This can cause long lasting damage if not fixed quickly.
A common symptom of supination is knee pain; this symptom is also common in adults of all ages.
"It can be corrected back to completely normal if caught early".
Supination is part of every stride you take. However over supination places extra stress on your foot and leg that can cause problems elsewhere. This is because the shock wave from your heel strike isn’t absorbed properly and the outside of your foot bears the full force of your step’s impact.
The following are other related causes:
• an inherited problem with the foot structure; it may ran in families
• prior injury to the foot causing damage to tendons and muscles
• improper shoes; loose fitting shoes, soft soled shoes
• bow leg causing excessive outward roll
• a leg length difference
• sports related activity
• chronic lateral ankle sprains
• daily lateral knee pain
• lateral thigh pain (olio-tibial band)
• calluses on the outer lateral aspect of the foot
• 4th and 5th toes contracted and twisted
• shoe midfoot aspect stretched wider
The heel can absorb 110% of the body’s weight during walking and 200% of the body’s weight during running. The plantar fascia is a multilayered fibroaponeurotic structure that arises predominantly from the medial calcaneal tuberosity and inserts distally through several slips into the plantar plates of the metatarsophalangeal joints, the flexor tendon sheaths, and the bases of the proximal phalanges of the toes.
Dorsiflexion of the toes applies traction stress at the origin of the plantar fascia. A contracture in the triceps surae, a pes cavus, or a pes planus can increase the traction load at the origin of the plantar fascia during weight bearing activities.
Other anatomic factors that can have similar effects are overpronation, discrepancy in leg length, excessive lateral tibial torsion, and excessive femoral anteversion. However, overuse, not anatomy, is the most common cause of plantar fasciitis in athletes. The pain of plantar fasciitis is caused by collagen degeneration associated with repetitive microtrauma to the plantar fascia
An inflammatory response and reparative process can double the thickness of the plantar fascia, which is normally approximately 3 mm. Biopsy specimens reveal collagen necrosis, angiofibroblastic hyperplasia, chondroid metaplasia, and calcification.
The heel pain can also have a neurologic basis. The tibial nerve, with nerve roots from L4-5 and S2-4, courses in the medial aspect of the hindfoot, through the tarsal tunnel, under the flexor retinaculum, and over the medial surface of the calcaneus. The calcaneal branch, arising directly from the tibial nerve, carries sensation from the medial and plantar heel dermis.
The tibial nerve divides into lateral and medial plantar nerves, which proceed into the plantar aspect of the foot through a foramen within the origin of the abductor hallucis muscles, which forms the distal tarsal tunnel. The first branch of the lateral plantar nerve changes course from a vertical to a horizontal direction around the medial plantar heel. It passes deep to the abductor hallucis muscle fascia and the plantar fascia and is the nerve supply to the abductor digiti minimi. The tibial nerve and its branches in the hindfoot can be involved with compressive neuropathies. A valgus heel can stretch in the tibial nerve.
Customized metatarsal arch to realign forefoot and guide the foot through toe-off.
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