Overpronation is the most common abnormality found in the foot, and for this reason, is the most studied. The term that most people attribute to overpronation is ?flat feet.? Pronation is the rolling
in of the foot and the collapse of the arch. Every person pronates to some extent and this is a necessary moment in the normal walking cycle as it allows the forefoot to make complete contact with
the ground. Overpronation is when a person pronates too much and for too long. This places excess stress on the tendons and ligaments in the foot and ankle.
Flat feet don't automatically mean you have a problem. The problem can be divided into a flexible flat foot or rigid flat foot. The rigid flat foot is one that does not change shape when the foot
becomes weight bearing. i.e. it does not go through the excessive motion of pronation. Generally speaking this foot does not provide too many problems. The flexible flat foot is the type that when it
becomes weight bearing the foot and ankle tends to roll in (pronates) too far. This type of person will often say I have great arches but when I stand up much of this arch disappears as the foot
excessively pronates When the foot is excessively pronating and causing problems like sore ankles, feet or knees when standing or exercising then arch support is extremely important to restore the
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 Facsitus). Metatarsalgia (ball of the foot pain). Ankle Sprains. Shin Splints. Achilles Tendonitis.
Osteochondrosis. Knee Pain. Corns & Calluses. Flat Feet. Hammer Toes.
One of the easiest ways to determine if you overpronate is to look at the bottom of your shoes. Overpronation causes disproportionate wear on the inner side of the shoe. Another way to tell if you
might overpronate is to have someone look at the back of your legs and feet, while you are standing. The Achilles tendon runs from the calf muscle to the heel bone, and is visible at the back of the
ankle. Normally it runs in a straight line down to the heel. An indication of overpronation is if the tendon is angled to the outside of the foot, and the bone on the inner ankle appears to be more
prominent than the outer anklebone. There might also be a bulge visible on the inside of the foot when standing normally. A third home diagnostic test is called the ?wet test?. Wet your foot and
stand on a surface that will show an imprint, such as construction paper, or a sidewalk. You overpronate if the imprint shows a complete impression of your foot (as opposed to there being a space
where your arch did not touch the ground).
Non Surgical Treatment
Over-pronation and the problems that go with it are treated with shoe inserts called arch supports or orthotics. You can buy orthotics at a pharmacy or athletic shoe store or they can be custom made.
Make sure the arch supports are firm. If you can easily bend them in half, they may be too flexible.
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