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What Is Overpronation?

Overpronation is the inward turn of the ankles and feet during the strike phase of walking or running. As the foot strikes the ground, the weight is transferred towards the inner side of the foot causing increased loads to be transferred over the big toe and second toe. A loss of arch height is usually seen when bearing weight through the feet. Increased wear and tear can be noted on the inner side of the sole of your shoe and calluses on the inner side of the big toe.

Overpronation can usually be identified through observation of the arch when standing or by a medical professional using video gait analysis. Diagnosis is made through a visual assessment of the foot in standing, where a reduced arch is noted. Overpronation is not usually serious but can lead to a host of conditions if left untreated.

Summary of Important Points

  • Inner turn on the ankles under weight 
  • Inner surface of shoe worn down 
  • Pain and inflammation can occur from overuse of the big toe or second toe
  • Causes by genetics or sudden onset on arch height 
  • Not everyone will experience symptoms of pain
  • May cause mobility and gait issues 
  • Symptoms may worsen with activity 
  • Diagnosed by a doctor or podiatrist 

Symptoms of Overpronation

  • Arch pain Pain experienced in the arch of the foot, usually due to overuse or fatigue of the muscles making up the arch of the foot. 
  • Shin splints Caused by the inwards twist of the tibia associated with pronation and decreased shock absorption ability of the foot when running. 
  • Heel pain Caused by altered heel striking while walking or running, increasing the loads through the heel.
  • Hammer toes Curling or bending of the toes that may be stiff or painful to move. 
  • Plantar fasciitis Burning or stabbing pain sensation experienced under the heel of the foot due to inflammation of the plantar fascia. 
  • Achilles tendinitis Inflammation due to overuse of the Achilles tendon due to an altered gait cycle. This is caused by the increased load requirements of the big and second toe while transferring weight over the foot from the heel forwards. 
  • Unstable ankles Ankles are prone to strains and injury. Ankle injuries predispose the ankle to further injuries in the future.

Causes and Risk Factors of Overpronation

The causes of overpronation can vary from systemic conditions to issues associated solely with the ankle and foot complex. Overpronation of the feet could be inherited from your parents. In this case, the arches do not develop in childhood. Should a loss of arch height develop in one or both feet in adulthood, seeking advice as to the cause and treatment thereof would be helpful in preventing complications like pain and immobility in the future. 

  • Ligament laxity Reduced stability provided by ligaments that are overstretched can lead to overpronation and injury. Laxity can be caused by genetic traits or previous injury.
  • Rheumatoid arthritis An autoimmune and inflammatory disease that leads to structural changes by attacking the joints in the foot. 
  • Obesity Increased load through the feet could lead to the arches dropping.
  • Pregnancy Ligament laxity and weight gain due to pregnancy are risk factors for loss of arch height or overpronation in women. 
  • Injury Damage to the structures comprising the arch is a risk factor for developing overpronation of the feet. 

The incorrect choice of insole might perpetuate your symptoms further. Shoes that do not provide enough support due to wear and tear could also increase aggravate symptoms, especially during endurance activities. 

Conservative Treatments for Overpronation

Exercises targeting the development and strengthening of the plantar muscles of the foot will aid in supporting the arch under weight and should reduce the inward turn of the ankles and feet. Strengthening the muscles will reduce the chances of developing an injury in the future. Stretching the big toe will be helpful in reducing tension and pain associated with increased workload of the first two toes. 

Orthotic insoles specifically tailored to support feet that overpronate while walking or running is important. The insole should distribute the weight through the entirety of the foot and prevent the inward rotation of the shin bone seen in people who pronate. Reducing the inward rotation will in turn reduce the load on the knees, hips, and lower back, thus reducing secondary pain associated with overpronation. 

Corrective footwear does the same as orthotics but often proves to be expensive and not as easily interchangeable. Orthotics are a cost-effective way to manage your foot pronation and are easily interchangeable between a variety of shoes. They can be removed and washed at your leisure. 

Can Overpronation Be Treated or Prevented Without Surgery?

Overpronation cannot be cured but rather managed well with a combination of orthotics, exercises, and therapy. The foot's inward roll can be reduced with orthotics or footwear that prevent pronation, which reduces the chances of developing overuse or strain injuries during activity. Choosing the correct orthotic insole for your foot is crucial to the way your feet strike the ground while walking or running. Doing this correctly, provides increased shock absorption, balance, and efficiency in the gait cycle. You are then less likely to suffer any of the conditions or injuries mentioned above. 

Custom orthotics are made according to a mold of your feet to correct your specific ankle overpronation. This will provide the most support and comfort for your feet and can be tailored to provide support to other conditions that a person may be experiencing with their feet. Adaptations to accommodate the structures associated with metatarsalgia or plantar fasciitis pain can be made as well.

Should You See a Doctor for Overpronation?

One should seek help from a doctor should adverse symptoms of pain or discomfort arise. Consult your doctor if you experience numbness in the feet or toes and a loss of balance. 

You should consult with a doctor if you experience:

  • Painful, numb, or stiff feet 
  • Sudden decrease in standing and walking balance
  • Loss of arch height in one foot 
  • Loss of arch height when previously never having flat feet
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