One of the most common causes of foot and leg discomfort is a condition known as overpronation. Normal pronation, or "turning inward" of the foot is necessary as the foot adapts to the ground. With
over pronation, the arch flattens, collapses, and soft tissues stretch. This causes the joint surfaces to function at unnatural angles to each other. When this happens, joints that should be stable
now become very loose and flexible. At first, over pronation may cause fatigue. As the problem gets worse, strain on the muscles, tendons, and ligaments of the foot and lower leg can cause permanent
problems and deformities.
Pronation can occur as an overuse syndrome in active runners, where a great deal of stress is placed on ligaments and tendons that support the medial column. Obesity is another predictor for
pronation and deterioration of the medial ligaments and posterior tibial tendon due to excessive stress on these tissues. Acute Trauma can also lead to over-pronation when ligaments are torn or
tendon is ruptured. Once again this can lead to a collapse of the medial column. Arthritic conditions involving the knee joint when the joint is in varus (inner collapse) posture, this places the
center of gravity over the ankle joint rather than the foot causing undue pressure on the inner ankle.
Because overpronation affects the entire lower leg, many injuries and conditions may develop and eventually cause problems not only in the leg and foot, but also the knee, hips and lower back. Pain
often begins in the arch of the foot or the ankle. Blisters may develop on the instep, or on the inside edge of the heels. As overpronation continues and problems develop, pain will be felt
elsewhere, depending on the injury.
The best way to discover whether you have a normal gait, or if you overpronate, is to visit a specialty run shop, an exercise physiologist, a podiatrist or a physical therapist who specializes in
working with athletes. A professional can analyze your gait, by watching you either walk or run, preferably on a treadmill. Some facilities can videotape your gait, then analyze the movement of your
feet in slow-motion. Another (and less costly) way is to look at the bottom of an older pair of run shoes. Check the wear pattern. A person with a normal gait will generally see wear evenly across
the heel and front of the shoe. A person who overpronates will likely see more wear on the OUTside of the heel and more wear on the INside of the forefoot (at the ball). A person who supinates will
see wear all along the outer edges of the shoe. You can also learn about your gait by looking at your arches. Look at the shape your wet feet leave on a piece of paper or a flat walking
Non Surgical Treatment
No matter what the cause in your case, over pronation can be remedied in several ways. Those who are overweight should consider permanently losing weight to naturally alleviate pressure on the
ligaments and heel of the foot. Also, you should consult a podiatrist to examine your posture and movement habits. You may be reinjuring yourself due to poor alignment without even knowing it. If you
also have lower back problems, this could be a sign of over pronation as a result of misalignment.
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.