Your Arch Enemy: Over-Pronation

It is very rare that people come to us with perfect ankle alignment.  This is because everyone has slight variations in joint structure and over the years bones begin to shift slightly according to the forces put through them and the supporting soft tissues around them such as muscles, ligaments and tendons.

When we walk and run the ankle naturally supinates (tilts upwards and outwards) and pronates (tilts down and inwards) as part of the movement.  It is only when the ankle moves too far into supination (over-supination) or pronation (over-pronation) that it can become an issue.  

Effects Of Over-Pronation

The ankle joint functions as a shock absorber and, when aligned correctly, distributes the shock from motion evenly.  Thus when misaligned extra force is misdirected and placed upon the other joints of the leg (hip & knee) and the spine.  As you could guess, this can lead to further issues along the kinetic chain.  The hip and the knee must rotate outwards to compensate for over-pronation, which in turn can damage the joints themselves and also affect the muscles and ligaments surrounding them.

Do I Have Over-Pronation?

Everyone’s ankle has some degree of pronation, the ankle naturally rolls inward to a certain extent.  So it may be difficult to spot yourself, only a qualified health practitioner can confirm if you have over-pronation.  However there are signs you can look out for that may help you decide whether you need to book that appointment.

• An over-pronating ankle will cause you to have a low arch (flat foot); you may be able to spot this by looking in the mirror.  You may also notice that the inner border of your foot may be touching the ground. 
  

• Your shoes may be worn away more on the inside edge of the sole that the outside and they might tilt when placed on a flat surface.
  

• You may have noticed you are regularly suffering from leg and ankle injuries – commonly plantar fasciitis or shin splints.
  

• Check the footprints you leave the next time you get out of the shower or bath.  Over-pronators will leave dense prints, with little distinction between the fore foot and hind foot.  A neutral footprint will be broad at the fore foot and slender from the mid to hind foot – on the left foot it may look almost like an off centre letter ‘P’ shape.
  

It Looks Like My Ankle Is Over-Pronating What Should I Do?

If you think you have over-pronation the best thing you can do is seek the advice of a health professional such as a sports therapist, podiatrist or physiotherapist who will be able to assess your ankle and general posture and determine if your suspicions are correct.  Depending on their findings your therapist will usually be able to help you reinstate your plantar arch and realign your lower limb.  They will help you to increase flexibility of the tighter structures and help you work on strengthening the muscles of the plantar arch and the lateral rotators of the leg.  In most cases a podiatrist will prescribe an orthotic insole to provide necessary support through your rehabilitation, especially if a contributing factor is a leg length discrepancy.

I Have Been Told I Have Over-Pronation, What Now?

As mentioned above, your therapist will work with you to correct your alignment, but there are some things you can be doing at home to help yourself further.

• Running shoes – try to get running shoes with extra support in the medial aspect (inner border) of the shoe.  This will help to prevent the foot rolling inwards.
  

• Regain your arch – strengthening the intrinsic plantar foot muscles will help to reinstate your arch.  Here are my favourite two exercises for this:
  

• Towel scrunch – in sitting or standing, place a towel on the floor and stand with your affected foot on top of the towel.  Using your toes and the bases of your toes (fleshy bits from which your toes sprout!) scrunch the towel up. Hold for 3 seconds and release.  Do this exercise around 20-25 times and once daily (twice if you can fit it in!).
  

• Short foot posture – exactly how it sounds, this exercise is about making your foot shorter, again working the intrinsic muscles in your foot.  Actively squeeze the bases of your toes and the heel of your foot towards each other, as though you’re trying to bring them together.  At the same time shift your weight slightly onto the outer border of your foot, this will facilitate the movement.  Try not to clench your toes, as the movement needs to come from the arch of your foot, splaying them slightly may help.  This can also be practised in standing and, once mastered, during your routine exercises such as lunges, squats, balancing exercises, etc. to strengthen your arch further.  To begin with try holding the pose in standing and then progress to single leg balancing before using it in your routines.

• Stretch out – tight calf muscles can often be the cause and if not, they may still be a contributing factor.  So try to stretch out your calves twice daily and before and after exercising.  The usual straight knee calf stretch is very good, but try to stretch out your soleus muscle as well as your gastrocnemius with a bent knee stretch:
  

• To target the soleus when stretching the calf, find a wall and shuffle the toes of the leg you want to stretch up to it.  Then gradually move the toes away from the wall to the point where when you bend your knee, your knee can just about reach the wall.  Hold this position to stretch out your soleus muscle.
  

If you think you may have over-pronation you should seek the advice of a health professional, this article is designed to give an insight into an issue and is in no way a replacement for treatment.