Overpronation still continues to be misused and misunderstood. For example, there was a study that got a lot of recent mileage in the mainstream media and the blogosphere that claimed to show that foot pronation was not associated with injury risk. It was intriguing following comments on the study in mainstream media and in social media, especially the parroting of the press release without any critical appraisal. The study actually eliminated the ?overpronators? that were probably at high risk from the study then found that ?overpronation? was not a risk factor. What is more intriguing was that there was another study from around the same time that found the exact opposite. Clearly, the data on ?overpronation? and risk for injury in runners is mixed, so we need to rely on the more formal systematic reviews and meta-analyses of all the data. The most recent one of those concluded that ?overpronation? is just a small risk factor for running injury risk, but it is still statistically significant.
In adults, the most common reason for the onset of Over-Pronation is a condition known as Post Tibial Tendonitis. This condition develops from repetitive stress on the main supporting tendon (Posterior Tibial Tendon) of the foot arch. As the body ages, ligaments and muscles can weaken. When this occurs the job of providing the majority of the support required by the foot arch is placed upon this tendon. Unfortunately, this tendon cannot bear the weight of this burden for too long. Eventually it fatigues under the added strain and in doing so the foot arch becomes progressively lower over a period of time.
Over-pronation is a condition where the arch flattens out which makes the feet roll inward while walking. This condition is also known as flat feet. It imposes extreme additional stresses on the plantar fascia, a fibrous band of tissue which connects the heel to the forefoot. Over-pronation makes walking a painful experience because of the additional strain on the calves, heel and/or back. Treatment for over-pronation involves the use of specially-made orthotics which offers arch support and medial rear foot posting as corrective measures.
Your healthcare provider will ask about your symptoms, medical history, and activities and examine your feet. Your provider may watch you walk or run. Check the motion of your feet when they strike the ground. Look at your athletic shoes to see if they show an abnormal pattern of wear.
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.
Subtalar Arthroereisis. The ankle and hindfoot bones/midfoot bones around the joint are fused, locking the bones in place and preventing all joint motion. This may also be done in combination with fusion at other joints. This is a very aggressive option usually reserved for extreme cases where no joint flexibility is present and/or the patient has severe arthritic changes in the joint.