Low Tone Pronation

Patients with weakness or lack of integrated muscle control of the feet and lower leg will usually present with some degree of pronation, fallen arch (flat-footed) with the forefoot turned outward (abducted) and the ankle leaning inward and heel angled outward (everted). This misalignment can vary from a mild to severe presentation. This low tone pronation is driven by the patient’s body weight bearing down on feet that are unable to support or maintain good biochemical positioning. The low tone foot can be extremely flexible and will usually be fully correctable to a neutral alignment with manipulation. In older patients, the foot may become more fixed, therefore, more difficult to correct.

Low Tone Pronation

•    Pronated foot - valgus (everted) heel, collapsed arch, forefoot abducted
•    Due to weakness or lack of integrated muscle control of the feet
•    Navicular and medial malleolus prominent
•    Foot usually easily corrected (especially in young patients)
•    Ankle range and function usually good

Brace Selection for Low Tone Pronation

Within each level of involvement, there are recommended brace solutions.

Mild
  • Visible medial arch
  • Mild heel eversion and forefoot abduction
  • Can correct when prompted
  • Can be manually corrected with no resistance
Moderate
  • Reduced medial arch
  • Moderate heel eversion and forefoot abduction
  • Can improve when prompted
  • Can be manually corrected with mild resistance
Strong
  • Absent medial arch
  • Strong heel eversion and forefoot abduction
  • Cannot improve when prompted
  • Can be manually corrected with moderate resistance

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