overpronation
If you overpronate, your heel’s outer edge hits the ground first while your foot rolls inward during your gait cycle.

Overpronation is a frequent biomechanical issue where the foot rolls and flattens during the walking process.

Some amount of pronation is necessary because it distributes impact force during walking and running, effectively functioning as a shock absorber. However, overpronation while bearing weight may result in collapsed arches (flat feet) and cause problems in the ankles, knees, hips, and lower back. This action can create considerable stress or inflammation on the fibrous tissue present along the bottom of the foot (plantar fascia), resulting in acute pain and the development of foot swelling.

The way a person's foot impacts the ground may have a major impact on their physique, such that many people who have flat feet or overpronate are more prone to injury.

Overpronation leads to common problems and injuries, especially in athletes and runners, which include:

4 ways to self-detect overpronation

People with overpronation put down their feet in such a way that their gait and posture changes. With certain observations, people may detect the presence of overpronation, such as:

  1. Identifying the pattern of soles
    • With regular walking, the heel contacts the ground somewhat on its outer or lateral edge, and the bottom of the shoes is worn out more in that region.
    • If the soles of the shoes look to be worn exactly in the middle of the heel area or on the inner or middle edge toward the backside of the sole, it may indicate overpronation while walking.
    • Overpronators may not be able to run quickly because their ankles and foot fold do not transmit a propulsive force up the leg.
  2. Check for space underneath the feet
    • While standing, the body’s weight falls on the feet. In this position, there should be adequate space beneath the inside of the feet to insert a finger without exerting too much strain or pain. So, to check for the space, ask someone to place their fingertip underneath the inner arches while standing on firm ground.
    • If they can do it without trouble or discomfort, it implies that you do not overpronate, whereas if the person cannot easily slip their finger, there is a possibility of flat feet caused by overpronation. However, the presence of a slightly flat arch while standing does not always indicate overpronation.
  3. Wet feet test
    • Wet the bottoms of your feet and walk over cardboard, thick paper, or any other surface that clearly shows the wet footprint.
    • Take prints of both feet and examine them attentively.
    • A healthy arch and normal degree of pronation will leave a print of the heel on the outside of the sole, linked to the front forefoot by a strip roughly half the width of the foot.
    • If a person overpronates, the print will show their whole foot because the entire underside of the foot touched the ground while walking, which is uncommon.
  4. Observe posture in the mirror
    • Examine your posture, especially below the waist while standing in front of a full-length mirror to see how your ankles and feet are performing while bearing weight and walking.
    • People who have their knees very close together or touch while standing (called knock knees or genu valgum) are possibly overpronators with flat feet because greater pressure is exerted on the middle portion of the foot. 
    • Examine the thick Achilles tendon as well that connects the heel to the calf muscles. It should appear straight. However, it is nearly always crooked and deviates laterally in overpronators.

If any one of the observations above is positive, it is recommended to visit a doctor for further examination and diagnosis.

In comparison, if the food doesn’t roll inward far enough, you may suffer from underpronation, which is known as supination. This should also be examined by a doctor.

SLIDESHOW

Common Causes of Foot Pain See Slideshow

How is overpronation diagnosed clinically?

The doctor may take foot X-rays, which are useful for detecting bone alignment (for example, a collapsing ankle joint), but not for determining the integrity of the ligaments and tendons that create the foot's arch.

Podiatrists (foot specialists) frequently use computerized gait analysis to better understand the gait and degree of pronation. The patient walks over a sensitive force plate that is linked to a computer. Some doctors may employ thermography (heat-sensitive pads) to better understand the biomechanics of the feet when walking.

During pregnancy, the hormones generated may cause ligaments to relax, resulting in temporary flat feet and overpronation. This may occasionally develop into a permanent problem. If symptoms continue for more than six months after delivery, a re-evaluation should be done.

How is overpronation treated?

Overpronation can be managed in two ways:

  1. Nonsurgical correction: Overpronation can be treated conservatively (without surgery) using custom-made orthotics.
    • To prevent overpronation, these orthotics should be constructed with insoles that offer enough arch support and medial rearfoot posting.
    • Footwear, especially running shoes, should be checked to ensure a suitable fit. If not correctly fitted, they may cause further foot issues.
    • For further support and stability, footwear with a strong heel counter is typically advised, such as motion control and stability shoes, which are a type of running shoe.
  2. Surgical correction: Podiatrists are qualified to do simple foot surgeries, whereas orthopedic surgeons often perform more complex surgical treatments.
    • The orthopedic surgeon may use computed tomography or magnetic resonance imaging scans or diagnostic ultrasonography to view the soft tissues of the foot to confirm overpronation and identify the main cause so they can perform surgery accordingly.

Overpronation potential causes

  • Tarsal coalition (an unnatural fusing of two or more bones surrounding the ankle)
  • Abnormally tight Achilles tendons (strong band of fibrous tissues that connect the heel bone and calf muscles)
  • Overly loose posterior tibial tendon (the primary tendon of the foot's arch)

The recovery period post-surgery may last for several months depending on the part of the leg (such as bones, tendons, or ligaments) that undergoes surgery.

The doctor may advise losing weight by modifying your diet, which may alleviate symptoms and lessen the amount of pronation.

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Medically Reviewed on 10/20/2021
References
Foot and Ankle Centers of North Houston. Watch Your Step: Do You Pronate or Supinate? https://footanklecenter.net/news/2019/1/16/watch-your-step-do-you-pronate-or-supinate

Tufts Medical Center. Over-Pronation. https://hhma.org/healthadvisor/aha-pronatio-sma/

Science Direct. Pronation. https://www.sciencedirect.com/topics/medicine-and-dentistry/pronation