Pronation refers to the inward and downward rotation of the foot each time a person takes a step. Pronation, when it occurs at a normal degree, helps the foot absorb the shock of the body's impact when hitting the ground in stride. When the foot rotates too far inward, this is called "overpronation" or "hyperpronation," which can lead to a variety of musculoskeletal problems.
Symptoms
The excessive inward motion of pronation can contribute to heel pain (plantar fasciitis), foot and ankle injuries, Achilles tendonitis, inflammation of the kneecap, shin splints, bunions, problems of the hip and lower back and injury to muscles, tendons and ligaments in the lower leg.
Causes
Exaggerated foot rotation puts the knee and hip out of alignment, placing additional stress through the shin, knee, thigh, pelvis and back. Heel pain in an individual who overpronates, for example, may result from excessive tugging and stretching of certain tendons and ligaments connected to the heel bone.
Diagnosis
Experiencing any of the symptoms listed above may point to a pronation problem. You can also examine the wear on your shoes to determine a possible pronation issue. Excessive wear on the inside of the heel may mean you are overpronating. If the arch of your foot is so slight that the inside of your foot touches the floor when you stand barefoot, your feet are overpronated. The lack of arch may make it difficult for your foot to remain stable in stride, resulting in hyperpronation.
Prevention and Treatment
Supportive footwear is perhaps the most important strategy to prevent the problems that can result from overpronation. Shoes should be well-fitting and appropriate for the activities you plan to undertake while wearing them. The American Academy of Podiatric Sports Medicine maintains a list of athletic shoes most appropriate for each type of motion control category, organized by sport. Overpronating runners should look for shoes that provide stability for the inside of the foot to prevent excessive inward motion; look for shoes categorized as "motion control."
You should replace shoes before they are too worn so that they will give your feet the support they need. It is also important to warm up properly before exercising, as well as to maintain a healthy weight. Excessive weight can put undue pressure on your feet and can lead to pronation problems.
Orthotics
You may need to supplement your shoes with orthotics, especially if your pronation is more pronounced. Drugstores and sporting goods stores carry premolded orthotics, which are less expensive than custom orthotics and can provide the support many overpronators require. Other people may need orthotic devices specially fitted to their feet by a podiatrist or physical therapist; these specialists can determine whether custom orthotics are right for you.
