February 8, 2013

Anti-pronation stretching exercise


This is an immensely important exercise. Despite what you have been told, it is possible to turn pronating ankles into strong, well aligned ones, and this exercise will build up the muscles in the feet, too. The colloquial term for pronation is "flat feet", but true flat feet (where a bone in the foot is displaced medially) is rare. 

To correct pronation is simplicity: you need a step, and something to hold on to, and a quantum of willpower.

Please note: kind readers pointed out some typos (note to self: take more time) and an anatomical detail that (for some reason) I persist in repeating!

Tibialis posterior, not peroneus longus! Thanks to Joshua (slizzardman) and JimP.

There is an excellent thread on the ST Community Forums: see https://kitlaughlin.com/forums/index.php?/topic/33-flat-feet-pronation-in-response-to-a-q-from-coach-sommer/#comment-76.

Read transcription

Hello, everyone, Kit Laughlin here. And as you can see, very sunny Canberra. This is our backyard. And iff we're lucky, we might be visited by Suu Kyi as well. We'll see.

We've had a posting on Coach's forum and my forum for some months now that's attracted a huge amount of attention, and it's about how to overcome pronating ankles, or what most people commonly call "flat feet." What I want to show you today is an absolutely wonderfully effective strengthening exercise, which is also a proprioception awakening exercise, and a whole bunch of other things as well. I'll get into that in a bit.

But what I want to show you first is, let's take a little look at the foot. The first thing you'll notice is that it has this big arch here. That's referred to by many different names anatomically, but let's call it the medial arch. But what most people don't realize that there is another arch alongside the outside of the foot as well, which is called the longitudinal arch. And very importantly, there's another arch in between the ball of the foot and the little toe side of the foot, which is called the metatarsal arch.

Ideally, we want all three arches to be operating perfectly, because when you stand on your foot, the weight is borne by that part of the foot behind the big toe, that part of the foot behind the little toe, and the heel. What we would like to see is that for most people, at least, anyway, there's a bit more weight on the outside of the foot than they normally do. And what happens, as you'll see in a moment, is that when you put a tiny bit more weight on the outside of the foot, so that effectively you've got even weight across the front of the foot, the arch of the foot is formed perfectly.

Now, one more thing. What most people don't realize about the arch of the foot is that, largely speaking, it's not actually the responsibility or the function of the foot muscles themselves. The bones of the foot arrange themselves according to how the femur is actually sitting in the pelvis. And that alignment is controlled by the external rotators of the hip joint, piriformis among them, but there are two, three or four others as well. And when the foot is aligned properly, then a muscle, a deep muscle here called peroneus longus, actually functions to evert the foot.

So what I'm going to do now, I've set up a chair for me to lean on. I'm going to turn away from you, a I'm going to show you what this exercise looks like, and I'll describe it at the same time. I'm standing on both feet, but when I go to do the exercise, I'll actually be exercising one leg at a time only. And here's how ... Just ignore my left leg.

I'm going to allow my right ankle to pronate deliberately as I lower my heel below the level of the steps. I'm leaning my weight for balance on the back of the chair here like this. Now what I'm doing, if you look closely, you'll see that the ankle has pronated completely. That is to say, my arch has almost disappeared. Then the strengthening part is, we come up to neutral like this, putting a little bit of weight on the outside of the foot, so that in this position here, the normal gait position, I've got the weight evenly across the ball of the foot and the little toe side of the foot. And then as I come right up on the ball of my foot like this, you can see that I've cheated a tiny amount of weight across to the little toe side of the foot, and I wait here literally until that muscle cramps, which it's doing now, and then I lower and pronate the ankle once again.

So we're going effectively from full pronation like this through neutral and then right into eversion. And you can see that in this position here, when I'm right up, not only is soleus activated, but the arch of the foot is fully formed. And that will be true for all people. So let the ankle pronate through neutral right up into this cramping everted position here that you can see where the arch is fully formed.

Now, this also, the fact of how all this works is the reason why we recommend the Vibram FiveFingers or other minimalist shoes so strongly, because when you're out in the actual world, I'm not talking about on pavement, I'm talking about bush tracks, where there are rocks and there are pebbles and so on that can impact on the arch of the foot or the bottom of the foot, anywhere on the foot, you'll find that if you watch carefully, what happens when you wear those kind of shoes out in the bush is that every time you step on something that's sharp, the arch of the foot literally pulls away from the ground like that. And in another video, I'll show you the wear pattern on my FiveFingers, but in fact, the only part that wears when you're out in the world is the tips of these toes here. Everything else hardly wears at all. And what that shows you, that's the evidence if you like, that the body is making every possible effort it can to lift the arch away from the ground.

This is the deep reason my modern people have pronating ankles so commonly. It's simply because the bottom of the foot where the proprioceptors are most common are simply not being stimulated as they're designed to be.

So, try this exercise. I would recommend two or three sets of five repetitions. That's probably enough. And I recommend you go up onto the ball of the foot, make sure you've got weight on the outside. Feel the muscle cramping, you'll feel the calf muscle, or maybe even the intrinsic arch muscles cramping, and then hold that for kind of one, two, and then let the heel go down, and let the ankle pronate.

We have had students of ours who've gone from having clinically pronating ankles and having been told that there's nothing can be done for that condition to having perfect arches, and it takes two or three years. You'll need to do this exercise once a week, that's probably enough. And I recommend that you go barefoot and use minimalist shoes in your exercise as much as you can. Thanks.


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