Pronation describes a slight inward rolling motion the foot makes during a normal walking or running stride. The foot (and ankle) roles slightly inward to accommodate movement. Some people, however,
over-pronate and roll more than normal. With over-pronation, the arch of the foot flattens and causes excessive stress and pressure on the soft tissues of the foot. Over-pronation is more common in
those with flat feet, and can lead to foot aches and pain, such as plantar fasciitis, Shin Splints and Knee Pain.
There are many causes of flat feet. Obesity, pregnancy or repetitive pounding on a hard surface can weaken the arch leading to over-pronation. Often people with flat feet do not experience discomfort
immediately, and some never suffer from any discomfort at all. However, when symptoms develop and become painful, walking becomes awkward and causes increased strain on the feet and calves.
Because pronation is a twisting of the foot, all of the muscles and tendons which run from the leg and ankle into the foot will be twisted. In over-pronation, resulting laxity of the soft tissue
structures of the foot and loosened joints cause the bones of the feet shift. When this occurs, the muscles which attach to these bones must also shift, or twist, in order to attach to these bones.
The strongest and most important muscles that attach to our foot bones come from our lower leg. So, as these muscles course down the leg and across the ankle, they must twist to maintain their proper
attachments in the foot. Injuries due to poor biomechanics and twisting of these muscles due to over-pronation include: shin splints, Achilles Tendonitis, generalized tendonitis, fatigue, muscle
aches and pains, cramps, ankle sprains, and loss of muscular efficiency (reducing walking and running speed and endurance). Foot problems due to over-pronation include: bunions, heel spurs, plantar
fasciitis, fallen and painful arches, hammer toes, and calluses.
Bunions, calluses and crooked toes may indicate alignment problems. So, it is important to ascertain the condition of a client's toes. Check the big toe to determine if the first joint of the toe is
swollen, has a callus or bunion, and/or looks as though it abducts (i.e., hallux valgus) rather than pointing straight ahead. Also, look to see if the lesser toes seem to "curl up" (i.e., the person
has hammer or claw toes). This may be indicative of damage to, or inflexibility of the plantar fascia caused by excessive flattening of the foot.
Non Surgical Treatment
Overpronation of the feet can be corrected in some cases and in others it can be effectively managed. Overpronators can train themselves to change their running gait, wear arch supports, orthotic
insoles or specialist shoes for overpronators. In order to determine exactly what is happening during the stride, it is necessary to have a gait analysis conducted by a professional. The extent of
overpronation can then be determined, and the causes can be identified and corrected directly. The main corrective methods used for excessive pronation are orthotics. Orthotics are the most
straightforward and simplest solution to overpronation. Orthotics are devices which can be slipped into shoes which will offer varying degrees of correction to the motion of the foot. Orthotics help
to support the arches and distribute the body weight effectively, and are usually the best treatment choice for moderate to severe overpronation. Orthotics may require existing insoles to be removed
from your shoes to accommodate them; although most running shoes will have a removable insole to accommodate an orthotic insole.
HyProCure implant. A stent is placed into a naturally occurring space between the ankle bone and the heel bone/midfoot bone. The stent realigns the surfaces of the bones, allowing normal joint
function. Generally tolerated in both pediatric and adult patients, with or without adjunct soft tissue procedures. Reported removal rates, published in scientific journals vary from 1%-6%.