Normally, when you walk or run, your heel is the first part of your foot to strike the ground. As your body weight shifts to the middle of the foot, the arch of the foot naturally flattens out a bit.
This flattening is called pronation. If your feet flatten more than normal, it?s called over-pronation or flat feet. Over-pronation can cause many problems, such as an Achilles tendon injury or heel
pain. It may lead to knee problems.
It is important to identify the cause of overpronation in order to determine the best treatment methods to adopt. Not all treatments and preventative measures will work equally well for everyone, and
there may be a little trial and error involved to get the best treatment. A trip to a podiatrist or a sports therapist will help you to establish the cause of overpronation, and they will be able to
tell you the best treatments based on your specific degree of overpronation and the cause. Overpronation has many causes, with the most common reasons for excessive pronation listed, low arches,
flexible flat feet, fallen arches, gait abnormalities, abnormal bone structure, abnormal musculature, bunions, corns and calluses.
Overpronation can negatively affect overall body alignment. The lowering of the longitudinal arch pulls the heel bone in, causing the leg, thigh bone and hip to rotate inwards, and an anterior tilt
of the pelvis. Unnecessary strain to the ankles, knees, hips and back can result. Plantar fasciitis and inflammation, metatarsal pain, problems with the Achilles tendon, pain on the inside of the
knee, and bursitis in the hip are just some of the conditions commonly associated with pronation.
To easily get an idea of whether a person overpronates, look at the position and condition of certain structures in the feet and ankles when he/she stands still. When performing weight-bearing
activities like walking or running, muscles and other soft tissue structures work to control gravity's effect and ground reaction forces to the joints. If the muscles of the leg, pelvis, and feet are
working correctly, then the joints in these areas such as the knees, hips, and ankles will experience less stress. However, if the muscles and other soft tissues are not working efficiently, then
structural changes and clues in the feet are visible and indicate habitual overpronation.
Non Surgical Treatment
Although there is no actual cure for over-pronation it is possible to correct or at least reduce this problem. In order to restore our normal foot function an 'orthotic' or orthotic insole device is
placed inside the shoes. Orthotics are designed to realign the foot and ankle bones to their natural position. This in turn restores our normal foot function and it helps alleviate not only foot
problems but also ailments in other parts of the body i.e. the legs, knees and lower back. In addition to wearing an orthotic, it is recommended to wear supportive shoes, like good quality athletic
footwear with a firm heel counter and sufficient flexibility in the forefoot area.
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