Excess pronation usually causes overuse type injuries, occurring most frequently in runners. When a neutral foot pronates during walking or running, the lower leg, knee and thigh all rotate internally (medially). When an athlete with an overpronates this rotation inwards movement is exaggerated. This in turn increases the stresses on the muscles, tendons and ligaments of the foot, lower leg including shin and knee as the limb rotates in too far.
Unless there is a severe, acute injury, overpronation develops as a gradual biomechanical distortion. Several factors contribute to developing overpronation, including tibialis posterior weakness, ligament weakness, excess weight, pes planus (flat foot), genu valgum (knock knees), subtalar eversion, or other biomechanical distortions in the foot or ankle. Tibialis posterior weakness is one of the primary factors leading to overpronation. Pronation primarily is controlled by the architecture of the foot and eccentric activation of the tibialis posterior. If the tibialis posterior is weak, the muscle cannot adequately slow the natural pronation cycle.
Because overpronation affects the entire lower leg, many injuries and conditions may develop and eventually cause problems not only in the leg and foot, but also the knee, hips and lower back. Pain often begins in the arch of the foot or the ankle. Blisters may develop on the instep, or on the inside edge of the heels. As overpronation continues and problems develop, pain will be felt elsewhere, depending on the injury.
People who overpronate have flat feet or collapsed arches. You can tell whether you overpronate by wetting your feet and standing on a dry, flat surface. If your footprint looks complete, you probably overpronate. Another way to determine whether you have this condition is to simply look at your feet when you stand. If there is no arch on the innermost part of your sole, and it touches the floor, you likely overpronate. The only way to truly know for sure, however, is to be properly diagnosed by a foot and ankle specialist.
Non Surgical Treatment
Podiatrists are trained to effectively detect and management over-pronation. You can get a referral to a podiatrist from your GP if you are presenting with the pain typical of over-pronation, or you can seek private podiatric care in anyone of several registered and accredited practices across the country. Your podiatrist will examine your foot and its shape to determine whether or not over-pronation is the cause of your pain. If your podiatrist determines that it is a problem with arch support that is giving you trouble, then they can effectively remedy that lack of support with orthotics.
Many of the prevention methods for overpronation orthotics, for example, can be used interchangeably with treatment methods. If the overpronation is severe, you should seek medical attention from a podiatrist who can cast you for custom-made orthotics. Custom-made orthotics are more expensive, but they last longer and provide support, stability, and balance for the entire foot. You can also talk with a shoe specialist about running shoes that offer extra medial support and firm heel counters. Proper shoes can improve symptoms quickly and prevent them from recurring. Surgery can sometimes help cure and prevent this problem if you suffer from inherited or acquired pes planus deformity. Surgery typically involves stabilizing the bones to improve the foot?s support and function.