Hi! Good evening, everybody! So, tonight’s session is about exercises to help if you over-pronate
in your feet. My name is Maryke. I'm one of the physiotherapists from sports-injury-physio.com,
where you can get online physiotherapy treatment for any of your injuries. So, what I'm gonna do:
I'm gonna first explain how come the foot can sometimes over-pronate and what I mean
with over-pronate, then I'll walk you through … We're gonna break it down … We're gonna break it
down into the different components of how you get the foot stronger, because there are actually two
parts to over-pronation, and then I'm gonna show you some exercises. So, let's dive right in. Now,
if you’re new to the livestreams then; if you've got any questions, just pop them in the comments;
if you're watching this on replay, make sure that you ask questions as well, and especially
if you're on Facebook, if you tag me, then I'll make sure that I answer, because then I see it;
sometimes the notifications don't show up immediately for me. Excellent! So, what do I
mean with over-pronation? That's when your foot turns in excessively as you walk and run. Now,
it's important to understand that all people's feet turn in as part of the terminal stance phase.
So, if I can show you what I mean with that. So, as we walk, as you ... You make contact,
usually with your outside of your heel, then you come over the heel and then you're … Let me just
do that again, because it didn't focus … You make contact on the outside of the heel – I'm
over-showing this – and then the foot moves in and twists in a bit and then you push off. So,
if you I show you this from the front: So your side of the foot rolls in, over, and then back.
But for some people it rolls in too much: that's over-pronation. And what's gonna happen then is,
you can strain the tendons on the inside, so your tib post tendinopathy; that's one
of the main causes of that. You can strain your ligaments there, you can even – if you see what
happens with the knee – you can even strain your knee, or your hip can get an impingement.
ITB syndrome can be caused by that if there's a lot of stress on that bit. It's very common,
if people have had an ankle sprain, for the foot – if they haven't rehabilitated it properly – for
the foot to sit in a slightly inverted position like that afterwards. So, ideal posture for the
foot is that you have a little bit … Let me just bring this down that you can see my foot better.
I'm actually gonna put it on the red thing because this is nice and hard; I think my mat otherwise
allows me to dip in. So, normal posture is that you have a little bit of an arch in your foot,
okay? So, a little bit of an arch there. Now, mine's not very high; some people have really high
arches; some people have really flattened arches. And that doesn't mean that that's a problem,
it's just how their arch looks. But we want the arch on the right and the left to be relatively
similar to each other. So, a little bit of an arch there is a good thing, and then you want your foot
to be in a neutral position. So, if you look at this part of the foot compared to your lower leg,
can you see that my line is kind of straight there when I'm in that position? Now, if I allow
my foot to roll in, can you see that it creates an angle, that bit, with the middle of my foot? Now,
if I walked with it like that, I will end up compressing this part of the joint. And there's
a condition called sinus tarsi syndrome, where people develop pain on the outside of the foot
a while after they've had an ankle sprain, and it doesn't want to go away. And it’s not the
ligaments, it's actually inflammation in that part of the joint because it's squashing so much. So,
if you're seeing a large angle at your foot when you look at it, that the foot is not neutral;
that's where we want it eventually to be. So, how do you get it there? There are two kinds
of components to it, and I'm gonna keep this camera focused on my own foot for now, if you
don't mind. So, we've got the component of, the foot needs to turn kind of from there … Whoops!
I'm moving my leg; I shouldn't … from there to there, but also if the arch is quite flattened,
the arch needs to lift up like that. So, if I can show you from there. So, if my arch is quite flat,
I need to lift the arch up. And we're going to practice those different components. So,
we're gonna work on the muscles inside the foot to get them stronger, to support the arch,
and we're going to also work and strengthen the muscles where the tendons run of the tib
ant and the tib post, that can … that pull on this part of the foot, that can support the arch. So,
the first exercise is very simple. You need a slippery surface, so, I'm using my book,
and you need a towel. And what we're going to do is, you're just gonna gather the towel with your
toes, like little monkey toes. And you can sit in front of the TV and do this, and you can even,
if you squeeze it, count till five or to ten, and then let go, and count again. And what you want
to see is, don't just do it gently; make sure that you get the arch, the whole foot, the arch, as you
do it so that you strengthen the muscles inside. If you've done it for a while and you find it
quite easy, then what you can do is, you can just pop something heavy on this part, so that … like
a bottle of water or a shoe or something, that it now becomes a weight that you're actually pulling
closer towards you, so it's harder work. You may find at the beginning, when you do this, that your
foot actually goes into a cramp, and that's often when the muscles are quite weak, or they’re just
not used to it. That will get better as you get stronger with it. So, that's exercise Number 1,
to get the flexors inside the foot to strengthen up. Now, the second exercise is very similar.
But if I can show you: With that one, you were squeezing your toes, that they're all crunched
up. With this one, I want you to press your toes straight into the floor. So, you can see my toes
are not bending; I'm pressing them, and especially the big toe I'm pressing hard into the floor. So,
it's as if you're pushing your thumb down. So, let me show you from the side again: I'm pushing my
big toe and my toes into the floor, enough that I lift my arch off, but I'm not turning my foot out;
I'm literally just pushing them straight into the floor, so that it's so hard that I actually
lift my arch off by doing that, and then I hold it and relax. So, pushing the big toe into the floor,
and the other toes, nice and straight, and just counting till ten or to 20, depending on how
strong you are, and relax. So, that's another good exercise to strengthen the muscles in the foot
that support the arch. Now, once you've practiced that, I want you to see if you can also push the
big toe into the floor without actually lifting the ball of the toe off. So, with the previous
one you were doing that. So, straight toe, but the ball was coming off. Now, can you press the
big toe into the floor but without lifting this up? Because remember, when you walk, this has to
be flat on the floor. So, see if you can do that, but do not let your other toes claw like that. So,
don't let them claw like that; you want them to be relaxed; you want to just squash the big
toe in. So, practice that for me as well. If you struggle to do that, take your finger, push it up,
and then just push your finger down with your toe. That resistance often activates the brain, that
you realize how to actually do that, okay? Now, the other two big muscles that support the arch
are … The first one is the tib post. Tib post runs from there, comes across there, and underneath the
foot, and it basically does that movement, okay? The tib ant is from there, crosses over the ankle,
and then it comes and switches under the foot there, and again, it also pulls the foot up,
but it also turns the foot in. So, we're going to strengthen both of them. And we'll do the tib
post … Well, you kind of do the tib post and the tib ant together with doing inversion. You need
an elastic, which I've tied to my bed – I hope it stays in place – but you can see, I tied it to my
shoe because otherwise it comes off my foot and it drives me absolutely nuts. So, I'll show you what
you do. Now, you can be in many positions; you can be flat on the floor, I just don't have the
space for that tonight, so I've decided I'm going to be sitting in a chair. You want the band around
the front of the foot. So, yes by all means, you can do this barefoot; mine just slips off if I do,
so I've put it through my laces and then 'round to keep it in place. And I like to then cross my
legs, so that now I can take it from the outside and pull it down and in and up, and hold it,
and then slowly release it again. So, you don't want to see a jiggly movement. And then in and
down and round and up, and hold it. And I'm not moving my knee, I'm just moving my ankle. There
we go! And again, and around and up. So, this one strengthens tib post as well as tib ant, okay? So,
it's a very nice one to do to get that stronger. Good! So then, if you want to strengthen tib ant
mainly … I'm just going to take my shoe off for a second … we're gonna use dorsiflexion, movement,
okay? So, pulling the toes up. But the problem is, if you do it with your toes sticking out,
so, like that, then other muscles also help the movement, and we want to isolate the tib ant. So,
what we're going to do is, we're going to flex our toes and keep them flexed throughout the movement,
okay? Like that, with a band around it. But again, I'm going to pop my foot into the trainer,
otherwise the band slips off, but I'm going to have my toes like that inside the trainer,
okay? And for this one, I'm actually going to be flat on the floor … Let me just get this
on ... Oh, my poor trainers … There we go; it's on. Good! So, remember, I'm now squeezing my toes,
okay? And keeping them squeezed as I bring my foot up, and slowly let it go down again,
and up, and slowly let it go down again. So, that then strengthens mainly my tibialis anterior,
especially if I keep my toes all flexed while I'm doing it. There we go! So, you could of course … I
think I can do this, and sitting like this ... If you wanted to do the inversion from here, you can
just turn your foot in and slowly out. So, you could actually just sit on the floor and do that
as well; it really doesn't matter where you are as long as you get the range of movement that you're
looking for. Good! Now, those other components … But they're great to strengthen the muscles up,
but that doesn't mean that you're gonna control your arch when you're standing or walking, because
you've learned how to walk with it in the wrong position, so you've got to retrain that. And I'll
show you how I start people to get their feet into better arch positions. And the first thing is,
that you are going to practice it in sitting, so that there's no weight going through, so that
you can just concentrate on getting the arch right. And then, once you're good in sitting,
then you concentrate on doing it when you're standing. And then what I find is best,
whenever you think about it, you try and correct your arches. So, when you're standing in a queue,
you think about, ‘Where are my feet? What am I doing with my feet?’ Because you'll often find
that you've become accustomed to just hanging with your feet in. If you find that, then correct them
and get them in a good position. But let me show you first how to do it in sitting. Okay, so again,
I'm just gonna focus on my feet here. Actually, I'm gonna … Can you see? … That should work,
yes. So, what we're looking for is, when we're standing, you have to feel equal pressure under
the triangle that's formed by the ball of the big toe, ball of the little toe, and your heel. Often
when people try to correct their arches, they tend to roll them out, that the big toe comes off the
floor. You have to make sure that the ball is in contact when you're there. Now, look at your … I'm
gonna over-pronate mine for now. So, have a look at your arches: Where are they? Look at the angle.
So, what we going to do is, we want to roll them out and also bring the arch up into a more neutral
position, okay? So, how do I do that? It's a combination of that movement that we practiced
and also a combination of that movement that we practiced. So, what I find the easiest for me is,
if I've got it there, to think of rolling it out a little bit, but not lifting my big toe up, okay?
And then also, just pushing my big toe nice and hard into the floor. But you'll notice these toes
are totally relaxed; they're not squishing up like that, okay? I'm just pushing my big toe into the
floor, but my big toe’s ball is still on there; I can feel equal pressure under both of those,
okay? So, if I can show you from the side: What's happened there is, my foot was there and I just
rolled it so that that bit lifted up, but this is still on the floor. And if you're still struggling
there, you can push your big toe hard but straight into the floor to just get this to lift up,
okay? So, let's see if I can do that with both. So, we're gonna do that and we're going to do
that. Now, I've got my arches there, can I keep it while I'm standing up? So, I'm gonna get them
in a good position and then I'm gonna stand up. There we go! Now, while you're standing,
allow them to collapse in and then see if you can bring them back out by using your feet. Try not to
just turn your knees out; try to feel that you're actually using your feet to get them out there,
and then also just press a little bit with your big toe into the floor, that you can get the arch
to kind of activate. Once you can find that easy, then you've got to balance on one leg and see if
you can keep that. And if you find that your arch turns in, bring it back out. It's not allowed
to … or if it's too difficult, put the foot down, get the arch in through the position first – I
find it useful if I bend my knee a little bit – and then see if you can hold it. So, let me show
you from that ... from this angle. So, I've got my arch in a good position, and I balance. Now,
if I find that it rolls in, then you've got to try and correct it. If you can't correct it, put the
other one down and correct it, and then balance again, okay? So, you first have to practice
it a lot, the different components of practice: lifting the arch up, practice turning the foot in,
and then practice putting that together, and just seeing, ‘Can I correct it a bit?’ If your foot has
been in that position for a very long time, it's not going to correct perfectly at the beginning;
these exercises are extremely annoying exercises, because you may find that your brain is totally
not connected to your feet at the beginning, okay? And that's fine. I see that often;
it makes for a very good laugh. So, just keep practicing the component parts of it,
and then eventually try to put it together. It will eventually come; it's just that our brains
are often very disconnected from our feet. So, just keep at it. If you get frustrated,
leave it, come back to it tomorrow, or later in the day, and you may find that, ooh, all of a
sudden you can actually do it. So, little bits of correction. You'll - especially if your feet
are very turned in or you haven't done anything after you've retrained or after you sprained
them - it can take a long time to come back. Now, let me know if you've got any questions;
I'll be keeping an eye on the comments. And remember, if you need more help with an injury,
you're welcome to consult me online; the link is all in the description of the video. Take care!