Over-Pronation Of The Feet What Are The Symptoms

Overview

Foot types can be divided into three major groups: the flat foot (Pes Planus), the high arched foot (Pes Valgus) and the normal to low arched foot. A true 'flat foot' is very rare. In fact, less than 5% of the population have flat feet i.e. a foot with no arch present whatsoever and the entire bottom surface of the foot being flat on the ground. About 5-10% of people have a high arched foot. The majority of the population have a normal to low arch. Even though the arches appear to be normal most of us suffer from over-pronation during walking, running and standing, due to the hard, flat unnatural surfaces we walk on, combined with wearing unsupportive footwear. With every step we take the arches flatten and the ankles roll inwards. Pronation itself is not wrong because we need to pronate and supinate as part of our natural gait cycle. Pronation (rolling in) acts as a shock-absorbing mechanism and supination (rolling out) helps to propel our feet forward. Over-pronation occurs when the foot pronates too deep and for too long, not allowing the foot to 'recover' and supinate. Over-pronation hampers our natural walking pattern. It causes an imbalance and leads to wear and tear in several parts of the body with every step we take.Over Pronation

Causes

Flat feet don't automatically mean you have a problem. The problem can be divided into a flexible flat foot or rigid flat foot. The rigid flat foot is one that does not change shape when the foot becomes weight bearing. i.e. it does not go through the excessive motion of pronation. Generally speaking this foot does not provide too many problems. The flexible flat foot is the type that when it becomes weight bearing the foot and ankle tends to roll in (pronates) too far. This type of person will often say I have great arches but when I stand up much of this arch disappears as the foot excessively pronates When the foot is excessively pronating and causing problems like sore ankles, feet or knees when standing or exercising then arch support is extremely important to restore the foot structure.

Symptoms

Common conditions that develop with prolonged overpronation typically include plantar fasciitis, achilles tendonitis, shin splints, posterior tibial stress syndrome and even IT band syndrome. With long term neglect you may see the development of bunyons, foot deformities and early onset of hip and knee arthritis.

Diagnosis

Look at your soles of your footwear: Your sneaker/shoes will display heavy wear marks on the outside portion of the heel and the inside portion above the arch up to the top of the big toe on the sole. The "wet-foot" test is another assessment. Dip the bottom of your foot in water and step on to a piece of paper (brown paper bag works well). Look at the shape of your foot. If you have a lot of trouble creating an arch, you likely overpronate. An evaluation from a professional could verify your foot type.Pronation

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.

Surgical Treatment

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%.

Write a comment

Comments: 0