Over-Pronation

Overview

Over-pronation occurs when the foot collapses too far inward stressing the plantar fascia (the area underneath the arch of the foot.) Normally, one pronates every time he/she walks, but excessive pronation is called over-pronation. When this occurs it can cause pain in the feet, knees, hips, low back and even the shoulder.Foot Pronation

Causes

There is a relationship between biomechanics and injury that is specific to each body part. Overall though, poor mechanics will either increase the landing forces acting on the body or increase the work to be done by the muscles. Both increase the stress, which, depending on the individual and the amount of running can become excessive and cause injury.

Symptoms

Over-pronation is a condition where the arch flattens out which makes the feet roll inward while walking. This condition is also known as flat feet. It imposes extreme additional stresses on the plantar fascia, a fibrous band of tissue which connects the heel to the forefoot. Over-pronation makes walking a painful experience because of the additional strain on the calves, heel and/or back. Treatment for over-pronation involves the use of specially-made orthotics which offers arch support and medial rear foot posting as corrective measures.

Diagnosis

To easily get an idea of whether a person overpronates, look at the position and condition of certain structures in the feet and ankles when he/she stands still. When performing weight-bearing activities like walking or running, muscles and other soft tissue structures work to control gravity’s effect and ground reaction forces to the joints. If the muscles of the leg, pelvis, and feet are working correctly, then the joints in these areas such as the knees, hips, and ankles will experience less stress. However, if the muscles and other soft tissues are not working efficiently, then structural changes and clues in the feet are visible and indicate habitual overpronation.Pronation

Non Surgical Treatment

The following exercises help retrain the foot and ankle complex to correct overpronation. Step Up and Over. This exercise is designed to integrate skills learned in the Duck Stand, Big Toe Pushdowns and Side Step with Opposite Reach exercises to mimic walking and even running. Using the gluteal muscles and big toe in tandem will prevent overpronation while moving back and forth over the BT in a more effective, balanced motion. Movement Directions. Stand with left foot on top of the BT dome. (Note: For added balance, the right foot can tap on the ground, if needed). Extend right foot backwards to the ground and drop hips into a lunge position. Make sure that the right arm rotates across the left leg (this will activate the gluteal muscles on the left side). Now, step through and over the BT into a front lunge with the right leg forward. While lunging forward, the torso and left arm now rotate over the right leg. Throughout the exercise, push big toe down into the BT. Perform 8 to 10 repetitions on both sides.

Surgical Treatment

Calcaneal “Slide” (Sliding Calcaneal Osteotomy) A wedge is cut into the heel bone (calcaneus) and a fixation device (screws, plate) is used to hold the bone in its new position. This is an aggressive option with a prolonged period of non-weightbearing, long recovery times and many potential complications. However, it can and has provided for successful patient outcomes.

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