Shoe inserts stop excessive pronation


October 20, 1992|By Dr. Gabe Mirkin | Dr. Gabe Mirkin,Contributing Writer/United Feature Syndicate

When you run, you land on the outside bottom of your foot and roll inward, causing your lower leg to twist inward -- at the same time your kneecap is pulled in the opposite direction. This natural "rolling in" motion is called pronation, and it helps prevent injury by distributing the force of a footstrike throughout your entire leg rather than concentrating that force in your knees, hips and back.

Place the outside bottom of your foot on the ground and deliberately roll your foot inward. You can see your lower leg twist inward.

Most people who have flat feet have normal arches, but they look flat-footed because their feet roll in so far when they walk or run; their arches roll under their feet and touch the ground. You can't see the arches because they're hidden under the feet.

Thus, flat-footers pronate excessively. To prevent the shock of a footstrike from traveling up the leg and damaging muscles, bones and joints, their legs twist inward more than they should. While excessive pronation may make footstrike-related injuries less likely (by dispersing the force of the footstrike so dramatically), it can also lead to painful leg injuries. Flat-footed people are still more likely than others to suffer from injuries caused by excessive pronation, such as pain behind the kneecap.

Excessive pronation can be reduced by putting special inserts in shoes. Any good sports medicine physician can recommend where you can obtain the inserts you need.

Some people, though, are born with genuinely flat feet. They have little or no arches. They can be helped by foot surgery or by wearing special shoes.

* Q: I've suffered from low back pain for years. My doctor says there is nothing seriously wrong, that I just have weak back muscles that hurt when I get tired. Are there any exercises I can do to help?

A: Most people with lower back pain will benefit from exercises that strengthen their belly muscles and stretch and strengthen their back muscles.

Belly-strengthening exercise:

1. Lie on your back with your knees bent. 2. Put your hands on your chest. 3. Keeping your shoulders off the ground, slowly raise your head; then raise your shoulders about 10 inches off the ground. 4. Slowly lower yourself back to the ground. 5. Do three sets of 10. 6. When this exercise becomes too easy for you, wrap a towel around a small weight (1 to 3 pounds) and hold it behind your neck as you raise yourself from the ground. Increase the weight as you become stronger.

Back strengthening exercise:

1. Sit on the floor with your knees straight and your legs as far apart as possible. 2. Place both hands on the same knee. 3. Slowly move both hands down that leg toward the ankle. Stop if you feel pain, and do not force yourself to go any farther than when you can hold comfortably for 10 seconds. 4. Slowly release your position and do the other leg. 5. Repeat 10 times.

* Q: My mother warns that drinking milk will make our son's asthma worse. Is that right?

A: In the 12th century, the physician and rabbi, Maimonides, claimed that drinking milk increased mucus production and caused asthma. He was wrong.

A study published in the Journal of Asthma shows that milk does not increase mucus production. Both asthmatics and non-asthmatics were given whole milk, skim milk and water and were checked for signs of respiratory obstruction. There was no worsening of asthma in any case.

While drinking milk does not worsen an asthmatic's condition, doing so during an attack may not be a wise decision: It may make it more difficult for an asthmatic to breathe. Have you ever tried spitting after you drink milk? Milk thickens mucus that is already there, offering greater resistance against the air you breathe.

Mucus helps rid pollen, mold, dust and other pollutants from the air you breathe. Tiny hairs lining your bronchial tubes sweep the mucus and pollutants up to your mouth where you can swallow them. Being an asthmatic means that the inner linings of the tubes that carry air to and from the lungs are swollen and covered with copious amounts of mucus.

If you drink milk during an asthma attack, the mucus in your mouth will thicken and you may find it more difficult to breathe. However, there is no evidence to support the belief that milk causes asthma.

Dr. Mirkin is a practicing physician in Silver Spring specializing in sports medicine and nutrition.

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