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Improving Your Musculoskeletal Health... Starting With Your Feet

Frequently Asked Questions

How do I know if I over-pronate?

Start by taking a look at the bottom of a pair of shoes you have worn outside for a while. Over-pronators typically wear their shoes out on the inside of the forefoot, particularly under the second metatarsal head (ball of the foot). They may wear either the inside or outside edge of the heel. If you wear your shoes out from the middle to the outside in the forefoot, and wear heavily on the outside of your heels, you are a supinator. Supinators are often over-pronators in disguise.

If you stand with your feet parallel and your back straight, lower your hips (bend your knees) without squatting or letting your heels lift off the floor, and your knees come together, you over-pronate.

What is the impact of over-pronation?

Over-pronation (hyperpronation) can manifest as foot pain, heel pain (plantar faciitis), arch pain, formation of bunions, bone spurs and calluses.

Hyperpronation can be the cause of leg pain, Achilles pain, shin splints, knee pain from tight or torn ligaments, meniscus tears and runners knee (Chondromalacia).

Hip and low back pain.

Over-pronators are typically impacted more by torsion and problems originating from a forward leaning posture.

What is the impact of supination?

Supination causes a harder than average heel strike, tight and sore calf muscles and shin splints from instability and overuse.

Higher than average incidents of rolling the ankle.

Supinators are typically impacted more from impact and instability (muscle overuse) problems.

How does over-pronation change the body?

Over-pronation causes the ankles to roll in. The legs are internally rotated causing the knees to track inside the feet (rather than over the feet). This causes the pelvis to rotate forward, forcing the upper body to lean forward.

What causes over-pronation?

Over-pronation (hyperpronation) is a structural problem of the foot. The head of the talus (ankle bone) is slightly rotated up so it elevates the inside of the foot. This causes the inside of the foot to collapse when weight is transferred to the forefoot.

This condition can easily be demonstrated by placing a persons foot in a position where the ankle is straight (the heel is perpendicular to the floor) and noticing how the first ray (first metatarsal and big toe) is no longer in weight bearing contact with the ground. When the forefoot is made weight bearing, the arch collapses and the ankle rolls in.

What causes supination?

If you supinate when you walk or run, you are an over-pronator (hyperpronator) in disguise. Supination is a neuromuscular overcompensation for hyperpronation that causes you to subconsciously favor the outside of your feet in an attempt to overcome hyperpronation.

Is over-pronation and supination symmetrical?

No. Over-pronation and supination is often asymmetrical. Most people seem to over-pronate more on the left side, but many over-pronate more on the right. Asymmetry is a major cause of pelvic instability.

Does over-pronation and supination cause different shoe wear?

Yes. Over-pronators typically show a wear pattern on the bottom of the shoe on the inside of the forefoot, particularly under the second metatarsal head (ball of the foot). They may wear either the inside or outside of the heel. Supinators wear their shoes out from the middle to the outside in the forefoot, and wear heavily on the outside of their heels with some wear underneath the big toe.

What is motion control?

In the footwear industry, motion control is overcoming the impact of over-pronation (ankles that roll in) or supination (ankles that roll out).

What are motion control shoes?

Motion control shoes incorporate features (technology) aiming at reducing and controlling over-pronation and supination.

How is motion control achieved?

Traditional thinking attempts to control the motion of the foot by immobilizing the arch and locking the heel in place (referred to as mid and rear foot control). This is done by using arch supports to immobilize the arch and heel cups and lacing systems to hold the heel in place. Some shoe companies are also incorporating wedges or multiple density materials to raise the inside of the entire shoe or just the heel to “shim the foot into a more desirable position”.

Who needs extra cushioning?

The need for exaggerated cushioning in shoes for “normal” feet is a sign that the motion control technologies (arch supports and heel cups) are not very effective. A hard heel strike is usually a function of supination when walking and running. A reduction in supination will typically soften the gait. Excessive cushioning serves to destabilize the foot (picture standing on an air mattress).

Who needs arch supports?

People who have flat feet often over-pronate significantly. An arch support will help reduce static over-pronation when the person is standing still. Arch supports start loosing their effectiveness the instant the heel lifts off the ground.

Who needs heel cups?

Nobody - unless they have heel spurs. If that is the case, heel cups helps disburse the pressure away from the painful area. A heel cup does nothing for foot mechanics. It does not laterally stabilize the heel.

Who needs wedges (medial heel post)?

Nobody, unless they have suffered deforming injuries and/or surgery that causes the heel to be physically rotated relative to the forefoot.

In a “normal” over-pronating foot, a medial heel post may cause pain and aggravate plantar faciitis by causing excessive twisting of the foot when walking.

What is the new concept of motion control?

The new concept of motion control is that the foot, including mid and rear foot motion and stability, is controlled from the medial column of the forefoot.

The new concept is to control the motion of the foot using muscles rather than passive support.

The new concept states that we can control the motion of the foot, lower extremity and body by providing a neuromuscular stimulus to the medial column of the foot – specifically the first metatarsal and the big toe.

What is the advantage of correcting the forefoot?

The advantage is that this correction really works. It is simple and uses small dimensions so there is no need for bulky supports.

Even while walking, the amount of heel contact is very brief. As walking turns to running and sprinting heel contact is virtually eliminated.

Jumping and landing from jumps is all about forefoot control.

Forefoot control works through the full gait cycle.

Remember: Whenever the foot is trying to over-pronate, the big toe is looking for the ground.

How was Neuromuscular Motion Control™ discovered?

This concept was discovered by Dr. Brian A. Rothbart, DPM, PhD through studying the motion of the foot to fully understand the root cause of over-pronation and how it impacts the body in motion. Noting that the first metatarsal and big toe was elevated when the foot was close to its optimal functional position, he investigated clinical literature published on the development of the fetus as well as studies done on cadavers to learn of an anatomical (structural) variation in the head of the talus (ankle bone) that seemed to explain this behavior.

It was discovered that over-pronation seems not to be caused by “fallen arches”, but rather by this anatomical variance of the talus. The head of the talus (lower forward portion of the ankle bone) controls the geometry of the first ray (first metatarsal and big toe). A congenital development causes the first ray to be elevated so that the foot rolls in when weight is shifted to the mid and forefoot.

Dr. Rothbart also came to question the logic of just building the ground up under the foot to support it. That was in fact his first approach, but he noticed this idea was not workable because in nearly 100 % of the cases, he ended up over compensating the patient. Through persistent work, he discovered that he only needed to build the ground up approximately one third of the way causing the first metatarsal and the big toe to have ground contact slightly earlier in the gait cycle. This timing change in ground contact appears to cause a proprioceptive response of the muscles controlling the medial column of the foot, causing a significant reduction in dynamic over-pronation.

What is proprioception

Proprioception is the body’s sense of position, direction and motion. Proprioception is the regulating neuromuscular mechanism that allows you to stand upright even if someone bumps into you. Proprioception causes an immediate muscle action intended to regain balance and equilibrium.

Why is this technology called Neuromuscular Motion Control™?

We call it Neuromuscular Motion Control™ because we believe it most closely describes how it works.

What does Neuromuscular Motion Control™ look like?

Neuromuscular Motion Control™ looks like a wedge underneath the first metatarsal and big toe. The patented geometry (wedge), dimensions and position has been verified on thousands of patients in clinical settings.

How are ProKinetics® Insoles different from orthotics?

Orthotics use passive support in an attempt to stabilize the foot by immobilizing it. ProKinetics Insoles® succeed in stabilizing the foot by properly activating and balancing the muscles controlling the foot.

How does Neuromuscular Motion Control™ work?

Neuromuscular Motion Control® causes a neuromuscular response. The muscles in the calf automatically respond to the stimulus underneath the first metatarsal and big toe by contracting and hence lifting the arch like when trying to pick up a towel from the floor with your bare foot.

This motion causes an external rotation of the leg, and posterior rotation of the pelvis. The result is better alignment of the joints, more linear motion, and better posture.

If over-pronation is asymmetrical should correction also be asymmetrical?

No. A substantial amount of testing has been done to determine if asymmetrical compensation is more effective. There is a chicken and egg scenario at work here because over-pronation is not the only factor that can impact pelvic instability. Common Compensatory Patterns (CCP) are muscle compensation patterns set up in the body as a response to asymmetry or imbalance, so conceivably a very small imbalance of over-pronation of the foot can lead to a compensatory pattern that magnifies it’s impact. We only recommend symmetrical use of ProKinetics® Insoles.

If over-pronation is very excessive, do I need more neuromuscular compensation?

Sometimes. ProKinetics® Insoles come in three different vertical dimensions. The generic version is 3.5mm. The intermediate version is 6.0mm and the extra strength measures 9.0mm. If you wear a generic 3.5mm ProKinetics® Insoles and you still think you pronate too much, increased compensation can be provided for you by specialists who are trained to recognize what is most appropriate for you.

Try this link: https://www4.adhost.com/posturedyn/search.html or contact Posture Dynamics to find a provider near you.

How will I notice the difference?

  • You will feel that your feet and ankles are more stable and less tired.
  • Your shoes will feel more comfortable – like they fit better.
  • You will feel more acceleration - Power
  • You will feel more balanced - Agility
  • You will feel more energetic - Endurance

How long will it take to notice the difference?

You will notice the difference immediately. People differ in the length of time it takes their muscles to re-posture, but you should expect to feel the full benefits of the ProKinetics® Insoles in 7-10 days provided you wear them full time in all your shoes. If you only wear them a little now and then, you may barely feel any benefits at all. As you use your ProKinetics® Insoles, you retrain and strengthen your muscles. A good golfer for example, plays by wrote (muscle memory). Muscle memory is created by repetition. Your postural muscles work the same way.

Do ProKinetics® Insoles work for everyone?

Almost everyone. ProKinetics® Insoles work for over 90% of the population because over 90% of the population over-pronates or supinates to various degrees.

Can Neuromuscular Motion Control™ harm me?

No, this technology does not structurally change your foot. It does not roll your foot out (supinate) it even though it might feel like it in the beginning. This technology does not cause any permanent changes to your structural or muscular systems. Muscles strengthened by using ProKinetics® Insoles will weaken if you discontinue wearing them in much the same way muscles atrophy when not exercised.

Are there conditions where ProKinetics® Insoles would not be recommended?

Yes.

  • Cavus Feet (ultra high “peaked” arches)
  • Insignificant static hyperpronation
  • Severe arthritic conditions of the foot, knee and hip. (may be helpful when combined with medical treatment)
  • Foot deformities from congenital defects, injuries and surgery. (may be helpful when combined with medical treatment)

Why don’t ProKinetics® Insoles have to be custom made like orthotics?

ProKinetics® Insoles are not passive supports molded after the shape of collapsed feet.  They are designed to provide a stimulus to the feet, and experience shows the amount of stimulus is less critical so long as it is within a reasonable range. Trying to fine tune the dimensions further is not cost effective, and can be distorted by other factors that vary from one pair of shoes to another.

What is the magic formula that translates an imprint, foam box cast or pressure plate output into a functional orthotic?

Why do generic 3.5 mm ProKinetics® Insoles work for so many people?

The technology used in ProKinetics® Insoles is unique because it is not linear. The effect of the stimulus provided by a generic pair of insoles is not doubled by doubling the amount of stimulus. Generic ProKinetics® Insoles are optimized to give the maximum benefit to the largest group of people without giving too much. The next level only adds 2.5 millimeters (.1 inch).

Do I need to wear ProKinetics® Insoles all the time?

Yes. First of all, you are making up for a structural deficit. It will not go away. Secondly, as you use your ProKinetics Insoles™, you retrain and strengthen your muscles. A good golfer for example, plays by wrote (muscle memory). Muscle memory is created by repetition. Your postural muscles work the same way. If you quit wearing your ProKinetics® Insoles you will return to your old pronation pattern.

What kind of shoes would you recommend?

For daily activity – A flat flexible shoe with a fairly straight last, no special shapes, toe grips, metatarsal arches etc. and no excessive cushioning.

For walking and running – A flat flexible shoe with good sturdy upper and heel counter. A fairly straight last and no excessive cushioning. No heel posts or medial wedges. No multi density mid-sole on the medial side.

When selecting a sports specific shoe, beware of excessive cushioning materials that destabilize the foot. There are more ankle injuries today than when shoes were of simpler construction. Cushioning and medial posting may be a contributor to these injuries.

Use ProKinetics® Insoles to convert a simple high quality shoe into an effective Motion Control Shoe.

What other advantages do ProKinetics® Insoles have over Motion Control Shoes?

The more stuff (features) shoe companies incorporate in their shoes, the more weight they add. ProKinetics Insoles® give you the advantage of turning a lightweight, flexible, neutral shoe into a comfortable Motion Control Shoe.

ProKinetics® Insoles help make shoes last longer.

Does it take time to get used to ProKinetics® Insoles?

You will feel the ProKinetics® Insoles for the first 2 or 3 days, but the feel is generally comfortable. You will be aware that something is different. Because ProKinetics® Insoles re-posture the body and thereby cause different muscle use, you may experience moderate muscle soreness similar to starting a new exercise.

If the ProKinetics® Insoles cause significant discomfort it may be because they have re-postured your body substantially. Give them a break for a couple of days, and break them in by increasing your wear time by two hours a day.

If the ProKinetics® Insoles cause prolonged pain beyond 5 days, discontinue use.

Become accustomed to wearing ProKinetics® Insoles in your daily shoes before using them in athletic activity.

How long do they last?

With typical use, ProKinetics® Insoles may last for 12-18 months. If you are very active in sports, don’t expect them to outlast your shoes. They are guaranteed against material defects for 6 months.

Can I switch them between shoes?

We recommend you do. Make sure they fit properly and that you have sufficient room over the big toe. They should not be able to slide around in your shoe.

Should I remove the sock-liners from my athletic shoes?

It depends. The sock liners in most shoes are just cheap pieces of plastic designed to make the shoe look and feel a bit more elegant. Sometimes they actually have a function such as absorbing and transporting moisture. If there is enough space in the shoe to slide the ProKinetics® Insoles underneath the sock liner, it will last longer while still providing the same benefit. If this makes the shoe too tight, remove the sock-liner and replace it with a trim-to-fit pair of single layer foam rubber inserts.  These are inexpensively purchased from drug stores often called, "air pillows".  This will give the sensation of cushioning but take up less volume in the shoe.

Can they be washed?

Hand-wash in mild soap and lukewarm water. Lay flat to air dry.

Can I wear ProKinetics Insoles®in high heel shoes?

Yes. We don’t recommend heels over 1.5 inches, but even for heels higher than that, ProKinetics Insoles® will have a positive impact. You will notice that your weight is more evenly dispersed over the balls of your feet causing less pressure underneath the second metatarsal head.

Can I wear ProKinetics® Insoles in soccer cleats?

Yes. ProKinetics® Insoles work well in soccer cleats. Soccer cleats are much more rigid shoes, and tests with both adults and teens show that ProKinetics® Insoles provide their positive effects by reducing over-pronation and supination.

Can I wear ProKinetics® Insoles in my ski boots?

Yes. Adding ProKinetics® Insoles to your ski boots is a good idea. Expect less pressure on the inside of your ankle and calf against the boot and better edge control. Good for snow-boarding too.

Do ProKinetics® Insoles work for Seniors?

Generally, yes. Seniors wearing ProKinetics® Insoles have responded well. Some have also experienced warmer feet from improved circulation caused by less pressure on the posterior tibial artery providing blood flow to the soles of their feet. If the person suffers from severe arthritis, ProKinetics Insoles® may not offer much relief from pain.

Will wearing ProKinetics® Insoles resolve all my muscle pain?

ProKinetics® Insoles will help resolve most muscle pain that is associated with hyperpronation and instability of the foot such as shin splints and tight IT (Iliotibial) bands. You may also find relief from many common compensation patterns that develop from pelvic instability, but what you should also know is that muscle cramps or trigger points can become self perpetuating. That means that a change in posture or muscle use caused by using the ProKinetics® Insoles will not necessarily relieve the the pain. You will need the assistance of a professional who knows how to treat trigger points.