Dr. Lee S. Cohen Newsletter
In This Issue
Pronation? What's It All About?
Don't Forget About Your Hips!
Quick Links
Join Our List

Join Our Mailing List
Dr. Lee Cohen
image credit http://teamdoctorsblog.com
Single Leg Squats
single leg squat
Rubber Tube or Suspension Exercises
Floor Bridges
floor bridge
Clam Shell Exercises
Quad Hip Extension 

March 2014 
Welcome to the Dr. Lee Cohen community.  Our practice is working together to realize a shared vision of uncompromising excellence in podiatric care.   We focus on addressing treatment, injury prevention, and athletic performance enhancement.

Pronation of the foot in running? What's it all about?


Whenever we read an article about running, the word pronation usually pops up. Most people think that pronation is a bad word (like a four lettered bad word).   I think the confusion is based on 2 different sources. First, there is a pronated foot type, which just means a flatfoot deformity. The second source of confusion is the word "pronation" in the gait cycle or running cycle reference. So let me try to clear some of this up for my new runner friends.


The first thing one must know is that some pronation is required in the running cycle during heel strike. A normal amount of pronation is required to attenuate the shock of heel contact. The problems and injuries occur in runners when there is too much pronation during the cycle. With excess pronation, the foot cannot convert to a rigid lever, which is the necessary position for propulsion or take off. This conversion from pronation, a loose bag of bones foot, to the supinated, rigid lever foot, is delayed in the over-pronated foot. This results in abnormal muscle activity and bone irritation. Some muscles and tendons are now working harder than they should be so they recruit other muscles, which is where the term overuse injuries gets its meaning. Stress reactions and stress fractures result from the excessive muscle pulls on the bone. The more severe the pull the more likely the stress fracture will occur and vice versa.


Overuse injuries also increase in severity with the timing in which the overpronation occurs. For example, if the over pronation occurs during propulsion, it is more destructive to the foot and leg than if the excess pronation occurs in the middle of the cycle. The reason this occurs is due to the abnormal forces spreading over a wider area at mid stance making propulsion delayed and sending a horrible torque through the great toe joint. So bad pronation is bad, but good pronation is helpful.



Train Smart


Don't forget your hips!


Don't forget to strengthen your hip adductors as well as your abductors!


The adductors are the muscles located in the inner thigh. They are named for their ability to bring the legs together toward the midline of the body. The main function is to stabilize your hips and legs to avoid excessive internal rotation that can cause knee pain or injury when you run.


Since the pelvic girdle doesn't like to wander around very much (even when you are running at full speed), contractions of the thigh adductors tend to pull your legs inward toward the imaginary midline of the body (therefore the name adductors).


Because the adductors wrap around from the front of the lower pelvic bone to the back of the thighbone, they also help control hip flexion and extension, abduction and addiction, and rotation.


Adductor strengthening exercises actually help strengthen the Vastus Medialis muscle, which is one of the quadriceps muscles (the thick muscle group on the front of the thigh). A weak Vastus Medialis, doesn't allow for proper tracking of your knee cap on the thigh bone and can lead to common knee pain in runners known as Runners Knee or Patella-femoral syndrome.


Another advantage of developing strength in the adductor group and the quadriceps group is the fact that these muscles aid the body in powerful extension of the leg during the propulsion phase of the running gait.


Exercises that increase the strength of the adductors and abductors and improve hip stability, strength and movement are the following:

1. Single leg squats

2. Rubber tube or suspension cable exercises 

3. Floor bridges 

4. Planks

5. Clam shell exercises

6. Quadricep Hip Extension exercises.








Dr. Lee S. Cohen