Pronation Syndrome

pron syn web backThis is another reasonably common posture pattern. In this pattern it’s possible that all of the postural distortions have come from the medial (inside) fallen arch of the left foot, which causes over pronation (foot rolling toward the centre line of the body).

With the left foot being in this compromised position, the body has compensated in the following ways:

The lower leg has rotated inwards (medially) and has become inclined inward, the thigh has followed in this pattern. When weight bearing, this makes the leg functionally shorter (Dr’s Travell & Simons, following their research, found that anatomical leg length discrepancies account for only 10% of all discrepancies). The result of this functional shortness is the pelvis is tilted to the left. To compensate for this, the body shifts the thoracic region to the right and in turn further compensation is made by the left shoulder dropping and the neck leaning to the right in order for the head to remain level. Notice how the left arm is further from the body than the right and the ‘S’ shape in the spine. This is called lateral scoliosis.

This pattern can cause pain and dysfunction in any number of the associated areas of the body. It commonly causes pain in the following: ankle, knee, hip, sacro-iliac joint (base of spine), lower back, thoracic area and shoulder. It may only be responsible for neck problems or even TMJ (temporomandibular syndrome, jaw pain).

There are steps that can be taken that may remedy pronation in terms of soft tissue release of the tibialis anterior muscle (shin) and strengthening the plantar muscles of the foot. In extreme cases orthotics (specially designed insoles) may be useful. Once the foot has been stabilised, work can begin on the other issues this condition has caused.

It would be incorrect to assume that massage techniques can be used to restore perfect alignment and, in fact, this would be a pointless strategy with any modality. Instead it is more important to restore the body’s own natural alignment. None of us are perfectly symmetrical and imposing symmetry on the body would probably cause more problems than it solves.