Overpronation is when there is excessive rotation beyond the optimum level, more specifically involving more than 15 degrees of difference in angle between the plane of the foot and the plane of the
leg. It is often linked with flat feet, fallen arches and collapsed arches. When the arches are high, there is not usually sufficient pronation. This is called underpronation or
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.
The best way to discover whether you have a normal gait, or if you overpronate, is to visit a specialty run shop, an exercise physiologist, a podiatrist or a physical therapist who specializes in
working with athletes. A professional can analyze your gait, by watching you either walk or run, preferably on a treadmill. Some facilities can videotape your gait, then analyze the movement of your
feet in slow-motion. Another (and less costly) way is to look at the bottom of an older pair of run shoes. Check the wear pattern. A person with a normal gait will generally see wear evenly across
the heel and front of the shoe. A person who overpronates will likely see more wear on the OUTside of the heel and more wear on the INside of the forefoot (at the ball). A person who supinates will
see wear all along the outer edges of the shoe. You can also learn about your gait by looking at your arches. Look at the shape your wet feet leave on a piece of paper or a flat walking
Non Surgical Treatment
Overpronation is usually corrected with orthotics and/or strengthening exercises for the tibialis posterior. Massage treatment can relieve myofascial trigger points in the tibialis posterior, and
other muscles, and address any resulting neuromuscular dysfunction in the leg or foot. Biomechanical correction of overpronation might require orthotics, neuromuscular reeducation, or gait retraining
methods, as well. Stretching the gastrocnemius and soleus muscles will reduce hypertonicity in these muscles and also is essential for effective treatment. Because of impacts throughout the remainder
of the body, the detrimental effects of overpronation should not be overlooked.
Hyperpronation can only be properly corrected by internally stabilizing the ankle bone on the hindfoot bones. Several options are available. Extra-Osseous TaloTarsal Stabilization (EOTTS) There are
two types of EOTTS procedures. Both are minimally invasive with no cutting or screwing into bone, and therefore have relatively short recovery times. Both are fully reversible should complications
arise, such as intolerance to the correction or prolonged pain. However, the risks/benefits and potential candidates vary. Subtalar Arthroereisis. 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. HyProCure Implant. A stent is placed into a naturally occurring space between the ankle bone and the heel bone/midfoot bone. The stent realigns the surfaces of the bones,
allowing normal joint function. Generally tolerated in both pediatric and adult patients, with or without adjunct soft tissue procedures. Reported removal rates, published in scientific journals vary