Overpronation And Its Management

Overpronation is the excessive inward rolling of the feet when walking and running

, which puts undue pressure on the balls of the feet, big toe area and other areas of the feet. Pronation is involved during foot movements such as walking, jogging, running and dancing. Normal pronation involves a little roll inwards, and helps with the distribution of the body weight and the dissipation of the forces of walking and running. However, when there is excessive pronation, the weight is unevenly distributed and excessive forces are placed on the toes, especially on the big toe during the push off phase of the stride. This can make foot injuries more likely to be suffered. Overpronation is opposite to underpronation or supination which is the tendency of the foot to bear weight on the lateral (outside) and this can similarly be bad for the feet and lower body.

Being an overpronator is usually caused by mechanical defects in the feet. One of these is having a foot varus, or an inward angluation of the feet, ankle or knees. Excessive pronation also results from discrepancy in the leg length, abnormal rotation of the hip, laxity of the ligaments in the foot and injury to the calf muscles. Any condition which puts the burden on weight bearing the ball of the foot can lead to overpronation. However the most common reason for overpronation is when the feet are flat or the foot arches have fallen. The arches collapse partially when walking and this is perfectly normal, and helps with shock absorption however a full collapse means that the feet cannot function correctly and there is a tendency for the foot to roll excessively inwards.

Overpronation leads to symptoms such as knee pain, ankle pain, hip pain, discomfort in the sole of the foot and the arches. It may lead to injuries being sustained to the muscles and tendons in the shin such as shin splints, strains to the ligaments and musculature of the knees, plantar fasciitis, Achilles tendonitis, tarsal tunnel syndrome, bunions, patellar injuries, injury to the metatarsals and sesamoiditis of the foot. These problems can all be the result of increased rotary motion of the feet.

Overpronation is usually diagnosed by examining the footprints for signs of flat feet or fallen arches, and by gait analysis. Absence of foot arch while standing indicates that overpronation will occur, and observation of the running gait from behind, in addition to foot pressure analysis are commonly used to confirm overpronation, and the extent to which it is a problem. Although overpronation is not necessarily bad, and some overpronators can exercise without suffering injuries, often overpronation needs to be managed, and the gait corrected (or the arches supported and held up) with orthotics such as arch supports, or foot movement controlled by specialist running shoes.

The following treatments can all be used to reduce excessive pronation and relieve any pain or discomfort when walking or running.

Orthoses. These devices improve the positioning of the foot and encourage normal pronation

Shoes for overpronation. Overpronator shoes reduce unwanted foot movement and enhance stability

Barefoot walking. This exercises the arches of the foot and promotes normal pronation

Arch Supports. These hold up the arch to prevent over-flattening and limit excessive pronation

Shortening the stride. Overpronation can be eased by shortening the stride

by: Mark Collins

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