The pronation wedge is an orthopedically effective element of shoe technology and, like the supination wedge, is attached to so-called wedge soles or wedge insoles. The wedge shape is used to compensate for malpositions of the foot axis that impede the natural rolling motion of the foot. For example, pronation wedges are used for malpositions such as bow legs or knock-knees, but also for phenomena such as clubfoot and ligament problems.
What is the pronation wedge?
The pronation wedge is an orthopedically effective element of footwear technology. Among other things, orthopedic footwear technology produces various types of insoles with medical benefits. Medical insoles become necessary especially in the case of foot malpositions. Foot malpositions are for example the bent foot, the flat foot or the flat foot. The insole technique supports the natural functions of the foot and counteracts malpositions, which in the course of time can lead to loss of function and secondary diseases such as joint wear due to incorrect loading. Different insoles are used for different malpositions and symptoms. One of them is the wedge insole or wedge sole. Wedge insoles with an internally raised shape are called supination wedges. On the other hand, externally elevated wedge insoles carry a so-called pronation wedge, which puts the foot in pronation and accordingly rotates it inward around its own axis. The outer edge of the foot is raised by the pronation wedge sole. The inner edge of the foot, on the other hand, is lowered when used. Both pronation and supination wedge soles are used primarily in the context of complaints during rolling.
Forms, types and types
The pronation wedge is made in the form of a wedge sole by the orthopedic shoe technician. The fitting and grinding in are all-important for the effectiveness of the wedge sole. Accordingly, the pronation wedges of two patients always differ from each other. So, in terms of shape, type, wedge soles are never the same, but depend on the shape of the foot and the patient’s individual clinical picture. Wedge soles also differ from each other with the use of different materials. Cork materials are sometimes the most commonly used. Cork has physical properties such as elasticity due to its air pockets. This means that the material does not behave rigidly. Rather, cork adapts to the foot and the weight of the patient, and thus fulfills primarily a bedding function instead of a rigidly supporting and guiding function. These properties make wedge soles or pronation wedges made of cork materials a relatively gentle way to correct deformities. Beyond cork, materials such as leather, felt and plastic can also be used in the pronation wedge. The correction power to be achieved by the wedge is the decisive factor. In addition to bilateral use of the wedge sole, unilateral use of the pronation wedge is also indicated for some clinical pictures. Typical heights of the design are three to five millimeters.
Structure and mode of operation
Pronation wedges are basically easy to use and can be inserted into many different shoes. As the name implies, pronation wedges have a wedge or triangular shape. When attached to an insole, they are capable of raising the outer edge of the patient’s foot to a greater or lesser degree and lowering its inner edge at the same time to a greater or lesser degree. By raising the foot under the heel, the pronation wedge relieves the ligaments of the hindfoot, including the miniscus. The pronation wedge supports the pronation of the foot, i.e. the natural inward bending movement when the foot hits the ground. Pronation is an absolutely necessary part of the natural movement process. With reduced pronation, but also with overpronation, complaints can occur in the long term. Pronation control can take place by means of a pronation wedge through the shoe itself. The wedge-shaped area on the inner midsole is usually made of harder material on the outside and thus absorbs the buckling movement. Pronation wedges are sometimes most commonly used in athletic shoes because the rolling motion is an essential movement, especially during physical activity. Malpositions of the foot or leg axis make a healthy rolling movement difficult and thus require the use of pronation or also supination wedges.As noted above, a pronation wedge must be precisely adapted to the concerns and dimensions of the wearer in order to achieve positive effects.
Medical and health benefits
A fairly typical clinical picture with indication for a continuous pronation wedge exists with valgus gon osteoarthritis or the so-called X-legs. Painful wear and tear of the knee joints can be a consequence of the X-leg position. Most often, the joint on the outside is affected. X-leg axial malalignments of the legs are either congenital or acquired through accidents. Such a phenomenon can also occur after partial or complete removal of the outer meniscus. In a x-leg axis malalignment, the knee is subjected to uneven loading. The outside knee joint is overloaded and cartilage wear occurs. In this context, the pronation wedge can support realignment surgery. Successes can be expected after realignment surgery, but these often dissipate without further follow-up treatment. In addition to knock knees, deformities such as bow legs can also be an indication for the pronation wedge. The same applies to conditions such as clubfoot. Both clinical pictures may require conservative insoles to ensure treatment success of the surgical measures, which usually carry a flat pronation wedge. Apart from these areas of application, the pronation wedge is also used for complaints, overloads and injuries of the external ligaments. Such complaints are usually meniscus injuries that, if left untreated, can result in secondary conditions.
