In my last post I introduced the term “pathomechanical foot type”. I’d like to give an overview of what this means and identify the most common problematic feet. A pathomechanic foot type is a foot that is put together in such a way that it can cause problems under the right (or wrong) circumstances. There are five pathomechanical foot types that I most often see in our clinics. They are as follows (I have included the problematic motion that the particular foot type causes in parenthesis):
- Rearfoot varus foot type (over-pronation)
- Forefoot varus foot type (over-pronation)
- Forefoot valgus foot type (under-pronation)
- Plantarflexed and rigid 1st ray (under-pronation)
- Forefoot equinus foot type (excessive ankle and mid-tarsal dorsiflexion)
These foot types are all naturally occurring meaning they are not the result of a trauma or anything that one has done wrong. These terms describe the way a foot is built. I believe many people go through life without significant problems but, others develop pain and dysfunction when their feet encounter circumstances that cause extra stress. These circumstances can be internal or external.
Internal circumstances can include level of maturity (age), changes in the level of fitness (strength, endurance, flexibility, body weight, muscular endurance, etc.) and injuries. External circumstances include chosen work and play activities as well as footwear.
The pathomechanical foot types listed above typically cause too much or too little pronation of the feet and lower extremities. Pronation is a fancy word for the “rolling-in” motion that our feet need to undergo initially with each step that we take. Feet that over-pronate roll-in too much and stay rolled-in too long during the stance phases of walking. Feet that under-pronate (often mistakenly called supination) pronate too little or for too short of a time during each step.
Over-pronation can lead to the following types of problems: heel pain, arch pain, bunions, hammer toes, shin splints (muscle/tendon pain in the lower legs), stress fractures, abnormal callousing patterns on the feet, anterior knee pain, lateral hip pain and sacro-iliac joint pain (in the low back area).
Foot types that cause under-pronation can cause chronic ankle sprains, stress fractures, joint pain in the feet/ankles/knees/hips/spine, lateral knee pain, abnormal callousing along the pinky toe and lateral aspect of the feet.
Once correctly diagnosed, these pathomechanical foot types and the associated problems they cause can be effectively treated with exercise, correct foot wear, correctly designed foot orthotics or some combination of the above. If you are having problems in the areas listed above, you may have a pathomechanical foot type.
If you are struggling with foot or lower extremity pain, we would be privileged to assist you. Please contact us at our Bozeman (406-556-0562) or Manhattan (406-284-4262) office to schedule an appointment. You will be thoroughly evaluated and a comprehensive, individualized treatment plan will be developed to address your problem and help you get your fun back!