Pronation is the natural way that our feet absorb shock: when our feet strike the ground the arches flex down and in to disperse the impact. Everyone pronates! Contrary to popular misconception it is healthy and normal. The problem begins when one or both of our feet pronate too much. When the arches flex too far inward or stay collapsed for too long pronation is considered excessive. We call this overpronation. The amount of overpronation can vary from mild to severe. In severe overpronation the feet and ankles can rotate too far inward just during standing.
Generally fallen arches are a condition inherited from one or both parents. In addition, age, obesity, and pregnancy cause our arches to collapse. Being in a job that requires long hours of standing and/or walking (e.g. teaching, retail, hospitality, building etc) contributes to this condition, especially when standing on hard surfaces like concrete floors. Last, but not least unsupportive footwear makes our feet roll in more than they should.
If ignored, overpronation can lead to complications such as hammer toes, corns and calluses, shin splints, hallux rigidus and many more foot and lower leg problems. Hammer toes appear when the toes are placed under too much pressure and the ligaments and muscles in the toes begin to reduce in size, leading to the curvature of the toes and making them look like little hammers. Overpronators can develop hammertoes if they don?t wear an appropriate pair of shoes. Corns and calluses also appear as a result of overpronation. They form in response to excess pressure, and overpronators may find that they have excessive hard skin on the balls of the feet and inside edge of the big toe. It is the body?s way of protecting against excessive forces and friction. They can be painful.
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
Heel counters that make the heel of the shoe stronger to help resist/reduce excessive rearfoot motions. The heel counter is the hard piece in the back of the shoe that controls the foot?s motion from side-to-side. You can quickly test the effectiveness of a shoe?s heel counter by placing the shoe in the palm of your hand and putting your thumb in the mid-portion of the heel, trying to bend the back of the shoe. A heel counter that does not bend very much will provide superior motion control. Appropriate midsole density, the firmer the density, the more it will resist motion (important for a foot that overpronates or is pes planus), and the softer the density, the more it will shock absorb (important for a cavus foot with poor shock absorption) Wide base of support through the midfoot, to provide more support under a foot that is overpronated or the middle of the foot is collapsed inward.
Wearing the proper footwear plays a key role as a natural way to help pronation. Pronated feet need shoes that fit well, provide stability, contain supportive cushioning, are comfortable and allow enough room for your foot to move without causing pain or discomfort. Putting special inner heel wedges, known as orthotics, into your shoes can support a flatfoot while lowering risks of developing tendinitis, according to the American Academy of Orthopaedic Surgeons. More extensive cases may require specially fitted orthopaedic shoes that support the arches.