31 Aug 2022
By Erin Lanting, BSc, MScPT
This is a blog for any of you who are either runners, have foot pain, have bought running shoes and were told you overpronate, think you have flat feet or were told by a health professional that you do, or simply wondering whether you have a foot problem. Often people are told they excessively pronate (flatten) their feet and therefore need orthotics or a stability shoe to correct it. Although there is such a thing as “overpronation” the reality is that our feet need to pronate just the same as they need to supinate in order for our body to move properly. Pronation itself isn’t bad, so it is of utmost importance to make sure that a proper evaluation has been done to determine first, if you do in fact overpronate and second, WHY this may be happening. The reality is that the quick assessment at the shoe store is probably not enough and orthotics or a stiffer shoe are not always the answer.
What is pronation anyway?
Simply put, it is the flattening of your arch as your foot bears weight on the ground. It is the rolling inward of the foot that aids in shock absorption and balance as well as creating the proper lever for push-off and propulsion forward. The opposite of pronation is supination, or the rolling outward of the foot. The movement of the foot and ankle is quite intricate but for the purposes of this article, I will stick with these basics of pronation and supination.
Can I overpronate?
As I mentioned above, yes, just the same as you can under-pronate. Too much or too little movement, regardless of where it happens, always has the potential to create a problem. Keep in mind, different sources will reference different ranges of what is considered a “normal” amount of movement and there is always going to be some variability. Over-pronation is essentially when the foot stays flattened for longer than it should. This can & does happen, BUT the real question is why. I find it is often a compensation for a dysfunction elsewhere in the pelvis, hip or lower leg. If this is the case, we are better off to try and get to the root cause and make sure we are treating the whole picture. This requires a functional and structural examination of everything from our lower back down to our toes. Personally, I like to look at a squat, a single leg stand, and sometimes a lunge to get a better idea of how the forces are being distributed through the body. Another good thing to check is leg length to make sure there aren’t any major discrepancies side to side.
Why might I overpronate?
One of the most common reasons I see for overpronation is a lack of ankle mobility. For example, if our ankle does not bend enough, then it will not allow our knee to move forward over our foot, making forward motion difficult. The foot then compensates by overpronating to help get that propulsion. In this case, it would be most beneficial to first start working on lower leg muscle flexibility and ankle joint mobility before doing anything else. When there is lack of mobility in one area, another area has to compensate and this happens all the time. The question then, is not IF you overpronate, but WHY you overpronate. This is just one example but there could be multiple factors at play and it does become a little bit of, “which came first, the chicken or egg” scenario. The main point I’m trying to make is that pronation gets a bad rap when it shouldn’t and we need to stop overgeneralizing everyone into the category of overpronation based on very limited assessment.
If you’re shopping for any kind of running shoes, go with the shoes that feel most comfortable to you. If you have tried a certain type of shoe in the past and that didn’t work for you, try something different. Consider the size of the toe box as many shoes are not made like the natural shape of our feet and end up squeezing our toes together. A wider toe box creates more space for our toes so that they all have a chance to function properly within our shoes. If orthotics feel good and work for you, great, continue to use them! Seek out physiotherapy if you have more questions or concerns. Additionally, we should all be giving our foot muscles some TLC on a weekly basis as well as keeping our core & hip muscles strong. Don’t forget about those toes either! Stay tuned for my favorite foot exercises, which I will post in the coming weeks on our Facebook page (https://www.facebook.com/TwoHandsPhysio)