Navicular Drop Test: Excessive Pronation of the Foot
Navicular Drop Test:
The Navicular Drop Test is described as a means of quantifying the amount of foot pronation.
Pronation isn’t the Big Bad Wolf…
There’s a lot of stigma around the whole ‘pronation’ saga…A lot of practitioners argue that pronation is a bad thing and really it isn’t. It’s a bit like a diet..everything in moderation.
Pronation has to occur to a certain degree – It’s a phase within the gait cycle. However, what this screen measures is excessive pronation – And that’s where it becomes a bad thing. We need to have control over this position and ultimately, we shouldn’t be living in pronation (A lot of us do though, and we cover more about that during our Knee and Foot course…)
Why is the Navicular Drop Test important?
An excessive navicular drop is thought to predispose individuals or increase the risk of overuse injuries such as medial tibial stress syndrome, plantar fasciitis and patellofemoral pain.
Not only this, but excessive pronation at the foot can create a spiral of dysfunction up the chain. An excessively pronated foot can affect the position of the hip, the pelvis, and the spine – Everything up the chain really, it’s all connected!
If you try to visualise the bones of the foot when it’s in pronation – The bones on medial aspect open up and on the lateral side, they close down. The talus also rotates medially, and the talus is a key bone because it influences the position of the pelvis. If the talus is medially rotated, this takes the tibia and the fibula with it into internal rotation. It then also takes the femur into internal rotation and because of that, it can take the pelvis into an anterior tilt. As a result of that, it can take that side of the back into extension.
You may find that someone has pronation in one foot and not the other…It’s not always something you would immediately go to correct. Something up the chain could be driving the foot down into pronation so it’s good to note whether someone is over-pronated in one or both feet and what the effect might have up the chain…Or indeed whether something up the chain is taking the foot into that position.
How to Perform the Navicular Drop Test:
First of all, you’ll need to palpate to locate the Navicular Tuberosity. If you’re not sure how to do this, or where that is – You may want to pop on over to our YouTube channel and watch the Bony Landmarks of the Foot video (P.S. Don’t forget to subscribe whilst you’re there!)
Once you’ve found the navicular tuberosity, mark it on your client with a pen.
Next, you’ll need to position the clients foot in a neutral position. In order to do this, you’ll need to find the talus. (Finding the talus is also included in our Bony Landmarks of the Foot video) You can do this by asking your client to lift their toes, then following the tendons up the foot, you can then place your forefinger and thumb either side of the talus. You need to position the foot so that the talus can be felt equally in both your forefinger and thumb – Once you feel that it’s evenly sat there, you’ll know your client’s foot is in neutral.
With your client’s foot in neutral, take a piece of paper and mark where the navicular is. Then you’ll need to ask your client to weight-bear on the foot and allow the foot to sit where it naturally sits.
You’ll then need to mark on that paper where the new position of the navicular is – And now measure the distance between these 2 marks. Anything within a 1cm difference would be considered a ‘normal range of pronation’ however, if your client has more than 1cm of pronation then this would be classified as excessive.
All of these screens are really helpful when you need assess for dysfunction or sub-optimal movement patterns and pain or discomfort – But what we look at on our courses is then how you would help your client to effectively strengthen and rehab these areas using Pilates based exercise. Pilates is all about optimal movement so if we know which area of the body is preventing that and we can work on correcting and strengthening the weak link then the benefits can be huge for you and your clients!
We delve deeper into this on our Knee and Foot courses and we still have a few spaces free should you wish to join us and learn more! So if you’re interested, please feel free to visit our Courses page or why not drop us an email at email@example.com