One of the most common causes of foot and leg discomfort is a condition known as over pronation. Normal pronation, or "turning inward", of the foot is necessary as the foot adapts to the ground. With
over pronation, however, the arch flattens, collapses, and soft tissues stretch. This causes the joint surfaces to function at unnatural angles to each other. When this happens, joints that should be
stable now become very loose and flexible. At first, over pronation may cause fatigue. As the problem gets worse, strain on the muscles, tendons, and ligaments of the foot and lower leg can cause
permanent problems and deformities.
There are many possible causes for overpronation, but researchers have not yet determined one underlying cause. Hintermann states, Compensatory overpronation may occur for anatomical reasons, such as
a tibia vara of 10 degrees or more, forefoot varus, leg length discrepancy, ligamentous laxity, or because of muscular weakness or tightness in the gastrocnemius and soleus muscles. Pronation can be
influenced by sources outside of the body as well. Shoes have been shown to significantly influence pronation. Hintermann states that the same person can have different amounts of pronation just by
using different running shoes. It is easily possible that the maximal ankle joint eversion movement is 31 degrees for one and 12 degrees for another running shoe.
Overpronation can lead to injuries and pain in the foot, ankle, knee, or hip. Overpronation puts extra stress on all the bones in the feet. The repeated stress on the knees, shins, thighs, and pelvis
puts additional stress on the muscles, tendons, and ligaments of the lower leg. This can put the knee, hip, and back out of alignment, and it can become very painful.
At some point you may find the pain to much or become frustrated. So what are you options? Chances are your overpronation has led to some type of injury if there's pain. Your best bet is to consult
with someone who knows feet. Start with your pediatrist, chiropodist or chiropractor. They'll be able to diagnose and treat the injury and give you more specific direction to better support your
feet. One common intervention is a custom foot orthotic. Giving greater structural support than a typical shoe these shoe inserts can dramatically reduce overpronation.
Non Surgical Treatment
Pronation and supination are bio-mechanical problems, and are best treated and prevented with orthotic inserts. But before you run out to buy orthotics it makes sense to get the right advice on
footwear, and the best advice I can give you, is to go and see a qualified podiatrist for a complete foot-strike and running gait analysis. They will be able to tell you if there are any concerns
regarding the way your running gait is functioning. After your running gait has been analysed, have your podiatrist, or competent sports footwear sales person recommend a number of shoes that suit
your requirements. Good quality footwear will go a long way in helping to prevent pronation and supination. And, if needed, invest in a pair of orthotic inserts to further prevent excessive pronation
Calcaneal "Slide" (Sliding Calcaneal Osteotomy) A wedge is cut into the heel bone (calcaneus) and a fixation device (screws, plate) is used to hold the bone in its new position. This is an aggressive
option with a prolonged period of non-weightbearing, long recovery times and many potential complications. However, it can and has provided for successful patient outcomes.