One of the most common causes of foot and leg discomfort is a condition known as overpronation. Normal pronation, or "turning inward" of the foot is necessary as the foot adapts to the ground. With
over pronation, 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.
During our development, the muscles, ligaments, and other soft tissue structures that hold our bones together at the joints become looser than normal. When the bones are not held tightly in place,
the joints are not aligned properly, and the foot gradually turns outward at the ankle, causing the inner ankle bone to appear more prominent. The foot moves in this direction because it is the path
of least resistance. It is more difficult for the foot to move in the opposite direction (this is called supination). As we develop, the muscles and ligaments accommodate to this abnormal alignment.
By the time growth is complete, the pronated foot is: abnormally flexible, flat, and its outer border appears raised so that as you step down you do not come down equally across the entire foot;
instead, you come down mostly on the inner border of the foot. Normal aging will produce further laxity of our muscles that causes the pronation to become gradually worse.
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.
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
The following exercises help retrain the foot and ankle complex to correct overpronation. Step Up and Over. This exercise is designed to integrate skills learned in the Duck Stand, Big Toe Pushdowns
and Side Step with Opposite Reach exercises to mimic walking and even running. Using the gluteal muscles and big toe in tandem will prevent overpronation while moving back and forth over the BT in a
more effective, balanced motion. Movement Directions. Stand with left foot on top of the BT dome. (Note: For added balance, the right foot can tap on the ground, if needed). Extend right foot
backwards to the ground and drop hips into a lunge position. Make sure that the right arm rotates across the left leg (this will activate the gluteal muscles on the left side). Now, step through and
over the BT into a front lunge with the right leg forward. While lunging forward, the torso and left arm now rotate over the right leg. Throughout the exercise, push big toe down into the BT. Perform
8 to 10 repetitions on both sides.
Wear supportive shoes. If we're talking runners you're going to fall in the camp of needing 'motion control' shoes or shoes built for 'moderate' or 'severe' pronators. There are many good brands of
shoes out there. Don't just wear these running, the more often the better. Make slow changes. Sudden changes in your training will aggravate your feet more than typical. Make sure you slowly increase
your running/walking distance, speed and even how often you go per week. Strengthen your feet. As part of your running/walking warm up or just as part of a nightly routine try a few simple exercises
to strengthen your feet, start with just ten of each and slowly add more sets and intensity. Stand facing a mirror and practice raising your arch higher off the ground without lifting your toes. Sit
with a towel under your feet, scrunch your toes and try to pull the towel in under your feet. Sitting again with feet on the ground lift your heels as high as you can, then raise and lower on to toe