n 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 in order 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.
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.
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.
If you have flat feet or low arches, chances are you overpronate. Although not always the case, the lower your arches the greater the overpronate. Stand on a hard surface (in front of a mirror if you
need to) and look at your feet, flat feet or low arches are easy to spot. If your feet look flatter than a pancake, have a look at your ankles and see if they seem collapsed or straight. If they are,
Non Surgical Treatment
Podiatrists are trained to effectively detect and management over-pronation. You can get a referral to a podiatrist from your GP if you are presenting with the pain typical of over-pronation, or you
can seek private podiatric care in anyone of several registered and accredited practices across the country. Your podiatrist will examine your foot and its shape to determine whether or not
over-pronation is the cause of your pain. If your podiatrist determines that it is a problem with arch support that is giving you trouble, then they can effectively remedy that lack of support with
Stand with your heels together and feet turned out. Tighten the buttock muscles, slightly tilt your pelvis forwards and try to rotate your legs outwards. You should feel your
arches rising while you do this exercise.
Stand facing a wall and place hands on it for support. Lean forwards until stretch is felt in the calves. Hold for 30 seconds. Bend at knees and hold for a further 30 seconds.
Repeat 5 times.
While drawing your toes upwards towards your shins, roll a golf ball under the foot between 30 and 60 seconds. If you find a painful point, keep rolling the ball on that spot for 10
Big toe push:
Stand with your ankles in a neutral position (without rolling the foot inwards). Push down with your big toe but do not let the ankle roll inwards or the arch collapse. Hold for
5 seconds. Repeat 10 times. Build up to longer times and fewer repetitions.
Place a ball between your foot and a wall. Sitting down and keeping your toes pointed upwards, press the outside of the foot against the ball, as though pushing it into the
wall. Hold for 5 seconds and repeat 10 times.
Stand on one foot on the floor. The movements needed to remain balanced will strengthen the arch. When you are able to balance for 30 seconds, start doing this exercise
using a wobble board.