Overpronating is a term that is thrown around loosely, whether it be a clinician?s office (PT, Ortho Doc, Podiatrist), in print publication, online, or at your local shoe shop.Being classified as an
overpronator is fairly subjective. There?s no criteria to classify you as a runner who overpronates. Pronation is completely normal. Pronation allows your foot to unlock and distribute force up the
chain (leg). Pronation that fails to occur, whether it be due to an orthotic, bony structure (high arch), or motion control shoe, may actually increase ground reaction forces (impact). It should make
sense, too. Blocking your foot from pronating disengages the first anatomical system for absorbing impact forces. ?Over? insinuates that you pronate too much, but who gets to determine what?s
considered normal? We have values that are deemed ?normal,? but varying foot structures complicate the situation. Varying degrees of high, neutral, and low arches all affect this ?normal? pronation
number. ?Normal? pronation numbers will simply be out of reach for rigid arches, while flexible feet with surpass the numbers. To dilute the situation further, your strength, habits, and flexibility
can all influence how much you pronate.
During our development, the muscles, ligaments, and other soft tissue structures that hold our bones together at the joints become looser than normal. When the bones are not held tightly in place,
the joints are not aligned properly, and the foot gradually turns outward at the ankle, causing the inner ankle bone to appear more prominent. The foot moves in this direction because it is the path
of least resistance. It is more difficult for the foot to move in the opposite direction (this is called supination). As we develop, the muscles and ligaments accommodate to this abnormal alignment.
By the time growth is complete, the pronated foot is: abnormally flexible, flat, and its outer border appears raised so that as you step down you do not come down equally across the entire foot;
instead, you come down mostly on the inner border of the foot. Normal aging will produce further laxity of our muscles that causes the pronation to become gradually worse.
Symptoms can manifest in many different ways. The associated conditions depend on the individual lifestyle of each patient. Here is a list of some of the conditions associated with Over Pronation.
Hallux Abducto Valgus (bunions). Hallux Rigidus (stiff 1st toe). Arch Pain. Heel Pain (plantar fascitis). Metatarsalgia (ball of the foot pain). Ankle sprains. Shin Splints. Achilles Tendonitis.
Osteochondrosis. Knee Pain. Corns & Calluses. Flat Feet. Hammer Toes.
Firstly, look at your feet in standing, have you got a clear arch on the inside of the foot? If there is not an arch and the innermost part of the sole touches the floor, then your feet are
over-pronated. Secondly, look at your running shoes. If they are worn on the inside of the sole in particular, then pronation may be a problem for you. Thirdly, try the wet foot test. Wet your feet
and walk along a section of paving and look at the footprints you leave. A normal foot will leave a print of the heel, connected to the forefoot by a strip approximately half the width of the foot on
the outside of the sole. If you?re feet are pronated there may be little distinction between the rear and forefoot, shown opposite. The best way to determine if you over pronate is to visit a
podiatrist or similar who can do a full gait analysis on a treadmill or using forceplates measuring exactly the forces and angles of the foot whilst running. It is not only the amount of over
pronation which is important but the timing of it during the gait cycle as well that needs to be assessed.
Non Surgical Treatment
Personal orthotics can be prescribed via your healthcare professional. If finances or insurance are issues, similar and often better options can be purchased online for overpronation. The right
walking shoes are also essential. Most shoes cater to neutral foot gaits, unless they specifically state otherwise. That won?t help you if your foot rolls inward. In order to correct the issue, you
need shoes with stability or motion control abilities, low heels, deep heel cups, and good arch support.
Subtalar Arthroereisis. The ankle and hindfoot bones/midfoot bones around the joint are fused, locking the bones in place and preventing all joint motion. This may also be done in combination with
fusion at other joints. This is a very aggressive option usually reserved for extreme cases where no joint flexibility is present and/or the patient has severe arthritic changes in the joint.