For such an uncommon word, overpronation describes a very common condition that affects millions of people — and can lead to heel pain, foot pain, and plantar fasciitis.
What exactly is overpronation? How can you tell if you overpronate when you walk or run? And what can you do about it?
What Is Overpronation?
The word “pronation” simply refers to the way your foot moves while you walk or run. As your foot strikes the ground, your arch rolls inward slightly, stretches, and flattens to absorb and distribute the impact.
Overpronation, on the other hand, is an abnormal gait that can happen when the foot rolls too far inward — making it more difficult for your arch to absorb impact. This condition is especially common in people with flat feet or people with damaged arches.
Causes of Overpronation
There are several possible reasons why you might overpronate while you walk or run. If you suspect you might overpronate (more on symptoms, below!) identifying the cause can help you correct the problem. The following are some of the most common causes of overpronation:
For some people, overpronation appears to be genetic and is present from childhood. However, keep in mind that according to the American Academy of Pediatrics, some overpronation is normal in very young children, since the arch of the foot doesn’t develop fully until about age six.
Individuals who have very flat feet or a collapsed arch tend to overpronate. Flat feet can develop as a result of genetics, standing for long periods of time, or wearing unsupportive footwear like flip-flops or slippers.
Wear and Tear
Strain, overuse, and wear on the muscles, ligaments, and plantar fascia (arch) of the foot can cause the foot to flatten too much–and roll inward excessively–as it strikes the ground, leading to overpronation. A damaged arch is one of the leading causes of overpronation since a compromised plantar fascia can’t “spring back” properly or distribute impact effectively.
Unsupportive or Worn Footwear
Standing or walking in high heels for an extended period of time puts a lot of strain and pressure on the arch and surrounding ligaments and muscles. Along those same lines, shoes that don’t fit properly, don’t have any arch support, are worn out in the sole, or slide around while you walk can cause the arch to flatten and roll inward excessively.
Plantar Fasciitis and Heel Pronation
Normal pronation helps the arch distribute impact properly so that no one part of the foot is forced to absorb too much strain or pressure. However, problems with heel pronation can lead to plantar fasciitis over time as the arch flattens and breaks down.
While overpronation is usually the culprit when it comes to plantar fasciitis and heel pronation, some people suffer from underpronation, or supination, which happens when the foot doesn’t roll inward far enough. This condition is usually the result of high arches, rather than flat arches.
Symptoms of Overpronation
If you overpronate while you walk or run, you’re likely to notice pain in the arch of your foot and heel. You may also notice that your feet generally don’t feel very stable while you run–which can lead to stumbles or falls.
Overpronation also causes the foot to turn outward during movement at the ankle, which means that you are effectively walking along the inner portion of your foot. This strain and pressure along the instep can lead to heel and foot pain, as well as pain in the knees, back, and hips.
One of the biggest clues that will help you determine whether or not you overpronate is the wear pattern on your favorite pair of sneakers. Severe overpronation will show a lot of wear along the inner edge of the shoe’s sole, near both the toe box and heel. Moderate overpronation will show wear near the inner edge of the shoe’s sole at the toe box, and along the outer edge of the sole at the heel.
Treatment for Overpronation
One of the best ways you can treat overpronation is by wearing supportive shoes. Shoes should have ample support and cushion in the sole, particularly through the heel and arch of the foot. Without proper shoes, the arch of the foot is left susceptible to strain and flattening.
The symptoms of overpronation can usually be corrected and relieved through a heel-cup style orthotic insert with Fascia-Bar technology. The cupped shape helps to stabilize the heel while you walk or run, while the Fascia-Bar lifts and realigns the arch so that it can properly absorb and distribute impact. For overpronators who have developed heel spurs or plantar fasciitis, Heel Seats also offer soothing cushioning that holds up to a significant impact from walking or running.
If you’re wondering how much you pronate while you run, you can stop by most running shops to have your gait analyzed (often for free!). Don’t be surprised if you learn that your gait isn’t quite properly aligned–and take comfort knowing that simple solutions like proper footwear and orthotic inserts can help!
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Choosing the best shoes for pronation involves assessing your level of pronation to gauge how much support is required. Manufacturers usually rate their shoes as suitable for mild, moderate, or severe pronation, so it’s important to know how much you overpronate. Shoes for pronation should provide a high level of support and contain firm insoles. Perhaps best way to ensure that you purchase the right running shoes is to get them professionally fitted. Other considerations include which type of terrain you run on and whether you have orthotics.
A normal foot is said to have a neutral arch. If you overpronate, however, your foot arch is lower than it should be. This puts the kinetic chain of the lower body out of alignment, and can cause serious problems, especially during high impact activities such as running. The best shoes for pronation help to support the foot arch and realign the ankle, knee, and hip.
To realign the foot and leg, shoes for pronation need to provide extra support and stability. Motion control shoes, which are rigid, durable and built to control pronation, are often the best type for severe overpronation. If you only have mild pronation, then a stability shoe may be enough to keep the arch from collapsing too much while running. A runner who over pronates usually should avoid shoes that have a lot of cushioning.
As with any shoe, it’s important to ensure that shoes for pronation are correctly fitted. Buying from a professional running shop is important for this reason. Shoe sizes measure the length of the shoe, but it’s also necessary to get the right width. If you wear orthotic inserts to correct for overpronation, then it’s mandatory to wear these while the shoe is fitted.
There are two main types of running shoe: trail and road. If you plan on trail running, it’s important to buy durable shoes for pronation that are built for this purpose. A trail running shoe will provide more grip and often extra protection from rocks and roots. Road running shoes tend to require greater shock absorption to protect the joints.
If you use orthotics, it’s important to purchase a shoe that will work in conjunction with them. In some cases, using highly supportive shoes and supportive orthotics can prevent the foot from pronating enough. For this reason, you should discuss the options with a podiatrist before choosing a pair of shoes for pronation.
There’s No Single Solution for Pronated Feet
Overpronation is too much of a good thing. Pronation is a natural movement of the foot and ankle that occurs in healthy humans when we walk and run that helps absorb the shock of your foot striking the ground.
Pronation is a combination of 3 movements:
3) Forefoot abduction
Overpronation is when too much of these movements occur, which can lead to repetitive stress injuries and pain because if you’re overpronating, you’re putting excess stress on medial ankle and medial knee tissues.
Some of the issues that can crop up as a result of overpronation include:
Achiles tendonitis: in fact, a 2017 study showed that achilles tendon blood flow was decreased in overpronators, which can lead to impaired tissue recovery and pain. 
Plantar fasciitis: this 2014 study from the Journal of Biomechanics shows that overpronation results in greater stress to the plantar fascia. 
Shin splints: also known as medial tibial stress syndrome, overpronation and a pronated foot posture showed strong evidence as a risk factor as outlined in this 2014 study. 
Patellofemoral pain syndrome: the same shin splints study also linked overpronation to PFPS.
As you can see, overpronation can result in a number of different issues.
So if you get knee pain and you have overpronation but your treatment only includes glute, quad and hamstring exercises and stretches, you’re missing a critical component of your rehab.
How to Correct Overpronation
In today’s video, we’re going to explore some of the root causes that can lead to overpronation in the first place, that must be addressed to correct the problem at the source.
These 3 causes are by no means comprehensive as the human body can compensate in creative ways to get around dysfunctions you have.
If you’re an overpronator, I hope this gives you more insight into the issue and gets you thinking about how to fix it.
One exercise that I love that’s a part of my Lower Limb Control course is the Seated 4-Way MTP Slide.
While the technique looks simple, there are a few important cues that must be followed to make it effective.
Check it out here:
This is a great technique to do when you’re at the office or sitting around at home. If you can’t slide your foot, no worries, just get to end range where you can keep your foot flat and apply metatarsal pressure and you’ll still benefit. But it is definitely done best on surface where you can slide your foot while applying metatarsal pressure the whole time.
The shape of the human foot and its mechanics are designed to minimize the stress of walking or running. When your foot pushes off, it propels you forward by rolling outward or supinating. When it strikes the ground again, it absorbs the shock of impact by rolling inward or pronating.
This process is normal and healthy. In fact, it’s crucial to protect your joints over the long haul. But when your foot rolls inward a little too much, that’s when you can start to have problems. This is called overpronation, and it’s the leading cause of most runners’ injuries.
Overpronation can destabilize your body when walking and running
Your foot continues to roll inward even after it’s made its landing. What happens next depends on the structure of your feet, ankles, and calves, but many runners experience nasty stress injuries:
Overpronation can also play a role in acute injuries, like ankle sprains.
Are you an overpronator?
Overpronation isn’t always obvious. Most people take the way that they walk or run for granted. You can always have your gait analyzed by a foot and ankle specialist, but there are some ways to tell at home.
First, overpronators typically have flat feet and extremely flexible arches. That excessive movement makes it hard for your body to support your weight while running.
Wet foot test
You can check this using the wet foot test. Dip just the sole of your foot into a pan of water. Be careful not to soak the entire foot and arch – just the bottom!
Next, step onto a newspaper or paper bag. If your footprint leaves you asking “what arches?” then you’re probably an overpronator.
Wear and tear on your shoes
You can also tell from the wear and tear on your shoes. Flip your running shoes over. If the heel and ball of the foot leading into the big toe are all worn in, then overpronation is the likely culprit.
How to correct for overpronation
So, you’re an overpronator? Don’t worry; you’re in good company! Livestrong.com estimates that 20-30% of runners are severe overpronators, while up to 60% are mild overpronators. Keep reading to learn how to reduce your risk of injury.
To keep your arches from collapsing with every step, you need sturdy, supportive footwear. Shoes with proper arch support will keep your foot in alignment and give you stability. Avoid any shoes with flexible soles, especially trendy “minimalist” shoes.
Even if you get brand new, motion-controlling shoes, they may not be enough to correct the effects of overpronation. That’s why our doctors can’t recommend this next solution highly enough.
Our patients LOVE their custom orthotic insoles. They’re specially fitted to your feet and tailored for your activity purposes. Insoles can both treat current injuries – like plantar fasciitis – and prevent new injuries from occurring.
According to a 2017 study published in the Journal of Biomechanics, custom insoles minimized the angle of pronation at ground strike and raised the height of the arch. “When feet are supported in correct alignment, also the position of the knees, pelvis, and hips are corrected, thereby providing a solid foundation for the entire body,” writes lead author Dr. J. Kosonen.
Forget the soft and foamy models you find at the drugstore. “What overpronators really need is structure,” said Dr. Bob Baravarian. “I’d recommend a semi-flexible plastic at a minimum, which can then be covered with a cushion for comfort.”
Tips to help pronate like the pros
Can’t afford new shoes or insoles at the moment? No sweat! There are steps you can take (see what we did there?) to reduce the impact of overpronation while you’re running.
Focus on your stride
Improving your form can help mitigate discomfort and prevent future injuries. Taking short, quick steps instead of long, drawn-out strides can minimize the foot’s rotation and decrease your chances of over-striding.
You can also employ stretching and strengthening exercises (really, if you’re not already stretching after your runs, then you’re just asking for a stress injury).
Try some of these easy stretches that take five minutes or less.
Calf raises. Stand with your feet shoulder-width apart, toes pointed forward. Slowly, lift your heels off the ground and lower them back down. Repeat 10 times. You can even try these on one foot at a time.
Ball roll. Massage the arches of your feet with a golf ball or a frozen water bottle. Repeat with each foot for one minute.
Point, flex, curl. Sit on the floor with your legs straight out in front. Point the toes, then flex them back. Finish with a toe curl. Repeat this 10-12 times.
If you are experiencing problems with your feet or ankles we are here to help. Our nationally recognized podiatrists and foot and ankle specialists offer the most advanced foot and ankle care along with the highest success rates in the nation. We are leaders in the field of research and treatment of all foot and ankle conditions.
For more information or to schedule a consultation, please call (877) 736-6001 or visit us at www.footankleinstitute.com.
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Dr. Avanti Redkar is board certified in podiatric medicine and joined University Foot and Ankle Institute under a fellowship in sports medicine and ankle reconstruction. She attended podiatry school at the New York College of Podiatric Medicine and went on to complete her surgical residency at Good Samaritan Hospital in West Islip, New York, where she was trained in foot and rearfoot surgery, wound care, and hyperbaric medicine.
Dr. Redkar specializes in foot and ankle pathology and is available for consult at our Mid-Wilshire Los Angeles and Beverly Hills locations.
Are You Suffering from Collapsed Foot Arches?
As OrthoFeet strives to share information with you about foot ailments, we’ve more than once raised the point that your feet support your entire body. When it comes to your feet, nothing should be taken lightly or for granted.
A very common biomechanical phenomenon is Flat Feet, or Over-Pronation, which occurs during standing or walking, when a person’s arch collapses upon weight bearing.
There are many conditions that can cause flat feet and over-pronation. Common foot deformities and flexible muscle structure are the most frequent causes. The structure of the foot begins to collapse, causing the foot to flatten and adding stress to other parts of the foot.
Other conditions including obesity, pregnancy or repetitive pounding on a hard surface, can weaken the arch and lead to over-pronation.
Often people with flat feet do not experience discomfort immediately, and some never suffer from any discomfort at all. However, when symptoms develop and become painful, walking becomes awkward and causes increased strain on the feet and calves. Over-pronation often leads to plantar fasciitis, heel spurs, metatarsalgia, tendonitis and/or bunions. In some cases over-pronation can affect your knees, hips and even lower back because when the foot pronates (flattens) it causes the leg to internally rotate, resulting in improper posture of the entire leg and back.
Treatment and Prevention
Over-Pronation can be treated conservatively with orthotic insoles that are designed with appropriate arch support to prevent the over-pronation. Stability shoes that feature a firm heel counter and wide soles help reduce over-pronation, as well.
Take a look at OrthoFeet shoes that are specifically constructed to support flat feet and over-pronation at https://www.orthofeet.com/collections/flat-feet-shoes
- Strengthen your foot muscles through toe curls, heel raises, and other exercises to improve foot support, stability and shock absorption.
- Do not walk barefoot – Always wear proper fitting and supportive shoes
- Avoid running or other high-impact sports
If you still experience foot pain, and your quality of life is affected by over-pronation you should seek the help of a podiatrist.
If you’ve been running long enough, you’ve most likely had to deal with various aches and pains in your feet, knees, hips or lower back. Plantar fasciitis, Achilles tendinitis, IT-band syndrome, meniscus tears, runner’s knee, bursitis of the hip or knee, patellofermoral pain syndrome, chondromalacia patella, lower back pain and piriformis syndrome are only some of many conditions an athlete may develop during the course of his or her running career.
Although there are many factors that can contribute to the development of these conditions, improper biomechanics of the body plays a large and detrimental role in the process. Of the many biomechanical elements involved, foot and ankle function perhaps contribute the most to these aches and pains.
During a normal gait cycle, the forward movement is a result of the body’s mass being displaced, putting the body in a forward-falling position. At this time, the lead foot hits the ground preventing the fall, followed by the rear leg as it swings forward, and the cycle repeats with each step.
Once the foot hits the ground its first function is to absorb and help dissipate the shock of impact. This is followed by pronation of the foot so that it can help accommodate the ground contour. The ankle goes into flexion allowing the knee to move forward, and the body follows. The heel raises, and the foot supinates becoming a rigid lever that aids in the pushing action that eventually ends with the toe-off.
Many other intricate and complex components of motion mechanics take place during this process, but for the purpose of this article, this helps to explain the basics.
I’ve see a lot of runners who’ve been told that their particular condition is a result of overpronation. Usually, they’ve had some form of a “postural or gait analysis” done by a coach, trainer or healthcare professional, or at a running store. They are typically fitted with stability shoes, off-the-shelf orthotics or costume-made orthotics; the general intention being to prevent excessive pronation of the foot.
Although this is needed in some cases, it should not be done in each and every case when a runner’s foot seems to over pronate. Doing so can and often does result in one symptom going away and another, usually a more complicated one, developing elsewhere.
Foot pronation (turning downward or inward) and supination (turning upward or outward) are normal and needed movements for proper function during the gait cycle.
The following is a brief and simplified reasoning as to why this practice may be flawed if a proper evaluation has not been performed prior to modifying shoes or using orthotics.
In a normal functioning ankle and foot there should be 15- to 20-degrees of ankle dorsiflexion present (leg moving forward on top of the foot; or, same as the foot bending backward toward the leg) as well as 60- to 65-degrees of first toe extension (bending backward).
Foot pronation (turning downward or inward) and supination (turning upward or outward) are normal and needed movements for proper function during the gait cycle. All feet must do this and do it well to minimize the forces that the body has to deal with during walking or running, and also to create the lever that is needed for propulsion.
It is the “excessive pronation” that has been considered a great offender in many of the above referenced conditions. This is when the foot remains in pronation for a longer than normal period of time. This also is what most people try to correct, and often do so improperly.
How many of you have gone to your favorite therapist, doctor or shoe store complaining of some sort of pain? You got a cursory evaluation; were fitted with shoes or orthotics and found that indeed your complaint(s) resolved; but only to find yourself complaining of something else hurting you a few weeks later without having changed anything else in your training.
As a parent, it’s almost impossible not to play the comparison game. Is my child ahead of the curve? Right on track? Behind?
But when milestone deadlines come and go, questions aren’t far behind. There are many reasons a child faces developmental delays.
One is pronation. And there’s definitely something you can do to help.
What Is Pronation?
Pronation, often called flat feet, flexible flat foot, pes planus, or overpronation, refers to the inward roll of your child’s ankle.
When standing barefoot, the problem is easy to spot. The naturally occurring arch of your child’s foot is either reduced or gone altogether. And while it looks like a foot problem, it actually starts in the heel. The calcaneus (a fancy word for heel bone) rotates inward. Body weight then shifts in also, causing your child to walk and stand on the inside part of his or her foot.
What Causes Pronation In Kids?
There isn’t just one cause. But for kids who have low muscle tone , ligament laxity is a common culprit.
Ligaments, the flexible fibers that connect bones or joints, serve as your child’s checks and balances system. They make sure joints don’t move beyond the normal range of motion. But if these ligaments are overly relaxed, joints move too far. And in the case of pronation, this causes ankles to roll in.
What Problems Does It Cause?
You may see the effects of pronation even before your child starts walking. Developmental delays with pulling to stand and cruising are common.
And then there are the clumsy steps. The gait of a toddler who pronates is often sloppy or immature compared to other kids the same age. Additionally, your child may be slow to master gross motor skills such as:
· Standing on one foot
Pronation can also leave your child exhausted. His or her muscles work harder due to the body’s poor positioning. This may be why your child is more inclined to sit rather than run and play.
Keep in mind that pronation isn’t just a foot problem. It starts a chain reaction. That inward ankle roll can cause knees, hips, and back to shift out of alignment. If left untreated, expect pain in all three areas.
What Should I Do If My Child Pronates?
First off, remember that some pronation is normal. A toddler’s body is always growing and changing. A slight ankle roll while standing or walking doesn’t mean you need to rush off to a doctor.
What you should keep an eye out for is pronation that is excessive and symptomatic. This means watch for pain, fatigue, clumsiness, and developmental delays. They’re all symptoms of a bigger issue.
For kids who fall into this category, start with a pediatrician. He or she can get you moving on to the next step, which could be physical therapy or a trip to an orthotist. If a little education or convincing is needed, you can direct your doctor to a variety of helpful resources found here on the Surestep site.
What Ankle Pronation Treatment Options Do I Have?
One highly effective treatment is the revolutionary Surestep SMO . These little ankle braces are custom-made pediatric orthotics designed to correct pronation. With uniquely flexible plastic, it provides the stability and comfort your child needs.
To understand how the SMOs work, think about training wheels. When learning to ride a bike, kids tip back and forth. They’re still pedaling and using their own muscles. Training wheels just provide that necessary stop before tipping over. With practice, kids don’t need them anymore.
It’s the same with Surestep SMOs. They provide stability and won’t let the foot/ankle slide into that excessive position. But your child’s muscles continue to do all the work. With enough repetition and muscle memory, the SMOs can be taken away without your child becoming dependent on them.
Don’t let the ordering process confuse you: GET SURESTEP
How Do Surestep SMOs Fight Pronation? Why Are They Unique?
This gets a little confusing but stay with us.
Pronation is triplanar. This means it happens in three planes of motion. More simply, you can think of it as affecting three parts of the foot:
· Back (the heel bone rolls in)
· Side (the arch flattens out)
· Top (the forefoot pushes out, creating a boomerang shape)
Surestep SMOs treat pronation in all three of these planes. We start at the source. By moving the heel bone back into place, the arch reappears naturally. And Surestep’s unique trim lines (as opposed to full footplates) help move the forefoot back into position.
Most other orthotic devices try to take a shortcut by simply forcing the arch back up. But this doesn’t address the root problem. It’s like taking medicine to fight symptoms rather than the sickness itself. And many kids who use this type of product still pronate. They’re just pronating on top of an orthotic.
This is one of many reasons why it’s important to ask for Surestep SMOs by name. You don’t want an inferior substitute.
Dr. Joel Seedman, Ph.D.
Flat feet, fallen arches, and ankle pronation are some of the most common forms of foot and ankle dysfunctions. However they all fall under a similar category of neuromuscular and structural issues, most of which are related to valgus collapse of the hip, knee, and ankle. Therefore by addressing one of these components you’re essentially helping to fix the others.
Here’s one of my NFL athletes, Minnesota Vikings quarterback Taylor Heinicke demonstrating a very simple eyes closed variation for addressing these issues as we strengthen his feet and ankles for the demands of the rigorous NFL season.
To improve issues associated with excessive foot/ankle pronation, flat feet, fallen arches, and eversion the key is to perform drills that require the individual to resist pronation or valgus forces. Essentially these drills force the individual to drive into supination by pushing to the lateral portion of their foot. Single leg variations of movements where the weight is loaded contralaterally (opposite arm and leg) are very effective for addressing this as you’re essentially feeding the dysfunction. For example performing a single leg stand on your left leg while holding the load in your right hand forces the lifter to push their ankle outward to resist the pronation forces created by the contralateral loading.
Performing these in an eyes closed fashion further challenges the stabilizers around the feet, ankles, and hips. It also forces the lifter to rely on proprioceptive feedback from muscles spindles to dial in the movement and stabilize the body. Simply put, eyes closed variations improve body mechanics and kinesthetic awareness as anything but proper alignment results in loss of balance. Just be patient as these can be incredibly difficult to master.
If you have trouble with ankle and knee collapse during squats, jumps, lunges, and other lower body movements, performing drills that are loaded in a contralateral fashion is critical as they not only help eliminate ankle pronation but also strengthen the outer hips, abductors, and glute medius muscles.
For individuals who suffer with the valgus collapse of the feet and ankles as well as pronation and flat feet, you’ll want to practice drills like this daily. Several sets of 30 seconds per side is ideal. Start with eyes open variations on a hard surface then progress to softer surfaces and eventually eyes closed. Once you can successfully perform a majority of your foot and ankle stabilization drills under eyes closed conditions you’ll most likely have eliminated a majority of your foot and ankle issues not to mention most lower body dysfunctions.
For those who suffer with excessive supination of the ankles, performing the same drills but in an ipsilateral loading fashion (loading the same arm and leg) is ideal for correcting this form of dysfunction.
For more on fixing foot and ankle issues check out my in depth Foot and Ankle Training Manuel