Pronation is a normal motion that our feet make as they walk. With each step, the heel touches the ground first, then the foot rolls forward to the toes, causing the ankle to roll inward slightly and
the arch to flatten out. That?s normal. But when that rolling inward becomes more pronounced, that?s over-pronation, which is a big problem. You can usually see over-pronation by looking at the back
of the leg and foot. The Achilles tendon normally runs straight down from the leg to the foot, hitting the floor at a perpendicular angle. In feet that over-pronate, the Achilles tendon will be at a
slight angle to the ground and the ankle bone will appear more prominent than usual.
Over-pronation may happen because the tissue that attaches to your foot bones is loose. You may be born with this problem or it may result from injuries or overuse, like from too much running.
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.
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
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.
Exercises to strengthen and stretch supporting muscles will help to keep the bones in proper alignment. Duck stance: Stand with your heels together and feet turned out. Tighten the buttock muscles,
slightly tilt your pelvis forwards and try to rotate your legs outwards. You should feel your arches rising while you do this exercise. Calf stretch: Stand facing a wall and place hands on it for
support. Lean forwards until stretch is felt in the calves. Hold for 30 seconds. Bend at knees and hold for a further 30 seconds. Repeat 5 times. Golf ball: While drawing your toes upwards towards
your shins, roll a golf ball under the foot between 30 and 60 seconds. If you find a painful point, keep rolling the ball on that spot for 10 seconds. Big toe push:
Stand with your ankles in a neutral position (without rolling the foot inwards). Push down with your big toe but do not let the ankle roll inwards or the arch collapse. Hold for 5 seconds. Repeat 10
times. Build up to longer times and fewer repetitions. Ankle strengthener: Place a ball between your foot and a wall. Sitting down and keeping your toes pointed upwards, press the outside of the foot
against the ball, as though pushing it into the wall. Hold for 5 seconds and repeat 10 times. Arch strengthener: Stand on one foot on the floor. The movements needed to remain balanced will
strengthen the arch. When you are able to balance for 30 seconds, start doing this exercise using a wobble board.