Overpronation is when there is excessive rotation beyond the optimum level, more specifically involving more than 15 degrees of difference in angle between the plane of the foot and the plane of the
leg. It is often linked with flat feet, fallen arches and collapsed arches. When the arches are high, there is not usually sufficient pronation. This is called underpronation or
There are many possible causes for overpronation, but researchers have not yet determined one underlying cause. Hintermann states, Compensatory overpronation may occur for anatomical reasons, such as
a tibia vara of 10 degrees or more, forefoot varus, leg length discrepancy, ligamentous laxity, or because of muscular weakness or tightness in the gastrocnemius and soleus muscles. Pronation can be
influenced by sources outside of the body as well. Shoes have been shown to significantly influence pronation. Hintermann states that the same person can have different amounts of pronation just by
using different running shoes. It is easily possible that the maximal ankle joint eversion movement is 31 degrees for one and 12 degrees for another running shoe.
Eventually, over-pronation can lead to a full list of maladies including flat feet, plantar fasciitis, plantar fibroma, neuromas, heel spurs, shin splints, ankle sprains, bunions, hammertoes,
calluses, and pain in the arches, knee, hip and lower back. But it doesn?t have to go that far, because there are steps we can take to correct the over-pronation. In the vast majority of cases, we?ll
prescribe custom foot orthotics, which will realign your ankles, redistribute the weight, support the arch and reduce the twisting. Many orthotics will fit snugly into your normal shoes. Although
we?ll also take a look at the type of shoes you wear to see if they are contributing to the problem.
You can test for pronation by looking at the leg and foot from the back. Normally you can see the Achilles Tendon run straight down the leg into the heel. If the foot is pronated, the tendon will run
straight down the leg, but when it lies on the heel it will twist outward. This makes the inner ankle bone much more prominent than the outer ankle bone.
Non Surgical Treatment
Your podiatrist will look at your current footwear to ensure that it is both well-fitted and possessed of adequate cushioning to protect your feet. Firm heel support is advised for over-pronators,
and a good fit is important to ensure that the foot as a whole is well supported as instability can exacerbate the existing problems caused by over-pronation.
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.