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Pronation is the normal movement of the foot when walking or running, but excessive pronation can lead to injuries. Two tests can diagnose excessive pronation, and treatment options include orthotic inserts, proper footwear, and exercise. Surgery may be necessary for severe cases.
Pronation is the normal movement the foot makes to absorb the impact of walking or running. It occurs once the heel touches the ground and the foot disperses the impact, lengthening and flattening the arch as the foot rotates inward. Supination is the opposite movement to pronation. The foot supinates, or rolls on the outer edge, to help with stability as we walk or run.
A reasonable amount of pronation is required for the foot to function properly. However, when the arch of the foot remains flat and the foot rolls inward too much, it can lead to overpronation or overpronation. This medical condition can result from continuous strain on the feet and from wearing shoes that lack sufficient arch support.
Excessive pronation causes the arch of the foot to collapse, which in turn causes the foot to twist outward. A person with excessive pronation usually walks abnormally, on the inside edge of the foot. This stresses and misaligns the ligaments, muscles and tendons in the foot, leg and even the back. Eventually, this misalignment leads to muscle inefficiency, reducing speed and endurance while walking or running.
Left undiagnosed and untreated, excessive pronation can lead to serious foot and lower body injuries. Common injuries include flat feet, weak arches, bunions, corns, calluses, plantar facsitus (heel pain), Achilles tendinitis (tendon pain), frequent ankle sprains, shin splints and knee, hip and back pain.
There are two general methods of recognizing excessive pronation:
1. The Achilles tendon test:
Stand straight with your back to the mirror, allowing yourself to look at your leg and foot from behind. On a normal foot, the Achilles tendon runs down the leg to the heel. With excessive pronation, the tendon runs straight up the leg, but twists outward as it reaches the heel. Your inside ankle will protrude significantly from your outside ankle.
2. The Used Shoes Test:
Place a pair of your most-used running shoes on the table, with your toes pointing away from you. Crouch down to eye level. If your shoes angle inward, your feet are overpronated. You can also take a look at the outer soles of your shoes. Extreme wear along the toes also shows pronation.
Once diagnosed, excessive pronation can be treated in several ways:
1. Orthotic inserts:
Orthotic inserts are devices that are inserted inside shoes to provide greater stability and arch support. They are available over the counter or can be custom made to meet individual needs. Over-the-counter orthotic inserts help reduce minor arch discomfort. Custom orthotic inserts do more by controlling foot motion, redistributing weight evenly across the foot, and accommodating any pain or impairment.
2. Proper Footwear:
Good footwear with stiff, multi-density midsoles and straight or semi-curved lasts limit the occurrence of excessive pronation. In measuring the most suitable shoe size, the length, width and depth of the foot should be taken into consideration. Footwear with a firm heel and strong medial and arch support are highly recommended.
3. Exercise:
Regular stretching of the feet, ankles, and legs ensures overall flexibility and stretch. These exercises increase blood flow and reduce the extra stress and strain caused by excessive pronation.
While the above recommendations are generally helpful, qualified podiatrists or orthopedic physicians may suggest surgery for cases of severe excessive pronation.
