Over Pronation (Flat Feet) refers to the biomechanical shock-absorbing motion of the ankle, foot and lower leg. It is the natural inward flexing motion of the lower leg and ankle. Standing, walking,
and running cause the ankle joint to pronate which in turn helps the body to absorb shock and allows it to control balance. An ankle joint that is too flexible causes more pronation than desired.
This common condition is called Over- Pronation (sometimes referred to as "Flat Feet"). This foot condition places an extreme degree of strain on various connective tissues of the ankle, foot, and
knee. If this condition is not addressed foot pain and toe deformities such as bunions and hammer toes (just to name a couple) may develop. Hip and lower back pain may also be residual results from
There is a relationship between biomechanics and injury that is specific to each body part. Overall though, poor mechanics will either increase the landing forces acting on the body or increase the
work to be done by the muscles. Both increase the stress, which, depending on the individual and the amount of running can become excessive and cause injury.
Overpronation causes alterations in proper muscle recruitment patterns leading to tightness in the outside of the ankle (lateral gastrocnemius, soleus, and peroneals). This tightness can lead to
weakness in the opposing muscles such as the medial gastrocnemius, anterior tibialis, and posterior tibialis. If these muscles are weak, they will not be able to keep the knee in proper alignment,
causing the valgus position. All this tightness and weakness can cause pain within the ankle, calf, and knee region. And it can send imbalance and pain all the way up to the upper back, if deep core
strength is lacking and can't hold the pelvis in neutral.
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
Over-Pronation can be treated conservatively (non-surgical treatments) with over-the-counter orthotics. These orthotics should be designed with appropriate arch support and medial rearfoot posting to
prevent the over-pronation. Footwear should also be examined to ensure there is a proper fit. Footwear with a firm heel counter is often recommended for extra support and stability. Improper fitting
footwear can lead to additional problems of the foot.
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.