When to Combine Pronation and External Rotation

Although external rotation and supination are paired, so too with internal rotation and pronation, sometimes you must drive pronation and external rotation. This need is especially common if you see a twist through the knee joint. In today’s post, we dive into when you have to do that. Steps for combining pronation with external rotation With these types of folks who present with hip external rotation loss and inability to pronate the foot, you have to untwist these folks. The first line of defense if you have manual skills is to perform manual therapy of the foot. I would look at restoring the following movements: Ankle dorsiflexion Calcaneal eversion First ray manipulations Cuboid manipulations If you don’t have manual skills, wedging the calcaneus laterally to drive eversion can work. You can also perform offset exercises, such as an offset wall squat, to drive rotation and further external rotation: Be mindful as you drive these motions, often people can cheat calcaneal eversion by plantarflexing the first ray even further!

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