An injury resulting in excess pronation of the foot

Shin Splints - An injury resulting in excess pronation of the foot Factor

Pronation is the natural inward roll of the foot that occurs as the arch collapses (like a spring to absorb shock) between the time the heel contacts the ground and toe-off.  The lower leg also rotates slightly inward during pronation.  Pronation is normal and necessary for the foot to adequately absorb shock and adapt to the surface it lands on.

Overpronation is an excessive inward roll of the foot while walking or running.  It is a common problem that can be due to a number of factors such as:

• congenital or developmental laxity in certain ligaments or a bony conformation that contributes to excess pronation;
• muscular tightness, particularly in the calf muscles;
• weakness in muscles medial to the ankle;
• flat feet; and
• Morton's foot, or Morton's toe (big toe shorter than second).  Morton's foot  is common.  If the big toe is shorter, the foot rolls inward further before toe-off.

HOWEVER, the SOP factor in shin splints requires that excess pronation must have resulted from an injury.  Such an injury eg an ankle sprain resulting in excess laxity of the ligaments may be a significant one worthy of medical attention at the time of injury.  However, chronic overuse injuries such as degenerative tears of the peroneal tendons occur over long periods of time.

Last reviewed for CCPS 12 December 2007.

Investigative Documents

Preliminary questions [36802]

36822 there is some evidence that an injury resulting in excess pronation of the foot may be a factor in the development of the condition under consideration.

36823 the veteran has medial tibial stress syndrome.

36824 the veteran has had an injury that resulted in excess pronation of other relevant side and site of the body at some time.

36825  an injury that has resulted in excess pronation of the foot means an injury that has caused a positional deformity of the foot such that there is excessive dorsiflexion, eversion and abduction (inward roll) of the foot when the foot is in a fixed position or in dynamic motion.

38786  the veteran has established the causal connection between an injury resulting in excess pronation of the foot and VEA service for shin splints.

36826 the veteran had the identified illness or injury, which resulted in excess pronation of other relevant side and site of the body, before the clinical onset of the condition under consideration.

36827   the veteran has established the causal connection between an injury resulting in excess pronation of the foot and VEA service for the clinical onset of shin splints.

36828  the veteran has established the causal connection between an injury resulting in excess pronation of the foot and operational service for the clinical onset of shin splints.

or

36829  the veteran has established the causal connection between an injury resulting in excess pronation of the foot and eligible service for the clinical onset of shin splints.

or

7334     the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

7335     the condition under consideration permanently worsened.

38787   the veteran had the identified illness or injury, which resulted in excess pronation of other relevant side and site of the body, before the clinical worsening of the condition under consideration.

38788   the veteran has established the causal connection between an injury resulting in excess pronation of the foot and VEA service for the clinical worsening of shin splints.

38789  the veteran has established the causal connection between an injury resulting in excess pronation of the foot and operational service for the clinical worsening of shin splints.

or

38790  the veteran has established the causal connection between an injury resulting in excess pronation of the foot and eligible service for the clinical worsening of shin splints.

Clinical onset and operational service [36828]

36830  the identified illness or injury, which resulted in excess pronation of other relevant side and site of the body, is causally related to operational service.

Clinical onset and eligible service [36829]

36831  the identified illness or injury, which resulted in excess pronation of other relevant side and site of the body, is causally related to eligible service.

Clinical worsening and operational service [38789]

36830  the identified illness or injury, which resulted in excess pronation of other relevant side and site of the body, is causally related to operational service.

38791 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, which resulted in excess pronation of other relevant side and site of the body, is causally related.

Clinical worsening and eligible service [38790]

36831  the identified illness or injury, which resulted in excess pronation of other relevant side and site of the body, is causally related to eligible service.

38792 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, which resulted in excess pronation of other relevant side and site of the body, is causally related.