One of the main postural deviations that cause pain and injury in the foot and ankle area (and resultant compensations in the rest of the body) is overpronation. Pronation is a normal function that
occurs when the foot rolls inward toward the midline of the body. This movement causes the heel to collapse inward and the medial arch of the foot to elongate and flatten. Overpronation, however, is
when the foot collapses too far inward for normal function. Consequently, this directly affects the ability of the foot to perform and can disrupt proper functioning through the entire
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.
If ignored, overpronation can lead to complications such as hammer toes, corns and calluses, shin splints, hallux rigidus and many more foot and lower leg problems. Hammer toes appear when the toes
are placed under too much pressure and the ligaments and muscles in the toes begin to reduce in size, leading to the curvature of the toes and making them look like little hammers. Overpronators can
develop hammertoes if they don?t wear an appropriate pair of shoes. Corns and calluses also appear as a result of overpronation. They form in response to excess pressure, and overpronators may find
that they have excessive hard skin on the balls of the feet and inside edge of the big toe. It is the body?s way of protecting against excessive forces and friction. They can be painful.
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
Get a gait analysis of your running style, this will highlight if you overpronate, oversupinate or have a neutral gait. Most podiatrists, physio's and sports therapists will offer this service, as do
some specialist sports shops. Find a clinic. If you overpronate, get orthotics with extra medial support. Many running shoes have a harder material on the inside of the midsole (the thick hard foam
part of the running shoe). This means the inside of the shoe will be compressed less under load and support the inside of the foot preventing it from rolling in or flattening. For people with
considerable overpronation, another option is to have an orthotic device fitted. Orthotic insoles come in many types and prices. Some are pre-molded and can be bought off the shelf. These are ok for
the majority of problem feet. However some cases may require specially casted orthotics from a relevant sports injury therapist or podiatrist.
Subtalar Arthroereisis. Primary benefit is that yje surgery is minimally invasive and fully reversible. the primary risk is a high chance of device displacement, generally not tolerated in
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.