Orthotics or Anti Pronation Running Shoes?

Orthotics or Anti-pronation Running Shoes for those Flat Feet?

In practice we are asked whether anti-pronation running shoes or orthotics are the best option for runners. This article will help you to understand pronation and guide you in your choice of running shoes to prevent over pronation.

What is Over Pronation?

Pronation describes the rolling in of the foot as it strikes the ground during walking or running. This rolling in is part of the normal mechanics of the foot. It allows the foot to absorb energy efficiently and reduce the impact forces up the leg and into the rest of the body.

For some people the foot will pronate too far, too fast or both. These situations will give rise to increased risk of injury as the impact forces will be greater and the stress on the supportive structures (muscles and ligaments) of the leg and low back will be increased.

Do This exercises to understand the mechanics better.

1. Stand up wearing shorts, place your hands on your hip bones at the front and roll your legs inwards, what happens to your the position of your hands? You will find them tilt forwards, your knees will also rotate inwards as your arches drop flatter.
2. Now raise your arches by rotating your feet outwards at the ankle. Notice how the knees rotate out and the pelvis tilts backwards.
3. Now try it the other way round. Stand and focus on the pelvis. Rotate it forward and see what the feet do. You will see them pronate.
4. Rotate or tilt the pelvis backwards and you will see them supinate (increase the arch).

From this you can get a picture of what is happening to the movement of the joints in the leg. This is called a kinematic chain as it describes a chain of movement.

Tackling Pronation

Go to any running shop and pronation will be on the radar. Since the 80's running foot wear has been developed to help cushion and stabilise feet and pronation has been seen as the enemy. This approach sprang up following research that linked over pronation to running injuries. Further research corroborated this and manufacturers responded to prevent pronation. This lead to various approaches to aid stability at the ankle. The footwear had increased arch supports or a cant to change the angle of impact or both. This lead to a heavy and bulky shoe.

However, it is important to remember that the foot is supposed to pronate as part of shock absorption and normal mechanics to allow the foot to flex during the heel strike to toe off phase of gait. Stopping this is equivalent to trying to run on a stiff leg or stump. That is not going to help your prevent injury and may even make things worse. So it is important to maintain a balance that reduces excessive pronation and slows its rate if you roll in too fast.

Runners with feet that over pronate will generally need an anti-pronation shoe or an orthotic, runners that have high arches (supinate) will need a better padded shoe.

New Thinking on How Anti-pronation Works

In 2001 Benno Nigg (1) proposed a new way of thinking on how these measures work. Rather than assume that they changed the position of the foot he postulated that they changed the pattern of firing of the muscles of the leg. This then created the stabilisation and slowing of pronation. This makes perfect sense as it is the firing of muscles in a co-ordinated fashion that stabilises and moves a joint. However as we saw in the exercise earlier the knee, hip and pelvis position also affect the ankle. So in order to achieve good ankle stability you also need top strengthen them.

A key muscle in this process are the Gluteal muscles. They stabilise the hip when you stand on one leg stopping the pelvis from dropping forwards on that side. Remember as the pelvis drops forwards it rolls in your ankle.

So in summary, if you want to run well, get your pronation assessed, select the appropriate stabilisation and strengthen the muscles around the hip, knee and ankle by following these exercises.

What Do We Recommend?

You may now be able to guess what I recommend to help the problem. In my opinion an orthotic in a neutral shoe is a good option. HOWEVER, it needs to be the right type. It should have an arch that is free to spring and not be a solid inflexible device such as the moulded bespoke carbon or plastic varieties that have little or no give in them.

Similarly it shouldn't be a foam based orthotic that fills the arch up. Now if you look at the anti-pronation shoes they basically tilt or cant the shoe to take out some of the roll. The problem with this is the lack of spring but also you have a clumpier, heavier shoe to carry round for your 40000 steps. That extra bulk and weight will have an effect after that many reps.

At Back In Form we recommend SOLE orthotics as they give the spring required and they are relatively inexpensive when compared to tailored orthotics. If you'd like us to assess you or for more information on how you can save over 10% off RRP just call us on 01202 733355.

1. Nigg, BM. 2001. ‘The role of impact forces and foot pronation: a new paradigm’. Clin J Sport Med. 11 (1): pp 2–9.