Over-pronation occurs when the foot collapses too far inward stressing the plantar fascia (the area underneath the arch of the foot.) Normally, one pronates every time he/she walks, but excessive
pronation is called over-pronation. When this occurs it can cause pain in the feet, knees, hips, low back and even the shoulder.
Over-pronation is very prominent in people who have flexible, flat feet. The framework of the foot begins to collapse, causing the foot to flatten and adding stress to other parts of the foot. As a
result, over-pronation, often leads to Plantar Fasciitis, Heel Spurs, Metatarsalgia, Post-tib Tendonitis and/or Bunions. 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.
When standing, your heels lean inward. When standing, one or both of your knee caps turn inward. Conditions such as a flat feet or bunions may occur. You develop knee pain when you are active or
involved in athletics. The knee pain slowly goes away when you rest. You abnormally wear out the soles and heels of your shoes very quickly.
You can test for pronation by looking at the leg and foot from the back. Normally you can see the Achilles Tendon run straight down the leg into the heel. If the foot is pronated, the tendon will run
straight down the leg, but when it lies on the heel it will twist outward. This makes the inner ankle bone much more prominent than the outer ankle bone.
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.
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.