Overpronation is when the foot rolls in excessively, or at a time when it should not, for instance late in the stance phase of gait. In this case much weight is transferred to the inner or medial
side of the foot, and as the runner moves forward the load is borne by the inner edge rather than the ball of the foot. This destabilises the foot, which will attempt to regain stability by
compensating for the inward movement. In a kind of chain reaction, this in turn affects the biomechanical efficiency of the leg, especially the knee and hip.
Congenital "Flat Feet" - an individual may be born with feet that lack an appropriately supportive arch thereby predisposing the individual to this foot condition. Excessive Weight (Obesity) Too much
weight on the foot from either obesity or pregnancy may be a factor. Repetitive Impact walking on flat, hard surfaces continuously places unnatural stress on the foot arch.
With over pronation, sufferers are most likely to experience pain through the arch of the foot. A lack of stability is also a common complaint. Over pronation also causes the foot to turn outward
during movement at the ankle, causing sufferers to walk along the inner portion of the foot. This not only can deliver serious pain through the heel and ankle, but it can also be the cause of pain in
the knees or lower back as well. This condition also causes the arch to sink which places stress on the bones, ligaments, and tendons throughout the foot. This may yield other common conditions of
foot pain such as plantar fasciitis and heel spurs.
Bunions, calluses and crooked toes may indicate alignment problems. So, it is important to ascertain the condition of a client's toes. Check the big toe to determine if the first joint of the toe is
swollen, has a callus or bunion, and/or looks as though it abducts (i.e., hallux valgus) rather than pointing straight ahead. Also, look to see if the lesser toes seem to "curl up" (i.e., the person
has hammer or claw toes). This may be indicative of damage to, or inflexibility of the plantar fascia caused by excessive flattening of the foot.
Non Surgical Treatment
Treatment with orthotics will provide the required arch support to effectively reduce excessive pronation and restore the foot and its posture to the right biomechanical position. It should be
ensured that footwear has sufficient support, for example, shoes should have a firm heel counter to provide adequate control.
Calcaneal "Slide" (Sliding Calcaneal Osteotomy) A wedge is cut into the heel bone (calcaneus) and a fixation device (screws, plate) is used to hold the bone in its new position. This is an aggressive
option with a prolonged period of non-weightbearing, long recovery times and many potential complications. However, it can and has provided for successful patient outcomes.