Runners Knee and pronation

This is the final piece about Runners Knee, there must be lots of other conditions I can write about, correct?

Prontation, eh? Now there’s a word that gets bandied (is that a word? I just checked the freedictionary and yes it is!) about a bit. How many of you have been to a physiotherapist, physical therapist, trainer etc and have been told about the nasty things pronation can do to you as a runner or if not even a runner. I have to admit I am probably one of those that discusses pronation as a possible cause of overuse injuries. Maybe not specifically to Runners Knee but certainly for other overuse syndromes associated with the lower leg.

Can pronation cause Runners Knee?

Well first of all how do you define pronation, how do we measure it, what’s perceived as acceptable? The naked eye cannot detect how much a foot pronates. You may have flat looking feet or fallen arches but do not assume or let anybody else assume you are a ‘pronator’ and purchase orthotics or expensive running shoe based on these poor assessments. I have taken many gaitscans at my practice of people with flat looking feet who display very little sign of pronation or over-pronation. Testing equipment in the form of gaitscans, video recording is necessary before that call can be made.
So to answer the question – can pronation cause runners knee? Ferber et al concluded “No definitive answer can be put forth regarding potential running-related injury mechanisms and excessive pronation” 1.

Many studies have shown that injured runners were more often overpronators when compared to uninjured runners. And I have to say that the majority of people I scan always tend to indicate as overpronators but mostly on only one particular side, the right foot for example. From my understanding these studies findings have been the medical equivalent of circumstantial evidence and according to Ferber “contradictory results were found in a study in which runners who had never sustained an overuse injury exhibited greater pronation”

If you have been told you are an over-pronator and suffer with knee pain or any other form of leg pain, it is worth getting a second opinion in the form of gait assessments and biomechanical assessments. Orthotics for example have saved me from many types of pain from blisters to neuromas and yes I am an over-pronator but have never experienced knee pain. Everybody is different and responds differently to many options. As I have discussed in many other posts the entire connective chain needs to be examined from foot to pelvis/low back to accurately get to the source of your knee pain. You are only as strong as your weakest link. What’s yours?

1. Ferber et al. Suspected mechanisms in the cause of Overuse Running Injuries: A Clinical Review. Sports Health: A Multidisciplinary approach. 2009.

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