Earleen Wilkerson
That which does not kill us makes us stronger.
What Causes Feet To Over Pronate
Overview


Pronation is a turning outward of the foot at the ankle, which allows the foot to flatten. The pronation helps to absorb some of the compressive shock forces, torque conversion, adjustment to uneven ground contours, and maintenance of balance. It is necessary to have a certain amount of pronation to disseminate the energy of the foot-strike. If there is too little or too much pronation injuries may occur. When a foot and ankle pronates to a great degree, we call it over-pronation. Normally you can see the Achilles Tendon run straight down the leg into the heel. If the foot is over-pronated, the tendon will run straight down the leg, but when it lies on the heel it will twist outward. This makes the inner ankle bone much more prominent than the outer ankle bone.Over-Pronation


Causes


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.


Symptoms


With over pronation, sufferers are most likely to experience pain through the arch of the foot. A lack of stability is also a common complaint. Over pronation also causes the foot to turn outward during movement at the ankle, causing sufferers to walk along the inner portion of the foot. This not only can deliver serious pain through the heel and ankle, but it can also be the cause of pain in the knees or lower back as well. This condition also causes the arch to sink which places stress on the bones, ligaments, and tendons throughout the foot. This may yield other common conditions of foot pain such as plantar fasciitis and heel spurs.


Diagnosis


One of the easiest ways to determine if you overpronate is to look at the bottom of your shoes. Overpronation causes disproportionate wear on the inner side of the shoe. Another way to tell if you might overpronate is to have someone look at the back of your legs and feet, while you are standing. The Achilles tendon runs from the calf muscle to the heel bone, and is visible at the back of the ankle. Normally it runs in a straight line down to the heel. An indication of overpronation is if the tendon is angled to the outside of the foot, and the bone on the inner ankle appears to be more prominent than the outer anklebone. There might also be a bulge visible on the inside of the foot when standing normally. A third home diagnostic test is called the ?wet test?. Wet your foot and stand on a surface that will show an imprint, such as construction paper, or a sidewalk. You overpronate if the imprint shows a complete impression of your foot (as opposed to there being a space where your arch did not touch the ground).Overpronation


Non Surgical Treatment


The way a foot orthotic works is by altering the weight-bearing surface of the foot. The simulated foot improvement is only possible when standing still with full weight applied. Orthotics are of little help through most of the actual walking cycle. observationPatients may experience some symptom relief, but the orthotic cannot correct the internal osseous misalignment. Over-the-counter foot orthotics are usually of little help and wear out quickly. Custom-made foot orthotics, obtained through your doctor's office, are generally expensive. Though they last longer and have less chance of ill-effects than OTC brands, they still need to be replaced often. Over a lifetime, an individual can spend several thousands of dollars in total costs associated with orthotics and see little or no results. This is because orthotics only work when you are wearing them and do not treat the cause of the problem. In many cases, the external pressure points created by orthotics can cause more problems than solutions. Blisters, sore feet, sore joints and many other long-term complications can arise as a consequence of wearing orthotics.


Surgical Treatment


The MBA implant is small titanium device that is inserted surgically into a small opening between the bones in the hind-mid foot: the talus (ankle bone) and the calcaneus (heel bone). The implant was developed to help restore the arch by acting as a mechanical block that prevents the foot from rolling-in (pronation). In the medical literature, the success rate for relief of pain is about 65-70%. Unfortunately, about 40% of people require surgical removal of the implant due to pain.
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