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Vet88

Pronation, what it means and what to do.

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I pronate and have been measured as a severe pronator on both feet (20 and 23 degrees). In addition to this my right ankle has suffered multiple critical sprains during my life and has never worked properly since my teens.
For those of you that have read my many posts on the subject, I support lace free skating - to teach you how to skate and to counter pronation. On the former, it definitely does this, you can't hide from poor technique. On the latter, it does work, to a degree..... It works for balance, it works for straight line skating, it works for mild edges. But after 3 years or so of training lace free I still find that when I get deep on an edge with lots of power I pronate. My reasoning for this is 2 fold - 1: You just can't spend enough time in this position to retrain your muscles. Maybe after 20 years of training you might get there, I don't have that time. Or if you spent all day every day in skates but that is just not practical. In addition to this, training lace free is hard. It comes with a lot of downtime as you retrain and often is considered just too hard to do for most skaters. 2: As soon as you take your skates off you go back to pronating, the muscles just do what they have done for most of your life and follow the path of least resistance.

PRONATION IS YOUR NUMBER ONE ENEMY IN LEARNING TO SKATE!!!

So it was back to the drawing board. I'm not going to include the theory, last year's 15 skater pre trial study, the 100% improvement success stories (see end for 2 stories) or the 120 skater study we are going to do this year. What I will state is this:
The calcaneous (heel) bone is the most important bone in the body in relation to ice skating. It is the largest bone in the foot and it is the one that takes the most weight. Now here is the important bit - the angle of the heel bone in relation to the lower limb determines the angle of the boot and blade in relation to the lower limb.

This is why manufacturers make ultra stiff form fit hugging skates, to help straighten and hold the heel bone and ankle in place in relation to the lower limb. The downside to this approach (unless you can afford these skates whenever you want) is that you are STILL pronating in the skate. Over time the skate will open up, guaranteed. And even with the stiffest best fitting boot, get deep on an edge under power and you will pronate in the boot.

So what can you do? The known boot fixes - orthotics (these don't work for pronation) / shimming / holder movement / posting are just band aids on the problem. Whilst they can help for a straight line glide, get on an edge under power and all your pronation problems are still there.
The fix is to address the problem outside of the boot and off ice, we need to reshape the heel bone to get it in line with the lower limb and to set it permanently in this position. Others have posted various off ice exercises, the toe scrunch with a towel is popular (see reference in video later on). Myself and 4 of our study group tried this for 6 months, it made no difference. I don't discount the drill, it does help to strengthen the intrinsic muscles at the front of the arch but we found it did not help to straighten the heel bone.
However there is one exercise that specifically targets the heel bone and straightens it and the ankle in relation to the lower limb. This exercise you need to do - every. single. minute. of. the. day. The beauty of this exercise is that you can do it every minute of the day, you don't need to set time aside, you just have to remember to make it part of your waking life.

Watch this video, it’s the exercise from the 6:10 minute mark (thanks to Sport Injury Physio for this video until we can do our own) :
https://www.youtube.com/watch?v=5ompYPEHbyM
See how at 7:15 she “rotates” the ankle outwards. This is the exercise you need to do every minute of the day. You can do it sitting, standing, driving the car, washing the dishes, cleaning your teeth, eating breakfast / lunch / dinner, at work, anywhere anytime. Every single minute of the day you want to be trying to rotate your ankles outwards to straighten them. Start with sitting, then standing, then balancing on one foot, then balancing on one foot and doing a small squat, then try walking – I would take 3 steps then stop then lock the ankle then walk 3 steps trying to keep it straight then repeat (I now walk the dog for around 1 hour a day practicing this).
How do I know when I am rotating the ankle enough? The key is to look at your achillies tendon, the ankle is rotated far enough when the achillies tendon is straight up and down in line with the middle of the lower leg and you can hold it in this position as you weight bear on it. For example if you are slightly bow legged this means the heel needs to supinate slightly to get this line correct yet the forefoot is level on the ground. As you get the heel starting to straighten then focus on the forefoot, concentrate on pushing the ball of the foot into the floor (with toes relaxed). You have to untwist the forefoot AS WELL as straighten the heel (when you first try the ankle straighten, watch the forefoot and big toe, see how it rises as the foot follows the ankle shape). After a while you will find you can activate the ankle roll by pressing the ball of the foot into the ground.
Re the other exercises in the video (and other exercises for pronation), they help but the heel straighten is the key one, straighten the heel and the rest will follow. A straight heel in skates means you will balance easily over the skate blade, a pronating foot makes it hard to balance properly over a skate blade.
Become obsessed with this, try and do it every minute of every day, make it part of your life and it will change how you skate.
If you do try this, let me know how it goes. Then message me in about 2 months time and I will give you other drills to strengthen the arch and keep the mid foot / heel straight whilst under load. However you can't do this drill until you have learnt to straighten the heel and untwist the forefoot.
I will give two warning notices with this:- 
1: the recommendation from the consulting PT's is to not do any running whilst you are doing this, at least for the first 6 months or so. This is changing your bio dynamics, pronation is a natural foot movement and acts as a shock absorber for the foot. You need to learn how to walk before you can run.
2: Lace bite. When you first start this you will be activating the Tibialis anterior muscle and the Extensor hallucis longus muscle. These are the muscles at the front of the ankle that are involved in lace bite, by rotating the ankle outwards you are activating these muscles. For the first 6 months or so, until this becomes learned muscle memory and these muscles begin to relax, you may get lace bite. I didn't as I don't lace up, 3 skaters from our pre trial control group reported minor pain, they were in low volume boots. 

Success stories (these are 2 of the 15 skater pre trial study group):
1: 45 yo female figure skater, ex national single figure skating champion. Retired from all skating 4 years ago after falling in competition and breaking 2 bones in her right foot. Her right ankle has never worked properly since the very first day she put on skates, for example she has never been able to properly do a one foot slalom on it. She pronates badly in both feet (<20 degrees), has tried everything to fix it, nothing worked. 
3 months after doing this exercise, she can now balance and slalom properly on her right foot. She has removed all modifications to her skates with the blades returned to a center alignment. Her pronation has gone, both on and off ice. She has now entered our 2023 national figure skating competition.

2: 25 year old male figure skater, beginner (started skating 3 months before entering the pre trial study). He pronates badly in both feet (<20 degrees), has tried everything to fix it, nothing worked. At the time of entering the study, he could not skate backwards, he had no balance. He spent 3 weeks off ice doing the exercise. On the day he returned to the ice, within 15 minutes he was able to skate backwards and balance on an outside edge. His pronation on and off ice is still there but greatly reduced (<10 degrees) and we expect his heel to return to neutral alignment within the next 3 months.

In summary - do the exercise in the vid, it will fix your pronation. It has completely fixed mine and improved / fixed everyone who has been involved with the study so far. Fix your pronation and take your skating to a new level, I can't say strongly enough how this is a game changer for pronation. 
I don't know why pronation isn't talked about more, it's like the dirty secret of ice and inline skating, it impacts on EVERYTHING you do in skates. I just wish I had a coach who told me this 40 years ago, if you pronate I hope this helps you.

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On 2/4/2022 at 8:31 AM, Vet88 said:

PRONATION IS YOUR NUMBER ONE ENEMY IN LEARNING TO SKATE!!!

Why is that? Can you elaborate on what it looks like and why it's an issue?

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5 hours ago, flip12 said:

Why is that? Can you elaborate on what it looks like and why it's an issue?

Pronation affects your balance over the top of the skate blade. When you pronate whilst weight bearing, your balance is shifting over the skate blade. It is very hard for the ankle to stop this weight bearing inward flexion once it starts, now it is only the boot that is holding you upright. Catch an edge, you roll over. Transition an edge, you fall off it. Your ankle and boot can't support the forces been driven thru the leg, you start to lose your balance and you have to put the other foot down (or not even get it off the ice). Drum roll here for super stiff form fitting ankle hugging boots, yes they help but it doesn't eliminate the pronation. Your foot is still trying to pronate, this is what it has done all it's life (and the boot breaks down quickly).
Try this, undo your laces, stand on the ice with your feet shoulder width apart and the ankles folded inwards, now lift one foot off the ice and try and keep your balance.....
For inward bending skates it is obvious (I don't think I need to post any pics showing this), however it's the same problem on outside edges. You still pronate. Below is an example of a skater just entering a spin (spinning to her left). Look at the angle of the leg versus the shape of the ankle and the vertical direction of the boot and blade. She should be on an outside edge, she is trying to be on an outside edge, her brain thinks she is on an outside edge but she is pronating "across" the top of the skate blade so she is actually on an inside edge. The boot and blade should be in line with her leg. Because the boot and blade alignment is off from her leg alignment, as the forces thru the leg change in the spin (weight and direction) she can't maintain her balance in the spin.
https://imgur.com/gallery/0hIckX7

Inside edges or outside edges, this is what pronation does, it throws you off the center of the blade. And I haven't mentioned anything about the health risk it is to the body.

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19 hours ago, marka said:

How do you measure / determine if you pronate/supinate?

Whilst the comment from GSwift is correct for a medical diagnosis, there are a number of things you can check yourself.

If you look at your skates, does your tongue tend to turn outwards as you skate? This is a classic sign that you are pronating in the skate.

For the purpose of initially determining if a skater pronates / supinates we have looked at a skater's stance in a static weight bearing position, knees slightly bent, not moving. This is akin to your glide position. If you pronate / spinate in this weight bearing static position then our data shows you will pronate / supinate in skates, be it in a glide or stride. Now this isn't all bad, after enough training and / or with good boot support, most people can learn to glide in a neutral-ish position. And if gliding was all we did then I'd end this discussion, it's when you get on an edge and or increase the forces thru the leg (eg in a turn) that all the problems come back. Without training, the ankle just cannot stop itself from moving in the direction it always has. 

For identifying pronation / supination, I do not favour the wet foot test, for example I have seen many examples of flat footed people who don't pronate. The direction of the achillies tendon and or the tibia are the indicators we use, the bones and tendons of the foot and lower limb don't lie. 

This vid does a simple analysis of pronation / supination from the rear by using the direction of the achillies tendon.
https://www.youtube.com/watch?v=gWaQLlpJEyU

This vid does a simple analysis for pronation from the front by following the line of the tibia into the ankle joint. Note at the end when he explains it should line up towards the first and second toe. Guess where the blade is aligned under your foot? Skate manufacturers have it under the 2nd toe.
https://www.youtube.com/watch?v=xMd7ivUU-LI

This one shows pronation / supination from the front, back and side of the foot and leg.
https://www.youtube.com/watch?v=_qo4XQDGS7k

Another good example of pronation / supination, slightly longer, from the front only:
https://www.youtube.com/watch?v=3UwZPz0C_zg

Whilst this one gives a much deeper explanation of the different terms and states used to describe pronation / supination:
https://www.youtube.com/watch?v=qguVWxPB9bg

Whilst this doesn't cover pronation / supination, it is a very easy to understand 8 minute video that shows the anatomy of the foot.
https://www.youtube.com/watch?v=ROd1Acma64o

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@Vet88 are you saying that ideally one should not have any ankle eversion when the leg is loaded for a push or that it makes it harder for people who do pronate to learn to skate initially due to the complications introduced by their pronation?

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Both. Neutral alignment should be the baseline, this is what we need to learn to skate from, our alignment / balance would be correct and we use our body position and leg angle to get the drive or edge we need. As you advance in skills and have complete control of the edge and any movement of the ankle then minor degrees of inversion / eversion could be used to improve the bite of the edge. I go back to the design of the boot as it is today, they are trying to lock the ankle in place which assists in keeping the skate /  leg combination in a straight line and shifting the control of the skate to the biggest muscles in the leg. We want the ankle to be able to flex forward and back, just not side to side in uncontrolled motions. 

Depending on what figures you want to believe, 80% of the population pronate. Putting your feet into skates doesn't change that, your foot still wants to pronate and this impacts on our skating. In my 15+ years of doing learn to skates, I reckon the perfect neutrally aligned skater is around 1 in a 1000 and I can teach them more things in just 1 hour than I can teach a pronating skater in an entire term / year.

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Just to add, for those that supinate (foot rolls towards the outside) you may find that after skating, you have pain on the outside of your lower leg. This is due to the peroneus longus muscle fighting to keep the skate blade straight or on the inside edge during the push of the stride. Until you correct the biometrics of that leg, stretching before you skate helps alleviate the pain, the following stretch was what helped me a lot.

 

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4 hours ago, Gswift said:

Just to add, for those that supinate (foot rolls towards the outside) you may find that after skating, you have pain on the outside of your lower leg. This is due to the peroneus longus muscle fighting to keep the skate blade straight or on the inside edge during the push of the stride. Until you correct the biometrics of that leg, stretching before you skate helps alleviate the pain, the following stretch was what helped me a lot.

 

It's also good to use trigger point therapy aka foam rolling etc on your calves, soles, and tibialis anterior (shin) muscles. 

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New to this forum but I've been taking in a lot of info here since my son decided to start playing hockey for the first time this summer. He's a first year PeeWee so he's gotten a late start but is holding his own in a low level traveling league. I never played hockey as a kid and looking back on it now it was mostly because my feet were always miserable in skates. I decided to get some skates and after going through a few models that reminded my why I didn't play before found that Bauer fit 3's were pretty good. I have wide flat feet with flexible arches. I can go out there and skate but there are certain things that are a battle and I get a lot of foot fatigue. I'm in the process of trying some different insoles but I'm already starting to come to the conclusion that it's probably my feet that need fixing and there is going to be no easy equipment fix. I'd really like to figure this out because my son has my feet and I notice he struggles with a lot of the same things I do  so I figure what works for me will likely help him.

The 2 biggest issues I have on skates are that I end up feeling a lot of pressure on the middle bottom of my feet. It's never feels as if my heels and the balls of my feet are supporting my weight. Best way to describe it is I feel like I'm standing on 2 baseballs in the middle of my mid foot (where most people have an arch).

The main issue with my staking all seems to involve the outside edge of my right skate. Turning left, crossing over left, skating forward is not a problem. Trying to cross over to my right feels downright impossible. When I turn right trying to use my edges it feels like the inside edge of my left skate is doing 99% of the work no matter how hard I try to get on the outside edge of my right foot.

I have a feeling these issues are due to flexible arches and flat feet along with other alignment issues. The thing is in tennis shoes I supinate. I think it's just an unconscious effort to stay off my arches.  In skates I often feel my big toe and arch curling in. I never have the sensation that my entire foot is relaxed and applying force to the ice or supporting my body (I'm assuming that is how it's supposed to feel).

What I have tried so far are Superfeet carbon insoles. When I used those I did immediately get the feel that things were lined up better on the ice but they seemed to apply way too much pressure to the inside of my feet and arch area. What was a dull pain in the middle of my feet became a sharper pain on the inside of my arch area. It was bad enough that I couldn't skate for more then a few minutes without needing to get off the ice. I returned those and just received a pair or Currex low arch insoles that I plan on trying tomorrow. They seem comfortable but I'm questioning whether these are going to make much difference.

What would be some things I can check to see if I need to fix me or my skates/insoles?

 

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32 minutes ago, Bcowette said:

New to this forum but I've been taking in a lot of info here since my son decided to start playing hockey for the first time this summer. He's a first year PeeWee so he's gotten a late start but is holding his own in a low level traveling league. I never played hockey as a kid and looking back on it now it was mostly because my feet were always miserable in skates. I decided to get some skates and after going through a few models that reminded my why I didn't play before found that Bauer fit 3's were pretty good. I have wide flat feet with flexible arches. I can go out there and skate but there are certain things that are a battle and I get a lot of foot fatigue. I'm in the process of trying some different insoles but I'm already starting to come to the conclusion that it's probably my feet that need fixing and there is going to be no easy equipment fix. I'd really like to figure this out because my son has my feet and I notice he struggles with a lot of the same things I do  so I figure what works for me will likely help him.

The 2 biggest issues I have on skates are that I end up feeling a lot of pressure on the middle bottom of my feet. It's never feels as if my heels and the balls of my feet are supporting my weight. Best way to describe it is I feel like I'm standing on 2 baseballs in the middle of my mid foot (where most people have an arch).

The main issue with my staking all seems to involve the outside edge of my right skate. Turning left, crossing over left, skating forward is not a problem. Trying to cross over to my right feels downright impossible. When I turn right trying to use my edges it feels like the inside edge of my left skate is doing 99% of the work no matter how hard I try to get on the outside edge of my right foot.

I have a feeling these issues are due to flexible arches and flat feet along with other alignment issues. The thing is in tennis shoes I supinate. I think it's just an unconscious effort to stay off my arches.  In skates I often feel my big toe and arch curling in. I never have the sensation that my entire foot is relaxed and applying force to the ice or supporting my body (I'm assuming that is how it's supposed to feel).

What I have tried so far are Superfeet carbon insoles. When I used those I did immediately get the feel that things were lined up better on the ice but they seemed to apply way too much pressure to the inside of my feet and arch area. What was a dull pain in the middle of my feet became a sharper pain on the inside of my arch area. It was bad enough that I couldn't skate for more then a few minutes without needing to get off the ice. I returned those and just received a pair or Currex low arch insoles that I plan on trying tomorrow. They seem comfortable but I'm questioning whether these are going to make much difference.

What would be some things I can check to see if I need to fix me or my skates/insoles?

 

Were you properly fitted for the skates or did you just try on different skates until you found ones that were comfortable? I often find that middle of the foot pain is caused by "monkey pawing" almost as if you're flexing your foot in order get the feeling of stability in a skate that is too big.

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Yes I was fitted and have tried several. Tried a bunch of skates some which induced pain comparable to a broken bone. I landed on Bauer Vapor fit 3 in 8.5 (super comfortable) but after skating on them realized that they could be a bit shorter and the heel lock wasn't perfect and returned them for 8 fit 3's. my toes now lightly brush the cap when standing in a relaxed position. I've been scanned 5 times and every time it puts me in 8 fit 3. I am wider than EE in every measurement except foot height so the vapors work well for me. For comparison I wear a 10.5 running shoe in my everyday life. I realized that I buy my shoes big in order to get the width that is needed. I did look at some dress shoes I have that I was fitted for and they are size 9.5 (43 euro) which leads me to believe I'm in the right size.

Again the sensation that I have is that it always feels like there is a giant hump smack dab in the middle of the soles of my feet. Like I'm standing on a baseball and the ball of my forefoot is just floating. This is what causes the pain or discomfort but I dont know if this is what is causing the performance issues.

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Have you tried taking the insoles out completely and skating for a bit? It sounds wacky, but if your arch is really low, getting material out of its way can help. I wouldn't suggest doing this for a significant length of time, but it could lead to some insight about insole tweaks that might help.

Edited by flip12

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6 hours ago, Bcowette said:

When I turn right trying to use my edges it feels like the inside edge of my left skate is doing 99% of the work no matter how hard I try to get on the outside edge of my right foot.

I have a feeling these issues are due to flexible arches and flat feet along with other alignment issues. The thing is in tennis shoes I supinate. I think it's just an unconscious effort to stay off my arches.  In skates I often feel my big toe and arch curling in. I never have the sensation that my entire foot is relaxed and applying force to the ice or supporting my body (I'm assuming that is how it's supposed to feel).

For turning right, this is an alignment issue. You can't put any pressure into the right skate because your alignment is off, you can't maintain any balance on it so your body transfers your weight to your left foot. Take a vid of yourself doing the turn, go thru it frame by frame, look at the blade alignment in relation to the leg, this will tell you what is happening under your foot.

If you supinate off ice, you will supinate in skates. You know this because you "feel my big toe and arch curling in". You won't fix this on ice, you have to fix it off ice. I go back to the reason I posted this thread, do the exercise to straighten the heel (you are rolling the ankle inwards), keep it locked in this position (it will help to flatten the forefoot and strengthen the peroneal tendon as it turns into an isometric exercise). Try it for 2 weeks then go for a skate, it costs you nothing, not even time, you just have to remember to do the exercise during your waking hours (and it may help to address the next point).

As to the pain in the bottom of the middle of the foot, you may have really flat feet and any arch shape in the sole can cause some discomfort. Add the slightly forward pitch of a skate and you curling your big toe / arch as you skate and this is putting a lot of pressure on your plantar fascia. This could all stem from your supination in the skate but you could try eliminating any arch shape, take an old sole and cut the arch out of it and put this in the skate, you are trying to make the foot bed as flat as poossible. As radical an idea as this sounds, go for a skate with your laces undone. Just slow easy pushes around the rink. Anyone can do this, you just have to be careful and slow. Instead of your foot getting forced into an unnatural shape in the boot, this allows your foot to sit and articulate more naturally in the boot. If you don't get any pain in the bottom of the foot then I would be looking at trying to change the shape of the footbed and or boot, for example a lift in the front tower to eliminate some of the forward pitch. Generally there is never a "this is it" answer, you have to try different things to identify the problem and then different things to find a fix. Again, I'd start at your supination first, by improving this you may then improve the pain in the foot.

 

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