Author: Staff

On the warm evening of 10 September 1960, a slender Ethiopian soldier
jogged to the start line of the Olympic marathon in Rome. He wore no
shoes. While the rest of the field arrived in purpose-built racing flats, Abebe
Bikila planted his bare feet on the cobblestones of the Appian Way and,
within two hours and fifteen minutes, rewrote the history of distance
running. It was not merely a sporting triumph; it was a declaration of
African capability broadcast to a world that had long underestimated the
continent.

Abebe Bikila was born on 7 August 1932 in the small village of Jato, in
the mountains of central Ethiopia. He grew up as a shepherd boy,
accustomed to moving across vast, rocky highland terrain, often with little
or nothing on his feet. At the age of twenty-four he joined the Imperial
Bodyguard of Emperor Haile Selassie, where he was noticed for his
prodigious physical fitness and exceptional lung capacity. His formal
running career began almost by accident. A friend invited him to watch a
training session run by the Finnish coach Onni Niskanen, who had been
sent to Ethiopia to develop the country’s athletics programme. Niskanen
recognised the young guard’s potential immediately and began coaching
him in earnest. Bikila trained at altitudes above 2,000 metres, a natural
physiological advantage that would prove decisive in competition.
When Ethiopia’s Olympic selection committee chose Bikila for Rome
in 1960, he was virtually unknown outside his own country. He had never
run an international marathon. The decision to race barefoot was partly
practical and partly symbolic. Adidas, the official supplier, had run out of
shoes that fitted him properly. Bikila had trained barefoot throughout his
preparation and felt more comfortable without shoes on the hard surface.
Niskanen agreed. In hindsight, the decision was inspired.

The Rome marathon was run at night under flickering torchlight, a
deliberate homage to the classical world, with the course winding along the
ancient Appian Way and finishing at the Arch of Constantine. The
atmosphere was theatrical and haunting. Bikila bided his time in the early
stages, settling into a compact, metronomic stride that consumed the road
with quiet efficiency. By the halfway point he had moved into contention.
By the 30-kilometre mark he was at the front. Moroccan runner Rhadi Ben
Abdesselam, the pre-race favourite, tried to match him but could not. Bikila
crossed the finish line in 2 hours, 15 minutes and 16 seconds, breaking the
world record by nearly eight minutes. He was so composed upon finishing
that he immediately began stretching and performing calisthenics, as if the
race had barely taxed him.

The symbolism of the victory was enormous and was not lost on the
watching world. Ethiopia was one of only two African nations never
colonised by a European power, the other being Liberia. It had successfully
repelled an Italian invasion in 1896 at the Battle of Adwa, only to suffer
Mussolini’s brutal occupation from 1936 to 1941. That Bikila won on Italian
soil, and won in Rome itself, carrying the Ethiopian flag with his bare feet,
was a profound act of postcolonial pride. Whether or not he consciously
framed it in those terms, millions of Africans and people of African descent
did. He was the first Black African to win an Olympic gold medal, and he
had done it in the most emphatic manner imaginable.

Four years later, at the 1964 Tokyo Olympics, Bikila proved that Rome
had been no fluke. This time he wore shoes. He had undergone an
appendectomy just forty days before the race, and his doctors had advised
him not to compete. He ignored them. He won again, setting another world
record with a time of 2 hours, 12 minutes and 11 seconds, becoming the first
person in history to win consecutive Olympic marathon gold medals. Once
more he finished the race in a condition that left his rivals bewildered. He
told reporters he could have run another ten kilometres. Whether or not
that was bravado, no one had the legs to test it.
His story, however, took a devastating turn. In March 1969, Bikila was
involved in a car accident near Addis Ababa that left him paralysed from the waist down. The nation was grief-stricken. Yet Bikila, with characteristic
resilience, refused to accept defeat. He took up competitive archery and
handpulled sledging, competing in the 1970 Stoke Mandeville Games for
Paralympic athletes. He died on 25 October 1973 from a brain
haemorrhage, complications arising from his injury. He was forty-one
years old. Ethiopia declared a national day of mourning. Emperor Haile
Selassie attended the state funeral in person.

The legacy of Abebe Bikila extends far beyond athletics. He opened a
door that Ethiopian and Kenyan runners would sprint through in the
following decades, establishing East Africa as the dominant force in
long-distance running. Names like Mamo Wolde, Miruts Yifter, Haile
Gebrselassie, Kenenisa Bekele, and Eliud Kipchoge all run in his shadow. He
also helped shift the global perception of African athletes from exotic
curiosities to serious competitors worthy of respect and study. In the years
since his death, sports scientists have revisited his barefoot running style
with fresh eyes, noting that his natural gait anticipated many of the
biomechanical insights that would only gain mainstream attention half a
century later.

Statues and portraits of Bikila stand in Addis Ababa. His image appears
on Ethiopian stamps and currency. A stadium bears his name. Yet perhaps
the most enduring monument to the man is the simple image that the
world cannot forget: a slight figure running in darkness on ancient stones,
barefoot and unhurried, moving through history as if it were merely
another training run through the highlands he called home.

Human walking is a beautifully orchestrated sequence of mechanical
events, each joint and muscle contributing a precisely timed movement to
propel the body forward with minimal energy expenditure. Among the subtler
yet clinically important observations a practitioner can make when analysing a
patient’s gait is the abductory twist. This brief, often fleeting motion at the heel
during the propulsive phase of walking has long intrigued podiatrists,
physiotherapists, and biomechanists alike. Understanding what drives it, what
it signifies, and how it can guide clinical management is essential for anyone
working with gait-related pathologies.

Defining the Abductory Twist
The abductory twist is an observable lateral flick or deviation of the heel
that occurs just as the foot is lifting off the ground during the late propulsive
phase of gait. Specifically, it appears in the window between heel rise and
toe-off — the moment when the forefoot and toes are the only structures still
in contact with the ground. Rather than the heel lifting cleanly and
symmetrically in a straight sagittal plane, it swings outward (laterally)
momentarily before leaving the surface entirely. The motion is often rapid
and subtle, lasting only a fraction of a second, yet it carries considerable
diagnostic value.
It is worth clarifying terminology here. The term “abductory” refers to the
direction of the heel’s deviation — moving away from the midline of the body,
which in this context means swinging outward. In clinical gait analysis, it is
observed from a posterior viewpoint, watching the patient walk away from the
examiner. When present, the heel marker or the back of the heel appears to
flick laterally, almost as though it is being pushed aside just before leaving the
ground.

The Biomechanical Basis
To understand why the abductory twist occurs, one must first appreciate
the mechanics of subtalar joint motion and its relationship to the gait cycle.
The subtalar joint — the articulation between the talus and calcaneus — is
responsible for eversion and inversion of the foot. During normal gait, the
foot pronates (the subtalar joint everts) during loading response to absorb
shock, and then supinates (the subtalar joint inverts) during the propulsive
phase to create a rigid lever for push-off.
The abductory twist arises when this resupination is delayed or
incomplete. If the foot has not adequately resupinated by the time heel rise
occurs, the ground reaction forces acting through the forefoot — combined
with the internal rotation forces still present at the lower limb — create a
situation where the calcaneus, instead of lifting straight, is torqued laterally.
Effectively, the foot is being asked to push off before it has achieved the rigid,
supinated position necessary to do so efficiently. The resulting lateral heel
flick is the body’s mechanical compromise.
Pronation itself is driven in part by tibial internal rotation transmitted
through the subtalar joint. When tibial internal rotation is excessive or
prolonged — due to structural or functional factors — it continues to drive
eversion of the calcaneus into the propulsive phase, long past its welcome. The
abductory twist is therefore often described as a visible manifestation of
delayed or excessive pronation.

Common Causes and Contributing Factors
A wide range of anatomical and functional variables can predispose an
individual to exhibiting an abductory twist. Foremost among these is rearfoot
valgus, or everted heel alignment, which places the subtalar joint in a
structurally pronated position even at rest. Similarly, forefoot varus — a
condition in which the forefoot is inverted relative to the rearfoot in a neutral
subtalar position — forces the foot to pronate excessively to achieve full
ground contact. Tibial varum and genu valgum can also contribute by altering
the mechanical axis and increasing the pronatory moments acting on the foot.
Functional factors are equally important. Weakness in the hip external
rotators or hip abductors can result in excessive femoral and tibial internal
rotation being transmitted all the way to the foot. Limited ankle dorsiflexion
range — from a tight Achilles tendon, for instance — can also delay the foot’s
ability to resupinate, as the body compensates through subtalar pronation to
achieve the necessary range of motion for forward progression.

Clinical Significance
The abductory twist is not merely an aesthetic curiosity; it has meaningful
implications for musculoskeletal health throughout the lower limb and
beyond. Persistent, excessive pronation and the associated delayed
resupination place repetitive strain on the plantar fascia, tibialis posterior
tendon, and the medial ankle structures. Conditions such as plantar fasciitis,
tibialis posterior tendinopathy, medial tibial stress syndrome, and
patellofemoral pain syndrome have all been associated with prolonged or
excessive pronation patterns that the abductory twist can signal.
Furthermore, the abductory twist reflects an inefficiency in the gait cycle.
Propulsion becomes less powerful when the foot cannot form a rigid lever at
toe-off. Energy that should be directed forward is dissipated in the lateral heel
flick, and the muscles of the calf must work harder to compensate. Over time,
this inefficiency contributes to fatigue, reduced performance in athletes, and
increased injury risk.

Assessment and Management
Identifying the abductory twist typically requires a trained eye observing
gait from a posterior view, ideally on a treadmill or along a clear walkway.
Video analysis, even at standard frame rates, is usually sufficient to capture it,
though higher-speed cameras can make the motion unmistakable. Clinicians
should also perform a comprehensive static and dynamic biomechanical
assessment to identify the underlying driver of the twist, as treatment must be
directed at the root cause rather than the symptom alone.
Orthotic therapy is among the most common interventions. Functional
foot orthoses, particularly those incorporating a rearfoot valgus post or medial
arch support, can correct the alignment of the subtalar joint and facilitate
timely resupination. However, orthotics function best when combined with
addressing muscular imbalances through targeted strengthening — especially
of the hip abductors, external rotators, and tibialis posterior — and improving
flexibility where restrictions exist. Footwear guidance, gait retraining, and in
some cases taping techniques may all form part of a well-rounded
management plan.

The abductory twist, though brief and easy to overlook, is a window into
the complex interplay of forces that govern human locomotion. Its presence
signals that the foot’s transition from a mobile adaptor to a rigid propulsive
lever is being disrupted — a disruption with potential consequences not just
for the foot, but for the entire kinetic chain above it. For the clinician, learning
to recognise and interpret the abductory twist is a valuable skill, one that
bridges the gap between observation and diagnosis, and ultimately between
diagnosis and effective, lasting treatment.

Overpronation has become the most misused and confusing words in running and health professional communities, specifically when it involves the prescription of running shoes. The whole conventional model of the design of different running shoes are derived from the idea of the normal or neutral posture of the feet. Pronation happens when the foot rolls medially at the rearfoot and the arch collapses. Supination happens when the feet rolls outwards at the rearfoot and the mid-foot height increases. They are normal healthy motions that are needed for normal biomechanics of the feet. It is the way the foot adapts to uneven surfaces and absorbs impact. There is nothing unhealthy with the motions of pronation or supination.

The phrase overpronation is used to infer if there is too much pronation. The reason why it becomes an issue is that overpronation is believed to be a risk factor for numerous different running injuries. For this reason, running shoes are made with design characteristics in them which are thought to help stop this overpronation. These design features include medial heel posts, dual density midsoles in addition to rigid heel counters. These footwear are supposed to be prescribed for those who overpronate. Those who tend not to overpronate will need to use shock absorbing neutral shoes.

The problem with this principle is that the term is misused considerably. There’s no general opinion regarding the cut-off stage between normal pronation and overpronation. There is hardly any evidence associating overpronation to running injury and if there is any, it’s showing that it really is only a very small risk factor. Lots of runners overpronate significantly and don’t have issues. Similarly, there are numerous runners which do not overpronate that have a lot of problems. Because of this confusion, there’s been a recent change in using the phrase and the comprehension of overpronation in connection to overuse injury and the use of running shoes.