Pronation is a normal motion that our feet make as they walk. With each step, the heel touches the ground first, then the foot rolls forward to the toes, causing the ankle to roll inward slightly and
the arch to flatten out. That?s normal. But when that rolling inward becomes more pronounced, that?s over-pronation, which is a big problem. You can usually see over-pronation by looking at the back
of the leg and foot. The Achilles tendon normally runs straight down from the leg to the foot, hitting the floor at a perpendicular angle. In feet that over-pronate, the Achilles tendon will be at a
slight angle to the ground and the ankle bone will appear more prominent than usual.
Over-pronation has different causes. Obesity, pregnancy, age or repetitive pounding on a hard surface can weaken the arch leading to over-pronation. Over-pronation is also very common with athletes,
especially runners and most of them nowadays use orthotics inside their shoes. Over-pronation affects millions of people and contributes to a range of common complaints including sore, aching feet,
ball of foot pain, heel Pain, achilles tendonitis, bunions, shin pain, tired, aching legs, knee pain and lower back pain. The most effective treatment solution for over-pronation is wearing an
orthotic shoe insert. Orthotics correct over-pronation, thereby providing natural, lasting pain relief from many common biomechanical complaints.
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.
If you have flat feet or low arches, chances are you overpronate. Although not always the case, the lower your arches the greater the overpronate. Stand on a hard surface (in front of a mirror if you
need to) and look at your feet, flat feet or low arches are easy to spot. If your feet look flatter than a pancake, have a look at your ankles and see if they seem collapsed or straight. If they are,
Non Surgical Treatment
When you see the doctor, he or she will likely perform a complete examination of your feet and watch you walk. The doctor will need to take x-rays to determine the cause of your flat feet. In some
cases, further imaging may be needed, especially if your symptoms are severe and sudden in nature. Once you are properly diagnosed, your doctor will create an appropriate treatment plan. There are
several options to correct overpronation, such as orthotics. In many cases, overpronation can be treated with non-surgical methods and over-the-counter orthotics. In severe cases, however,
custom-made orthotics may work better. Orthotics provide arch support and therefore prevent collapse of the arch with weight bearing. They are made of materials such as spongy rubber or hard plastic.
Your doctor will also want to examine your footwear to ensure they fit properly and offer enough medial support. Extra support and stability can be achieved with footwear that has a firm heel
counter. If you are experiencing pain, you should be able to use over-the-counter pain medications such as ibuprofen to relieve symptoms.
Hyperpronation can only be properly corrected by internally stabilizing the ankle bone on the hindfoot bones. Several options are available. Extra-Osseous TaloTarsal Stabilization (EOTTS) There are
two types of EOTTS procedures. Both are minimally invasive with no cutting or screwing into bone, and therefore have relatively short recovery times. Both are fully reversible should complications
arise, such as intolerance to the correction or prolonged pain. However, the risks/benefits and potential candidates vary. Subtalar Arthroereisis. An implant is pushed into the foot to block the
excessive motion of the ankle bone. Generally only used in pediatric patients and in combination with other procedures, such as tendon lengthening. Reported removal rates vary from 38% - 100%,
depending on manufacturer. 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