Over Pronation of the Foot

What is foot pronation?

Pronation is the movement of the subtalar joint (between the talus and calcaneus) into:

Eversion (turning the sole outwards)
Dorsiflexion (pointing the toes upwards) and
Abduction (pointing the toes out to the side)

When standing, pronation occurs as the foot rolls inwards and the arch of the foot flattens. Pronation is a normal part of the gait cycle (walking/running) which helps to provide shock absorption at the foot.

The opposite movement to pronation is supination. This is also a normal part of the gait cycle and can be excessive (oversupination)

What is overpronation?

The problem with pronation is when it is excessive, here the term overpronation (or hyper-pronation) is used. This is quite a common problem and can lead to a number of injuries, especially in runners, including:

The picture on the right shows someone who over pronate's. The right foot is rolling in. This causes the lower leg to turn inwards which puts the knee and hip out of alignment and can cause the back to be rotated.

The left foot is corrected with an orthotic device. This is inserted into the running shoe and controls the position of the heel allowing the rest of the foot to fall into place.

How Does this Cause Injury?

Excess pronation usually causes over-use type injuries, occurring most frequently in runners. When a neutral foot pronate's during walking or running, the lower leg, knee and thigh all rotate internally (medially). When an athlete with an overpronated foot runs, this rotation movement is exaggerated and becomes more marked.

Excess stress on the inner surface of the foot through over pronation can cause injury and pain in the foot and ankle. Repeated rotational forces through the shin, knee, thigh and pelvis also place additional strain on the muscles, tendons and ligaments of the lower leg.

How Can I tell if I Overpronate?

Firstly, look at your feet in standing, have you got a clear arch on the inside of the foot? If there is not an arch and the innermost part of the sole touches the floor, then your feet are overpronated.
Secondly, look at your running shoes. If they are worn on the inside of the sole in particular, then pronation may be a problem for you
Thirdly, try the wet foot test. Wet your feet and walk along a section of paving and look at the footprints you leave. A normal foot will leave a print of the heel, connected to the forefoot by a strip approximately half the width of the foot on the outside of the sole. If you’re feet are pronated there may be little distinction between the rear and forefoot, shown opposite

What can you do?

Get a gait analysis of your running style, this will highlight if you overpronate, oversupinate or have a neutral gait. Most podiatrists, physio's and sports therapists will offer this service, as do some specialist sports shops. Find a clinic
If you overpronate, get a running shoe with extra medial support. Many running shoes have a harder material on the inside of the midsole (the thick hard foam part of the running shoe). This means the inside of the shoe will be compressed less under load and support the inside of the foot preventing it from rolling in or flattening.....choosing the right running shoes.
For people with considerable overpronation, another option is to have an orthotic device fitted.
Orthotics and insoles come in many types and prices. Some are pre-molded and can be bought off the shelf. These are ok for the majority of problem feet. However some cases may require specially casted orthotics from a relevant sports injury therapist or podiatrist.