Is Pronation Bad or Good, Revisited

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Culmination of 50-plus years of clinical research and private practice:

Almost without exception, all ambulating feet pronate. What makes pronation bad (abnormal) or good (normal) has less to do with its magnitude and more to do with etiology.

Succinctly: foot pronation driven by the horizontal oscillations of the hips (e.g., hip-driven pronation) is good (normal) because it does not lead to distorted posture. Whereas foot pronation driven by a collapsing foot (e.g., gravity-driven pronation) is bad (abnormal) because it leads to distorted posture.

Keep in mind, distorted posture is unarguably linked to the development of chronic musculoskeletal pain.

That simple, as it should be.

The cause of ambulating feet collapsing has been a lively discussion on this forum for many years—my answer to that question: medial column supinatus.

Again, very simple, as it should be.

How one describes the series of events that start with medial column supinatus and terminate in postural distortions depends on whether you are an advocate of the Foot Biomechanical Postural Model or the Foot Neurophysiological Postural Model. Personally, I ascribe to the latter.

If I had made the above statements 15 years ago, I suspect it would have incited a nuclear discussion on this forum. Now, I am not so sure.

 

The most common etiology of abnormal pronation is:

• PreClinical Clubfoot Deformity
• Metatarsus Primus Supinatus Deformity (aka Rothbarts Foot)

Either of these genetic structural aberrations produce global postural distortions.

 

Not clearly written. It should read:

Foot pronation resulting from a structural aberration (e.g., Rothbarts Foot) is bad (abnormal) because it leads to distorted posture. I have termed this type of pronation - Gravity-Driven Pronation.