Pronation Distortion Syndrome: All You Need To Know

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Pronation distortion syndrome (PDS) is a term that defines the wrong (downwards) orientation of one’s foot. When a person’s foot faces downwards, it is pronated. It may sound a little messed up and confusing but don’t you worry, it is very treatable!

As we grow up in childhood, our curves create versatile pliancy. Basically, they lose a portion of their strength and begin to twist and bounce as we step. This bounce makes our foot roll internal, our lower leg and knee roll internal, and our hip stick outward. It has been assessed that up to 98% of the people experience impacts of Pronation Distortion to an extent. 

Keep reading to learn everything about the pronation distortion syndrome!

What Is Pronation Distortion Syndrome?

Pronate refers to facing downwards in the medical world. If you have ever visited a doctor that said “you have flat feet” and it got you staring at your feet? Well, having flat feet means you have pronation distortion syndrome.

This lower limit distortion example can prompt a chain response of muscle imbalances in nature all through the kinetic chain, prompting foot and lower leg, knee, hip, and lower back pain. Flat feet are followed by inward rolling of ankles. Pronation distortion syndrome is portrayed by excessive foot pronation i.e. flat feet with accompanying knee interior rotation and adduction i.e. knock-kneed.

Pronation is the foot is used to describe medical terms that show how you walk, run or stand. All your weight is balanced by and on your feet whether you sit, walk, stand, or run. If your feet lean in, they are pronated.

What Are The Symptoms?

Flat feet are followed by inward rolling of ankles. Pronation distortion syndrome is portrayed by excessive foot pronation i.e. flat feet with accompanying knee interior rotation and adduction i.e. knock-kneed. Following is a list of what can be counted as one of the symptoms of pronation distortion syndrome:

  1. Knee pain
  2. Hip pain
  3. IT band issues
  4. Plantar fasciitis
  5. Limping

Signs & Causes in Pronation Distortion Syndrome:

Pronation Distortion Syndrome implies that when you walk, your weight will in general be more within your foot. Foot dysfunction is usually said to be one of the primary causes of this body posture that can also be related to hip dysfunction. Following are the signs and causes of pronation distortion syndrome:

  1. Pronation Distortion Syndrome And Foot Dysfunction

While you are standing you might have noticed a flat foot. This flat foot causes the tibia to turn around internally that as a result causes an internal rotation of the femur. The femur rests on the top of the tibia. This rotation in the femur while you are standing causes simultaneous adduction. This refers to an obligatory joint motion that occurs in closed chain movements.

  1. Pronation Distortion Syndrome And Hip Dysfunction

In case of any weakness in the abductors (gluteus medius), it is an alarming symptom for this dysfunction. In such cases, the femur might rotate or begin to rotate and adduct which causes the foot to pronate.

Pronation Distortion Syndrome Signs:

  1. Flat feet
  1. Knocked knees

Negative Effects of This Syndrome

Normally pronation distortion syndrome does not involve any high risk of pain and can easily be treated, however it can lead to any sort of injury or pain. Here is a list of injuries that can be a result of pronation distortion syndrome:

Pronation Distortion Syndrome Injuries

  1. To The Foot And Ankle

Pronation distortion syndrome has a lot to do with lower-body injuries. Pronation Distortion Syndrome can cause pain to the lower leg, ankle, or foot. This pain may include:

  • Pain in the foot
  • Pain in the toe
  • Plantar fasciitis
  • Achilles tendinopathy
  • Posterior tibialis tendinitis
  • Anterior tibialis tendinitis

As mentioned in the first line, pronation distortion syndrome can be associated with overuse injuries. These develop when a part of the body or tissues is under stress for a long time. For example too much stress on the tissues on the foot or ankle (usually while walking or running). If not treated, over time these tissues can damage due to irritation, inflammation, or weakness leading to an even more serious health hazard such as ruptured tendons or stress fractures.

  1. To The Hip, Knee, And Lower Back

Another very common area of the target of pronation distortion syndrome is the knee, hip, and lower back. Patellar tendinitis is a very common knee condition associated with pronation distortion syndrome. The reason is that knee too can also come under too much stress in case of any femoral internal rotation and adduction.

Noncontact wounds are oftentimes likened to overuse wounds in that the tissues are stressed over the long haul; normally inferable from a lot of continuous pressure with no ideal opportunity for full recuperation between stressing on occasions. Likewise, pronation distortion syndrome is likely to move the ship out of the appropriate arrangement, causing general hip and lower back pain.

Excess Pronation

If when you walk, your foot rolls towards the inside and the arch is flattened out you are likely to have excessive pronation or overpronation. Usually, people are more likely to have overpronation as compared to underpronation. In such case of overpronation or excess pronation, your following body parts can be targeted to pain:

  1. Heel
  2. Arch
  3. Ankle
  4. Knee
  5. Hip
  6. Bacl
  7. Shin

What Is The Treatment?

The joints due to pronation distortion syndrome rotate and get stuck. The joints that have now become stuck should be cleared. The opposite side of the joint will have lethargic muscles that have failed to remember how to contract. These need some straightforward activities to awaken them back.

One side of the joint will have muscles and delicate tissue that are spastic, short, and tight. These should be delivered with one of numerous accessible delicate tissue methods strategies that not all suppliers are knowledgeable about. The best convention for treating pronation distortion syndrome has a few phases. 

Pronation Distortion Syndrome can cause an unusual placement of joints due to rotation that can cause pain in the following areas:

  1. Feet
  2. Knees
  3. Hips
  4. Legs
  5. Back 

Here is a list of treatments that can be done to ease the pain of pronation distortion syndrome, however, the severity of pain can also change the nature of your treatment. Always visit a doctor!

  1. The Shoe Treatment:

In order to ease the pain caused by pronation distortion syndrome, wearing supportive shoes is essential. Not only should they be supportive but also should suit your shoe size and be well fitted. This can involve having proper cushioning and great room space for your toes. Thanks to modern technology, you can easily find such sports shoes out there!

The best shoe type is one that is stable, has a firm midsole, and supportive cushioning so that your heel gets proper support to balance the inward rotation of the foot. 

  1. Physical Therapy

Another helpful treatment for pronation distortion syndrome is physical therapy. A physical therapist can help in several exercises such as stretching that you can easily do at your home. Moreover, manual therapy can also help relieve your foot or leg pain.

Some Exercises That May help:

  1. Overhead Squat Both Normal And With Elevated Heels
Overhead Squat Without Elevation

2. Overhead Squat With Elevation

Overhead Squat With Elevation


If the horizontal part of the foot which includes the fifth toe and metatarsal, raises or pivots off the floor, or if the kneecap moves inside the primary toe, the person is encountering pronation distortion syndrome. For this situation, playing out an adjusted Overhead squat can help recognize the probable source of the issue.

When Should You Consult With a Doctor?

It’s a smart thought to see a specialist on the off chance that you have any foot pain. This can be your standard specialist or any sports expert.

They can help in the following: 

  1. improve  the manner in which you walk or run 
  2. Instruct you on the best kind concerning shoes 
  3. Recommend you suitable exercises to manage pronation distortion according to your level of severity

Bottom Line

Pronation distortion syndrome is portrayed by excessive foot pronation i.e. flat feet with accompanying knee interior rotation and adduction i.e. knock-kneed. Pronation is terms used to depict down direction of your hand, lower arm, or foot. 

In the event that your feet are pronated it can lose your body’s arrangement and make you inclined to wounds. It’s critical to see a specialist and get medicines that can help right your position. While pronation distortion syndrome may sound a little confusing, it is treatable. It can be done through either some physical exercise like stretching or through wearing the right type of shoe.

In any case, we recommend you to visit a doctor if you experience severe pain in your foot, knee, hip, or back. 

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