of, "You know there's nothing clever about all this hyperpronation you are doing. All this attention seeking is not going to get you anywhere. It's time you got a grip on that subtalar joint of yours. So just stop it."

Bill.

PS Possibly, had the author related the amount of pronation of the individual to an average or ideal, he might have had a better chance of getting away with it.

 

I think we are on a similar page, Bill. Since kinetics drive kinematics any kinematic change has to be the required amount for the force applied, no more, no less. Thus their definition is completely hat stand. There are others.

 

Starter for 10- By definition the motions are not greater than that required to 'balance morphology'- the motions are the net result of the forces placed on the morphology.

Just by putting words like kinetic in there doen't itself impart meaning. The phrase 'word salad' comes to mind. I haven't got access to the full text- I presume this is taken from the paper?

 

In your inbox.

 

It would be easier to list the parts that make sense.

 

Come on lads give the man/woman a chance.

The way I se it, as I alluded to in my previous posting on the subject, is that the author had intuitively identified a "conscious" element to subtalar joint motion, ie a psychosomatic element. At some level above the subconscious/conscious interface the patient or their carer decides to pronate the subtalar joint beyond the range required to control the 'forces placed on the musculoskeletal system by kinetic and kinematic events..."

By identifying this potential component of STJ pronation the author has infact answered/solved the "quandary of over- hyper pronation."

The "over or hyper" componenent is the consciously induced part of pronation!

I am sure all will become clear if, rather than prefixing pronation with "over or hyper", I prefix it with STOCKHAUSEN.

Yes the patient is presenting with STOCKHAUSEN PRONATION or as I suggested a couple of paragraphs back STOCKHAUSEN PRONATION BY PROXY.

Such patients are easily identifiable as they or their carer will enthusiastically inform you that they have a drawer/cupboard full of insoles/orthoses at home and or that they have seen another practitioner/s who didn't resolve their problem. A word of advice - if the patient/carer says that they have a room/garage or storage facility full of orthoses treatment is futile as they are incurable.

However the author has not only intuitively identified and documented "Stockhausen pronation" he/she has unwittingly Opened the door to a new and emerging speciality PODIATRIC PSYCHOLOGY.

Give that man/woman a medal, I say.

Bill.

 

Does anyone have a copy of this paper?