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Pronation Syndrome

Pronation syndrome is a condition where excessive strain or overuse of a nerve in an improper position causes problems. and the nerve becomes irritated and inflamed. It is a common issue typically seen in the forearm or foot. If left untreated pronation syndrome can cause continued pain, and in some cases, impairment of movement.

  1. The Forearm and Pronation

    • There are two fascial compartments in the forearm. A fascial compartment is a section separated by fascia, a web of connective tissue which covers and supports the internal structures of the body. The anterior or palm side contains the median nerve. The median nerve originates in the lower cervical or neck region and runs down the arm to the fingers.

      Pronation of the forearm is rotational movement which moves the palm posterior, or in other words, rotates the palm down. This movement occurs as the radioulnar joint. The radioulnar joint is where the two long bones of the forearm, the radius and the ulna, make contact.

    The Foot and Pronation

    • The tarsals are the long bones in the foot. Just below the inside ankle bone there is a passageway of two nerves. These nerves are the medial and the lateral plantar nerves.

      Pronation of the foot occurs when the foot rolls inward, flattening the arch. This movement occurs at the subtalar joint. The subtalar joint is where talus, or the upper bone of the foot which connects to the ankle, and the calcaneus, or heel bone, make contact.

    Pronation Syndrome of the Forearm

    • Pronation syndrome of the forearm can occur with repeated and prolonged pronation of the forearm, usually coupled with forceful flexion or bending of the fingers. This can lead to an inflammation or entrapment of the median nerve. This syndrome of nerve irritation can cause pain and parasthesia, or numbness and tingling, in the forearm and hand. Due to the nerve entrapment, a general weakness of the wrist and fingers may occur.

    Pronation Syndrome of the Foot

    • When the foot rolls inward and the arch collapses, pressure is applied to the medial and lateral plantar nerves. This can result in an entrapment or restriction of these nerves which results in nerve irritation and inflammation referred to as tarsal tunnel syndrome. This syndrome of nerve entrapment can cause problems with activities or prolonged standing. Symptoms include pain, a pins and needles sensation, or numbness and tingling which can radiate into the arch of the foot, heel and toes.

    Treatment

    • It is best to consult with a primary care physician when experiencing these nerve conditions to rule out a more serious cause and to assure proper, timely treatment to avoid future problems. Pronation syndrome, whether of the hand or foot, requires the application of ice and the use of anti-inflammatory medications to decrease inflammation for the first few days of symptoms. A comprehensive stretching and exercise routine to increase flexibility and strength in the area of pain to prevent further injury is recommended once the pain and symptoms start to ease. Correction of the improper movements through exercises, body mechanics instruction and possible bracing will prevent a recurrence of symptoms.

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