Normal, healthy feet pronate! Normal pronation does not need to be ?corrected?. However, some people OVER-pronate. Those people need a shoe that supports their over-pronating foot to help guide the foot and avoid injury. So, what does pronation mean exactly? Well, ?pronate? is the word used to describe the natural motion of the foot after it strikes the ground. When a person with a normally pronating foot runs, the outside part of the heel strikes the ground. As the individual shifts the body weight forward, the foot rolls inward (pronates) and the entire foot comes into contact with the ground. This allows the foot to properly support the body and absorb the impact forces. Motion continues forward and the peron pushes off (called ?toe off?) evenly from the front of the foot. Someone who OVER-pronates strikes the ground with the heel in the same way, but the foot rolls too far inward (overpronation). This causes foot and ankle strain, as it does not allow the foot and ankle to properly support the body nor to properly absorb the impact forces. As motion continues forward, they will toe-off more from the ball of her foot. Runners who overpronate are susceptible to foot, ankle and knee problems if they don't wear a shoe that properly supports the motion of their feet.
There has been some speculation as to whether arch height has an effect on pronation. After conducting a study at the Rose-Hulman Institute of Technology, Maggie Boozer suggests that people with higher arches tend to pronate to a greater degree. However, the generally accepted view by professionals is that the most pronation is present in those with lower arch heights. To complicate matters, one study done by Hylton Menz at the University of Western Sydney-Macarthur suggests that the methods for measuring arch height and determining whether someone is ?flat-footed? or ?high-arched? are unreliable. He says, ?For this reason, studies investigating the relationship between static arch height motion of the rearfoot have consistently found that such a classification system is a poor predictor of dynamic rearfoot function.
Not all foot injuries affecting runners are necessarily down to a particular running gait; it is rarely that simple to diagnose how a foot problem developed . Simply being an overpronator does not mean that a foot injury has been caused by the running gait and it could be due to a number of factors. However mild to severe overpronators tend to be at a higher risk of developing musculoskeletal problems due to the increased stresses and strains which are placed on the body when the foot does not move in an optimum manner. The following injuries are frequently due to overpronation of the feet. Tarsal tunnel syndrome. Shin splints. Anterior compartment syndrome. Plantar fasciitis. Achilles tendonitis. Bunions. Sesamoiditis. Stress fractures. Back and hip pain. Ankle pain.
When sitting, an over-pronating foot appears quite normal, i.e. showing a normal arch with room under the underside of the foot. The moment you get up and put weight on your feet the situation changes: the arches lower and the ankle slightly turns inwards. When you walk or run more weight is placed on the feet compared to standing and over-pronation will become more evident. When walking barefoot on tiles or timber floors over-pronation is more visible, compared to walking on carpet or grass.
Non Surgical Treatment
Fortunately, there are simple things you can do to cure and correct your overpronation issues. Certain exercises help. Pull your toes back using a rolled up towel. Roll your feet over a golf or tennis ball for a minute. And do calf raises by standing up and lifting up on your toes. These all help reposition the foot and strengthen the muscles and tendons necessary for proper support. Beyond that, simple adjustments to footwear will help immensely.
Hyperpronation can only be properly corrected by internally stabilizing the ankle bone on the hindfoot bones. Several options are available. Extra-Osseous TaloTarsal Stabilization (EOTTS) There are two types of EOTTS procedures. Both are minimally invasive with no cutting or screwing into bone, and therefore have relatively short recovery times. Both are fully reversible should complications arise, such as intolerance to the correction or prolonged pain. However, the risks/benefits and potential candidates vary. Subtalar Arthroereisis. An implant is pushed into the foot to block the excessive motion of the ankle bone. Generally only used in pediatric patients and in combination with other procedures, such as tendon lengthening. Reported removal rates vary from 38% - 100%, depending on manufacturer. HyProCure Implant. A stent is placed into a naturally occurring space between the ankle bone and the heel bone/midfoot bone. The stent realigns the surfaces of the bones, allowing normal joint function. Generally tolerated in both pediatric and adult patients, with or without adjunct soft tissue procedures. Reported removal rates, published in scientific journals vary from 1%-6%.