Foot posture and pronation


Over pronation or "flat feet"

Over pronation, hyper pronation or "flat feet" are all terms used for feet that give the appearance of rolling in excessively.

Pronation is often assumed to be a bad thing and regularly will be suggested that it should always be prevented. However, during walking and running it is quite normal for the foot when first hitting the ground (shock absorption phase) for the foot to pronate or roll inwards slightly.

Pronation is only normally an issue if this rolling in is excessive and the patient is complaining of symptoms often related to over pronation. Some examples of these are given below. 

(for more information you can click on each symptom listed)

Arch or heel pain (plantar fasciitis)

Achilles tendoniitis

Toe joint pain (metatarsalgia and sesamoiditis (1st or big toe)

Shin splints

Knee pain 

Hip and back pain

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Pronation in itself is not necessarily a problem but if you experience pain in any of the areas described above. A biomechanical assessment is always advisable to establish why you may have these issues, and how you may help reduce these symptoms. Our biomechanical assessment clinic in Hamilton (near Glasgow) can help you with this.

Pronation is an important movement of your foot to allow your foot to absorb the shock when the foot hits the ground. However when your foot is preparing to "push" on to the next step (propulsive phase of gait) the foot has to act as a rigid lever to push off efficiently. To do this pronation reduces to make the foot more rigid and allow you to get leverage from the foot. 

The problem with an over pronated foot is that the amount of movement required to go from the over pronated position to a neutral or supinated foot can be too much for your body to cope with.

Muscles around the foot and ankle then have to work much harder and place stress on these resulting in some of the issues described above (shin splints, arch or heel pain). Or alternatively the over pronated foot, means the inside of your foot takes too much presure and becomes painful (in toe pain).

Pronation of the foot causes rotation of the long bones in the leg (tibia and femur). Again, over pronation can sometimes lead to more rotation in the leg than is normal. This is why it can lead to issues in the knee, hip and back.


How to treat the symptoms of over pronation?

The symptoms of the over pronated foot are often related to the stress and strain the foot is under by this excessively rolled in foot.

The key is to address the underlying biomechnical cause of the over pronation. There are are a number of reasons for a foot over pronating, these include;

  • Tight Achilles tendon
  • Leg length discrepencies
  • Previous injury
  • Joint alignment issues within the foot
  • muscle imbalance/weakness
  • Arthritis
  • Neuromuscular conditions
It is important that a biomechanical assessment is undertaken by a qualified Orthotist or Podiatrist to establish the reason for your over pronation

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From this assessment Orthotics (special insoles), stretches and strengthening of muscles and tendons are often prescribed. 

The purpose of your orthotics or insoles is to change the biomechanics (or way your foot/ankle moves) on activity. 

Orthotics/insoles are not designed to restrict your foot movement, but instead to encourage the foot to move within more normal limits. Thus preventing excessive stress on the muscles, ligaments and joints  which leads to issues such as

Plantar fasciitis, arch pain, heel pains, shin splints, toe pain etc.

To find out more about biomechanical assessments and orthotics provided within our orthotics and biomechanics clinic at The Treatment Hub in Hamilton (near Glasgow), South Lanarkshire, click on the links below.