During initial contact or heel strike, the ankle rolls inward, causing excessive pronation or flattening of the foot. This action forces the big toe (instead of the ball of foot and all toes) to do
all the work to push off the ground. When the ankle overpronates, this causes the tibia (shin bone) to rotate and the femur (thigh bone) to adduct (move toward the mid-line of the body), causing
internal rotation or knee valgus (knock-kneed).
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
People with overpronation may suffer from pain in the knees, hips, and low back. Overpronation itself does not necessarily cause any other symptoms but is a contributing factor of many foot
conditions such as Plantar Facsiitis, Heel Spur Syndrome, Posterior Tibialis Tendon Rupture or Tendonitis, Hallux Valgus, Bunion Deformities, Metatarsalgia, Hallux Limitus or Hallux Rigidus, Hammer
Toes, and Morton?s Neuroma.
The best way to discover whether you have a normal gait, or if you overpronate, is to visit a specialty run shop, an exercise physiologist, a podiatrist or a physical therapist who specializes in
working with athletes. A professional can analyze your gait, by watching you either walk or run, preferably on a treadmill. Some facilities can videotape your gait, then analyze the movement of your
feet in slow-motion. Another (and less costly) way is to look at the bottom of an older pair of run shoes. Check the wear pattern. A person with a normal gait will generally see wear evenly across
the heel and front of the shoe. A person who overpronates will likely see more wear on the OUTside of the heel and more wear on the INside of the forefoot (at the ball). A person who supinates will
see wear all along the outer edges of the shoe. You can also learn about your gait by looking at your arches. Look at the shape your wet feet leave on a piece of paper or a flat walking
Non Surgical Treatment
If pronation is diagnosed before the age of five it can usually be treated in such a manner that the bones and joints will be aligned properly as growth continues. This may prevent the arch from
collapsing, as well as allowing the muscles of the leg to enter the foot without twisting. With proper and early treatment, the foot will not turn out at the ankle, and the child?s gait will improve.
Treatment for pronation in children may include: night braces, custom-made orthotics, and exercises. These treatments usually continue until growth is complete, and then the adult may need to wear
custom-made orthotics to prevent the pronation from returning (the foot, as every other part of our body, tends to return to its original form if preventive measures are not taken). One side note:
frequently, pediatricians will wait too long, hoping that the child will ?outgrow? the problem. By the time they realize that the child?s feet will not improve, it is too late to change the foot. In
these cases, custom-made orthotics is used to prevent the pronation from becoming worse.
Subtalar Arthroereisis. The ankle and hindfoot bones/midfoot bones around the joint are fused, locking the bones in place and preventing all joint motion. This may also be done in combination with
fusion at other joints. This is a very aggressive option usually reserved for extreme cases where no joint flexibility is present and/or the patient has severe arthritic changes in the joint.