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The Truth Regarding Over-Pronation

Overview

Your feet are the foundation for your entire body. When this foundation is misaligned or functioning poorly the effects can be felt throughout the body, whether in muscle and joint pain or through more serious injuries. Over 75% of the population suffers from overpronation or excessive supination, yet most of us are unaware of our own foot type and how it affects the rest of our body.Over-Pronation

Causes

Over-pronation may happen because the tissue that attaches to your foot bones is loose. You may be born with this problem or it may result from injuries or overuse, like from too much running.

Symptoms

Because pronation is a twisting of the foot, all of the muscles and tendons which run from the leg and ankle into the foot will be twisted. In over-pronation, resulting laxity of the soft tissue structures of the foot and loosened joints cause the bones of the feet shift. When this occurs, the muscles which attach to these bones must also shift, or twist, in order to attach to these bones. The strongest and most important muscles that attach to our foot bones come from our lower leg. So, as these muscles course down the leg and across the ankle, they must twist to maintain their proper attachments in the foot. Injuries due to poor biomechanics and twisting of these muscles due to over-pronation include: shin splints, Achilles Tendonitis, generalized tendonitis, fatigue, muscle aches and pains, cramps, ankle sprains, and loss of muscular efficiency (reducing walking and running speed and endurance). Foot problems due to over-pronation include: bunions, heel spurs, plantar fasciitis, fallen and painful arches, hammer toes, and calluses.

Diagnosis

When you overpronate your foot rolls inwards causing the lower leg to rotate inwards too. It's thought that this increases stress on the soft tissues of the lower leg causing pain and inflammation, or more commonly known as shin splints.Pronation

Non Surgical Treatment

Supportive orthotics in the shoe is a method commonly implemented to treat many common running injuries associated with pronation. An advantage of orthotics is that they often allow the sufferer to continue to participate in athletic activity and avoid other treatment options that could be potentially costly and time consuming. Seventy-five percent of injured runners are successfully treated with the prescription of orthoses. Orthotics are the most effective treatment for symptoms that develop from unusual biomechanics within the body such as overpronation, resulting in either great improvement or complete healing of the injury in about half the cases.

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%.