Pronation

Overview

Pronation of the foot is a natural motion that occurs during the gait cycle. Most commonly people think pronation is where the foot rolls inward and the arch of the foot flattens. This is correct but leaves out some important details. Specifically, when your foot lands on the ground, your foot pronates to absorb shock and adapt to the terrain. This movement is important for shock absorption and weight distribution during activities like walking, running, and jumping.

Excessive pronation can sometimes lead to problems. These can include overuse injuries as it is causing increased stress and strain on the muscles and ligaments of the foot and leg. Additionally, it can lead to alignment issues up your ankle, knee, and hips. It’s important to wear appropriate footwear and orthotics or other supportive devices if needed to help correct any abnormal or excessive pronation. A healthcare professional, such as a podiatrist, physical therapist or one of our trained fitters can also provide guidance on proper pronation and treatment options for any related conditions.

Benefits of pronation

One of the main benefits of pronation is shock absorption. When the foot pronates it allows the body to distribute forces more evenly and reduce the impact of each step. This helps prevent injuries to the foot, ankle, knee, and hip.

Pronation can also help improve balance and stability as the foot adapts to the uneven surfaces and changes to the terrain. Some studies suggest pronation may be associated with increased efficiency during running and other physical activities. This is because pronation allows the foot to act as a more effective lever, propelling the body forward with each step.

As mentioned earlier, excessive pronation can have negative effects. It is important to maintain a healthy balance and seek professional advice for any lower limb discomfort.

Does your foot pronate?

There are a couple things you can take a look at to see if your foot pronates. Stand barefoot and observe the shape of your arch; if your arch appears to be flat or collapsed, this may be a sign of overpronation. Find someone with a trained eye to take a look at your gait while you walk barefoot. Our staff is trained to be able to identify when excessive pronation is taking place.

What kind of footwear will help with pronation?

The first recommendation would be to talk with one of our fitters at Roderer Shoe Center to have your foot evaluated. When selecting footwear, look for shoes that provide good arch support, stability, and cushioning. A firm midsole and a straight or slightly curved last can help control excessive pronation and improve foot alignment. Avoid shoes with a lot of flexibility or excessive cushioning as these will not control the foot throughout the gait cycle.

Over the counter or custom orthotics could also be beneficial when fit correctly. Over the counter orthotics vary from style to style, brand to brand, and type of support. It is important to make sure you work with someone who understands the differences and how they could affect your body positively or negatively.

Exercises

There are a few exercises you can do to help pronation:

1. Towel Scrunches: Place a small towel on the ground and use your toes to scrunch the towel towards you. This exercise can help strengthen the muscles in the arch and foot.
2. Calf raises: Stand with your feet hip-width apart and slowly raise up onto the balls of your feet. Hold for a few seconds and then lower back down. This exercise can help strengthen the calf muscles which will help support the arch of the foot.
3. Single-leg balance: Stand on one leg and try to maintain your balance for 30 seconds to a minute. This exercise can help improve balance and stability, which can especially be beneficial for pronation.
4. Ankle circles: Sit down and lift one foot off the ground. Slowly rotate your foot in circles moving your foot in progressively larger circles. This exercise can help open up ankle joints and reduce stress and tension.

Potential Pain

Pronation is typically associated with pain on the bottom of the foot in two different places. One spot is along the main arch. The other spot is typically under the heel towards the medial side of the foot and close to the arch. This is because the pronation causes a pulling of the plantar fascia. Some of the pulling can result in micro-tears along the arch, and in other people the pulling will result in the connection of the fascia and the heel bone (calcaneus).

It is possible to have pain on the top of the foot due to pronation. Overpronation can lead to excessive pressure and strain on the muscles and tendons including those on the top of the foot. The extensor tendons that run along the top of the foot can be negatively impacted at times when this happens resulting in pain on top of the foot. Usually in cases of pain on the top of the foot, an orthotic is the quickest solution as it will reduce the amount of pronation and allow the tendons to function without excessive pulling or stress.

Hypermobility and Pronation

Hypermobility refers to the ability of a joint to move beyond its normal range of motion. It is possible for hypermobility to contribute to pronation of the foot, but the relationship isn’t very straightforward. Some individuals with hypermobility may have increased flexibility in the muscles and tendons of the foot and ankle, which can make it easier for the foot to pronate excessively. However, other individuals may have increased muscle tone or strength, which can help support the foot and prevent excessive pronation.

Hypermobility can also contribute to other foot and ankle conditions like flat feet or plantar fasciitis. Often strengthening exercises or orthotics are recommended, but seeking out a medical professional for help would be recommended.

Hypomobility and Pronation

Hypomobility is the opposite of hypermobility and is the reduced range of motion. It may seem counterintuitive but it is still possible to have overpronation with hypomobility. Limited range of motion in the ankle joint can lead to an individual compensating with their gait, altering their mechanics, and leading to pronation. This can put stress on the foot and lead to pain and other symptoms but is much less common.

What movements make up pronation?

Pronation of the foot is a combination of several movements that occur at the joint between the ankle and heel bone, known as the subtalar joint. These movements are eversion, abduction, and dorsiflexion. Eversion is the outward rotation of the heel bone, which causes the foot to tilt inward. Abduction is the movement of the foot away from the midline of the body causing the arch of the foot to flatten out. Dorsiflexion is the movement of the foot upwards towards the shin bone which further flattens and elongates the arch of the foot.

When all three of these movements happen together, they can cause excessive pronation or the inward rolling we typically recognize.