When standing, pronation occurs as the foot rolls inwards and the arch of the foot flattens. Pronation is a normal part of the gait cycle which helps to provide shock absorption at the foot. The
opposite movement to pronation is supination. This is also a normal part of the gait cycle just after the heel strike however over-supination is also not good.
Pronation can occur as an overuse syndrome in active runners, where a great deal of stress is placed on ligaments and tendons that support the medial column. Obesity is another predictor for
pronation and deterioration of the medial ligaments and posterior tibial tendon due to excessive stress on these tissues. Acute Trauma can also lead to over-pronation when ligaments are torn or
tendon is ruptured. Once again this can lead to a collapse of the medial column. Arthritic conditions involving the knee joint when the joint is in varus (inner collapse) posture, this places the
center of gravity over the ankle joint rather than the foot causing undue pressure on the inner ankle.
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.
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
If you overpronate, you should talk with a foot and ankle specialist, especially if symptoms have not developed yet. Questions you may want to ask your doctor include what are the best running shoes
on the market? Where can I find those shoes? If over-the-counter orthotics don?t work, how long should I wait before contacting you for custom-made orthotics? On my next visit, what type of
diagnostic testing should I expect? If I limit the amount of time I spend running, will my overpronation symptoms disappear? What additional treatment options can we try?
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.