Over pronation of the foot is commonly referred to as "flat feet." Many middle-aged men and women suffer from over pronation over time and as a result of wearing poor-fitting shoes, continuing with
repetitive exercising habits, or walking in high heels for long periods over several years. Regular speed-walkers often experience over pronation as well as a result of this activity.
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.
Common conditions that develop with prolonged overpronation typically include plantar fasciitis, achilles tendonitis, shin splints, posterior tibial stress syndrome and even IT band syndrome. With
long term neglect you may see the development of bunyons, foot deformities and early onset of hip and knee arthritis.
Bunions, calluses and crooked toes may indicate alignment problems. So, it is important to ascertain the condition of a client's toes. Check the big toe to determine if the first joint of the toe is
swollen, has a callus or bunion, and/or looks as though it abducts (i.e., hallux valgus) rather than pointing straight ahead. Also, look to see if the lesser toes seem to "curl up" (i.e., the person
has hammer or claw toes). This may be indicative of damage to, or inflexibility of the plantar fascia caused by excessive flattening of the foot.
Non Surgical Treatment
Over-Pronation can be treated conservatively (non-surgical treatments) with over-the-counter orthotics. These orthotics should be designed with appropriate arch support and medial rearfoot posting to
prevent the over-pronation. Footwear should also be examined to ensure there is a proper fit. Footwear with a firm heel counter is often recommended for extra support and stability. Improper fitting
footwear can lead to additional problems of the foot. If the problem persists, call your doctor to schedule an appointment.
Hyperpronation can only be properly corrected by internally stabilizing the ankle bone on the hindfoot bones. Several options are available. Extra-Osseous TaloTarsal Stabilization (EOTTS) There are
two types of EOTTS procedures. Both are minimally invasive with no cutting or screwing into bone, and therefore have relatively short recovery times. Both are fully reversible should complications
arise, such as intolerance to the correction or prolonged pain. However, the risks/benefits and potential candidates vary. Subtalar Arthroereisis. An implant is pushed into the foot to block the
excessive motion of the ankle bone. Generally only used in pediatric patients and in combination with other procedures, such as tendon lengthening. Reported removal rates vary from 38% - 100%,
depending on manufacturer. HyProCure Implant. A stent is placed into a naturally occurring space between the ankle bone and the heel bone/midfoot bone. The stent realigns the surfaces of the bones,
allowing normal joint function. Generally tolerated in both pediatric and adult patients, with or without adjunct soft tissue procedures. Reported removal rates, published in scientific journals vary