Overpronation and underpronation describe general foot movements. These terms do not necessarily describe a medical problem with a foot. For example, you can overpronate and not have any problems or
symptoms at all. It is important to have your foot structure and symptoms adequately assessed by your prescribing physician and a qualified practitioner such as a Canadian Certified Pedorthist. Once
the underlying conditions and mechanical faults are assessed, an appropriate treatment plan including possible orthotic and footwear recommendations can be made.
Overpronation often occurs in people with flat feet, whose plantar fascia ligament is too flexible or too long, and therefore unable to properly support the longitudinal arch of the foot. People tend
to inherit the foot structure that leads to overpronation. In a normal foot the bones are arranged so that two arches are formed, the longitudinal and the transverse. Ligaments hold all the bones in
their correct positions, and tendons attach muscles to bones. If the bones are held together too loosely, they will tend to move inwards as this is the easiest direction for them to go. Over time the
soft tissue structures will adjust to the misalignment and the foot will become permanently over-flexible, with a flat arch.
In addition to problems overpronation causes in the feet, it can also create issues in the calf muscles and lower legs. The calf muscles, which attach to the heel via the Achilles tendon, can become
twisted and irritated as a result of the heel rolling excessively toward the midline of the body. Over time this can lead to inflexibility of the calf muscles and the Achilles tendon, which will
likely lead to another common problem in the foot and ankle complex, the inability to dorsiflex. As such, overpronation is intrinsically linked to the inability to dorsiflex.
Your healthcare provider will ask about your symptoms, medical history, and activities and examine your feet. Your provider may watch you walk or run. Check the motion of your feet when they strike
the ground. Look at your athletic shoes to see if they show an abnormal pattern of wear.
Non Surgical Treatment
Mild cases of Overpronation may be controlled or corrected with a supportive shoe that offers medial support to the foot along with a strong heel counter to control excessive motion at the heel
starting with heel strike. In mild cases with no abnormal mechanical pressures, an over the counter orthotic with heel cup and longitudinal or medial arch support to keep the foot from progressing
past neutral may help to realign the foot. A Custom foot orthotic with heel cup and longitudinal arch support to help correct position of the foot as it moves through motion. Heel wedges may also
assist in correcting motion.
Subtalar Arthroereisis. Primary benefit is that yje surgery is minimally invasive and fully reversible. the primary risk is a high chance of device displacement, generally not tolerated in
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.