Over-pronation: Causes and TreatmentsBy Amit Bhanti, CPO

Pronation is sometimes a term that is misunderstood. Pronation is a complex motion of the foot that helps allow it to adapt to the ground. It enables the foot’s joints to unlock, making the foot flex and adapt to the ground, sort of like a foot’s shock absorption system.

During pronation, the arch drops, causing the foot to flatten. A certain amount of pronation, or flattening, is normal. The problems occur when the foot pronates more than it should, causing excessive flattening that place undue stress and pressure on the tissues and ligaments in the foot. This over-pronation can cause pain, heel spurs, plantar fasciitis, ankle sprains, weak arches, sprains and shin splints. If left untreated, it can lead to knee, hip and lower back pain.

Over-pronation vs. flat feetSome people mistakenly use the term pronation when describing flat feet. A flat foot is a foot that has a flat arch when both sitting and standing. Flat feet may not necessarily be a problem or cause pain. In fact, the appearance of flat feet is normal and common in infants, due to the arch not being fully developed and masked with “baby fat”. It’s only when flat feet become painful that you may be suffering from over-pronation.

Pronation is actually the natural motion of the foot as it roles inward after the foot makes contact with the ground. Too much pronation (over-pronation) can cause the muscles, ligaments and other soft tissue structures loosen and the foot to gradually turns outward at the ankle. As a result, when you step down you put pressure on the inner border of the foot instead of in its entirety.

Causes of over-pronationThe most common source of over-pronation is heredity. Another common cause is due to the way our feet may have been positioned in the uterus – known as a congenital defect. The condition can also develop as a symptom of foot abuse as a result of weakened muscles due to aging or heavy strain, standing or walking for long periods in high heels, or wearing shoes that don’t provide proper arch support. In addition, factors such as obesity and pregnancy can contribute to over-pronation.

Treatment for over-pronationIn children, over-pronation can usually be corrected if diagnosed before the age of five by aligning the bones and joints so proper growth can occur. Treatments in children may include exercises, night braces and custom-made orthotics to support the arch as well as each bone and joint that forms in that arch. One innovative orthotic option is a dynamic stabilization system known as SureStep, which employs a system of compression to encourage more natural muscle development and assist with appropriate balance and motor skills. Specifically designed for children, it is made of flexible materials, which allow for normal movements like squatting, jumping, and running. The combination of design and function allow the proper development of a

child’s gait, while not restricting movement.

In adults, custom orthotics may be necessary to support not only the arch, but also the individual bones and joints that form the arch. As opposed to over-the-counter arch supports, a custom orthotic’s materials compress as you place your weight on the orthotic, absorbing the shock of each step. In addition to reducing over-pronation, muscle imbalance and foot and leg pain and fatigue are lessened as well.

The first stepIf you suspect you or your child may suffer from over-pronation, make an appointment with your orthotist. Based on an evaluation of the condition, he or she can provide the appropriate treatment to alleviate pain, promote mobility and help restore the foot to the correct position.