Excessive Pronation of the Ankle Joint – What Can Be Done?

Our body is a beautiful machine, made up of many elements that complement each other. Unfortunately, poor habits, injuries, and wearing, for example, overly tight shoes can disrupt even the natural movement of the foot. Not all terms that refer to medical conditions are inherently "bad."

Such terms include pronation and supination, which are two foot mechanisms that can be damaged by bad habits.

Pronation and Supination – Natural Foot Movement

Pronation, also known as internal rotation, is a term often used in the context of running, especially in relation to foot pronation. However, it’s important to note that the term pronation refers not only to the foot but also to other parts of the body, such as the forearm. Pronation is a completely natural process inherent to our body.

In the case of the foot, pronation refers to the rotation of the foot inward at the ankle joint. This movement occurs when the foot rolls from the heel to the toes, and it is a natural mechanism that allows the foot to adapt to the surface it moves on. Pronation plays a crucial role in the natural shock absorption process of the foot.

Supination is also a natural foot movement, but, as you might guess, it occurs outward. It also applies not only to the foot but also to the forearms and wrists. Without supination, we wouldn’t be able to hold a spoon, a pen, or even walk.

Although these two movements are completely natural, the problem arises when pronation is overly exaggerated, also known as overpronation.

When Does Unnatural Pronation Occur?

Excessive pronation happens when the inward movement of the foot is too pronounced, causing heavy load on the inner part of the foot. The foot doesn’t roll optimally through the center but rather on the inside, leading to strain, injuries, and health problems. This condition is often referred to as flatfoot, although excessive pronation does not always lead to flatfoot.

The causes of overpronation can vary – it can be genetic from birth or develop due to specific conditions such as pregnancy, overweight, obesity, or excessive and prolonged physical activity (e.g., running on asphalt).

How to Diagnose Unnatural Pronation?

If you stand barefoot and notice the absence of a natural arch between the foot and the floor, it may suggest a tendency toward overpronation. After walking a few steps with wet feet, if you see an imprint covering the entire width of the foot and notice greater wear on the inside of the shoe sole, it's worth considering a visit to a specialist.

It’s best to consult an orthopedic doctor, podiatrist, or physiotherapist, who can assess whether you have a lowered arch and overpronation after a thorough examination and appropriate functional tests. If you experience pain while walking, it is important to act quickly to prevent further issues with foot alignment and to avoid disturbing the biomechanics of the entire movement system.

Flatfoot and Overpronation – Are They the Same?

While these conditions are closely related, there are a few subtle differences:

Flatfoot (Pes Planus): This condition occurs when the feet seem to lack the natural longitudinal arch that normally appears on the inner side of the foot. Flatfoot can be hereditary or result from weakened foot muscles and ligaments, causing the foot to flatten. Flatfoot doesn’t necessarily have to be associated with excessive pronation.
Excessive Pronation: This is the inward rotation of the foot when it is bearing weight. Overpronation can occur in individuals with flatfoot, but it can also affect those with a normal arch. Overpronation can lead to various issues such as foot pain, ankle pain, knee pain, hip pain, and injuries related to running or other physical activities.

It is important to properly identify the type of deformity with a specialist, which will allow for the correct treatment approach.

Treatment for Excessive Foot Pronation

If foot pronation does not cause pain, it often does not require immediate treatment, but it can lead to problems in the future. In the case of a painful or deformed foot, conservative treatment is necessary, which includes various therapeutic elements.

Exercises play a key role in pronation therapy. They help strengthen weakened muscles responsible for arch formation, restore ankle joint mobility, stretch the shortened muscles of the posterior leg, and improve neuromuscular stabilization and control. Corrective exercises also help in developing proper posture and foot load habits.

Additionally, walking barefoot on uneven surfaces can be beneficial. In some cases, pharmacotherapy, such as painkillers or anti-inflammatory medications, both topically and orally, may be used. Physiotherapy includes treatments aimed at relaxing, reducing pain and inflammation, and improving circulation and soft tissue nourishment. Foot massage and kinesiology taping may also be part of corrective therapy.

It’s also worth considering participating in sports that strengthen muscles while relieving the feet, such as swimming. The use of corrective insoles or special shoes can also help improve foot alignment. In some cases, corrective devices for bunions and hallux valgus may be necessary.

It’s important to also consider factors affecting the feet, such as proper footwear, especially in children, maintaining a healthy body weight, and foot hygiene. Untreated flatfoot can lead to more serious problems such as foot deformities, ankle or knee joint pain, and muscle discomfort.

Excessive Pronation and Footwear Selection

There is special footwear available for pronated feet. These shoes typically reinforce the inner side of the shoe, which helps align the foot properly. However, remember that choosing such footwear is not a magic fix, and strengthening the inner part of the foot only gives the illusion of proper alignment. Yes, it will provide relief and allow activities like running, but it’s important not to rely solely on these shoes for therapy or rehabilitation. Otherwise, you may struggle with the condition for a long time.

Minimalist Footwear and Overpronation – Support for Proper Foot Movement

One solution for flat feet and excessive pronation is the use of minimalist footwear. Unlike the shoes mentioned earlier with stabilization, minimalist shoes have no inserts. We recommend consulting a specialist before using them if the condition is advanced.

How do these shoes help?

For children, whose foot development is still ongoing, minimalist shoes force the foot to perform natural movements all the time. This helps strengthen the foot and does not restrict the freedom of either the toes or the movement apparatus. As a result, after years, the foot becomes strong and accustomed to the proper movement – which can help even in cases of acquired overpronation.

For adults, depending on the severity of overpronation, attention to natural movement can be increased – this is encouraged by the zero-drop sole, which is extremely flexible, unreinforced, and without cushioning. This helps strengthen the foot continuously, potentially reducing problems with excessive pronation.

You can find minimalist shoes for every occasion in our store. Additionally, we offer special exercise devices, Move Magical, to actively fight foot conditions.