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Overpronation

Reviewed by
Dr. James Milidantri

Overpronation is a term used to describe excessive flattening of the plantar arch. Pronation is a normal part of our gait (the way we walk), and it comprises three movements: dorsiflexion, eversion, and abduction. Dorsiflexion is the upward movement of the foot, eversion describes the foot rolling in, and abduction is “out toeing,” meaning your toes are moving away from the midline of your body. When these three motions are extreme or excessive, overpronation results. Overpronation is very common in people who have flexible flat feet. Flatfoot, or pes planus, is a condition that causes collapse of the arch during weight bearing. This flattening puts stress on the plantar fascia and the bones of the foot, resulting in pain and further breakdown.

Overpronation

Symptoms of Overpronation

If you overpronate, your symptoms may include:

  • Discomfort in the arch and sole of foot
  • Your foot may appear to turn outward at the ankle
  • Your shoes wear down faster on the medial (inner) side of your shoes
  • Pain in ankle, shins, knees, or hips, especially when walking or running

Will Overpronation Cause Problems?

Unfortunately, overpronation can lead to additional problems with your feet, ankles, and knees. Runners in particular find that overpronation can lead to:

  • Shin splints
  • Tarsal tunnel syndrome
  • Plantar fasciitis
  • Compartment syndrome
  • Achilles tendonitis
  • Bunions (hallux valgus)
  • Patello-femoral pain syndrome
  • Heel spurs
  • Metatarsalgia

You do not have to be a runner or athlete to suffer from overpronation. Flat feet can be inherited, and many people suffer from pain on a day-to-day basis. Flat feet can also be traumatic in nature and result from tendon damage over time. Wearing shoes that do not offer enough arch support can also contribute to overpronation.

Is Overpronation Painful?

Overpronation can lead to injuries and pain in the foot, ankle, knee, or hip. Overpronation puts extra stress on all the bones in the feet. The repeated stress on the knees, shins, thighs, and pelvis puts additional stress on the muscles, tendons, and ligaments of the lower leg. This can put the knee, hip, and back out of alignment, and it can become very painful.

Do I Overpronate?

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.

Overpronation Treatment

When you see the doctor, he or she will likely perform a complete examination of your feet and watch you walk. The doctor will need to take x-rays to determine the cause of your flat feet. In some cases, further imaging may be needed, especially if your symptoms are severe and sudden in nature. Once you are properly diagnosed, your doctor will create an appropriate treatment plan. There are several options to correct overpronation, such as orthotics. In many cases, overpronation can be treated with non-surgical methods and over-the-counter orthotics. In severe cases, however, custom-made orthotics may work better. Orthotics provide arch support and therefore prevent collapse of the arch with weight bearing. They are made of materials such as spongy rubber or hard plastic. Your doctor will also want to examine your footwear to ensure they fit properly and offer enough medial support. Extra support and stability can be achieved with footwear that has a firm heel counter. If you are experiencing pain, you should be able to use over-the-counter pain medications such as ibuprofen to relieve symptoms.

Preventing Overpronation

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.

Questions to Ask Your Doctor

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?
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Medical References:

  1. Sports Injury Clinic, Overpronation, http://www.sportsinjuryclinic.net/cybertherapist/general/pronate.htm
  2. Run Blogger, On Overpronation and Neutral Shoes: Guest Post, http://www.runblogger.com/2010/08/on-overpronation-and-neutral-running.html

This page was last updated on June 13th, 2014



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