One of the main postural deviations that cause pain and injury in the foot and ankle area (and resultant compensations in the rest of the body) is overpronation. Pronation is a normal function that
occurs when the foot rolls inward toward the midline of the body. This movement causes the heel to collapse inward and the medial arch of the foot to elongate and flatten. Overpronation, however, is
when the foot collapses too far inward for normal function. Consequently, this directly affects the ability of the foot to perform and can disrupt proper functioning through the entire
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.
When standing, your heels lean inward. When standing, one or both of your knee caps turn inward. Conditions such as a flat feet or bunions may occur. You develop knee pain when you are active or
involved in athletics. The knee pain slowly goes away when you rest. You abnormally wear out the soles and heels of your shoes very quickly.
Look at your soles of your footwear: Your sneaker/shoes will display heavy wear marks on the outside portion of the heel and the inside portion above the arch up to the top of the big toe on the
sole. The "wet-foot" test is another assessment. Dip the bottom of your foot in water and step on to a piece of paper (brown paper bag works well). Look at the shape of your foot. If you have a lot
of trouble creating an arch, you likely overpronate. An evaluation from a professional could verify your foot type.
Non Surgical Treatment
Studies have shown that the most effective way to dexrease a high Q angle and lower the biomechanical stresses on the knee joint is to prevent excessive pronation with custom-maflexible orthotics.
One study found that using soft corrective orthotics was more effective in reduknee pain than a traditional exercise program. A more recent study showed that Q angle asymmetries, secondary to
excessive pronation affecting knee alignment, can be effectivecontrolled or corrected utilizing custom-made, flexible orthotics. Another project involving meof a running club determined that 75% of
those using orthotics eliminated or greatly reduced pain in the feet, ankles, shins, knees and hips
Strengthen the glutes to slow down the force of the foot moving too far inward. Most individuals who over-pronate have weak glute muscles and strengthening this area is a must. A simple exercise to
strengthen glutes is lateral tube walking across a field/court/room. Place a lateral stretch band around your ankles and move your leg sideways while keeping your feet forward.