When the arch of the foot collapses excessively downward or inward, this is known as overpronation. Sometimes, people call this condition flat feet.

The way a person’s foot strikes the ground can have significant effects on their body. People with flat feet or who overpronate may be prone to more injuries than people with normal pronation.

However, there are simple treatments available to prevent injuries due to overpronation.

Pronation and overpronation

Overpronation and flat feet or fallen arches. Image credit: FA RenLis, (2011, January 26)
Overpronation is when the arches of the foot roll inward or downward when walking, and is often referred to as flat feet.
Image credit: FA RenLis, (2011, January 26)

Pronation refers to the foot’s natural way of moving from side to side when a person walks or runs.

It occurs as the weight is transferred from the heel to the ball of the foot as a person goes through their walking or running stride.

Pronation also occurs while standing, and in this case, pronation refers to the amount that the foot rolls inward toward the arch.

Some pronation is normal. Overpronation is when the foot rolls inward toward the arch excessively and can cause various injuries.

Overpronation and injuries

Overpronation puts people at an increased risk of developing specific injuries. This is because it disrupts the body’s natural alignment and causes increased impact when the foot strikes the ground.

Athletes with overpronation, particularly runners, see an increased likelihood of developing overuse injuries.

Injuries that frequently occur in people with overpronation include:

Causes

Overpronation, causing fallen arch and flat foot, demonstrated in diagram alongside hollow foot or high arch, known as supination.
Overpronation may be caused by a fallen arch, commonly known as flat foot.

Overpronation is generally caused by flat, very flexible feet.

Sometimes, people are born with flat feet. However, there are also conditions and situations that can increase a person’s chances of developing flat feet or weakened arches, which can lead to overpronation.

These conditions and situations include:

  • being pregnant
  • being overweight or obese
  • taking part in any activity, such as running, that involves repeatedly striking the foot on a hard surface for an extended period

Diagnosis

Many people who overpronate know they have flat feet without seeing a doctor.

If a person thinks they may overpronate, then they can self-assess first using one of the three following methods:

  1. They should first look at their feet while standing. If there is no clear space between the foot and the floor where the arch should be, the person likely overpronates.
  2. If a person is a runner, they can check the state of their running shoes. If the majority of the wear is on the inner part of the running shoes, they are likely a person with overpronation.
  3. They can also check their footprint after taking a few steps with bare, wet feet. A person with normal pronation will see their heelprint connected to the toeprints with about half of their foot width. A person who overpronates will see their heelprint connected with the full width of their foot.

If a person tries these three methods and is still not sure whether they overpronate, they may choose to either visit a specialty running store, podiatrist, or orthopedic surgeon. At some specialty running stores, the clerks are trained to check for overpronation.

A podiatrist, orthopedic surgeon, or physical therapist can make a definite diagnosis. A person should see a specialist for overpronation if they are experiencing pain or chronic injury, especially if they have tried to self-correct the problem in the past.

A specialist can recommend treatment options that may help solve the problem.

Treatment options

There are many different treatment options available for overpronation. The main treatment options are:

  • choosing supportive shoes
  • wearing orthotics
  • doing exercises that strengthen the arches and muscles around them

Choosing supportive shoes

A person with overpronation should take extra care when selecting shoes, particularly when picking shoes for any activity that involves repeated foot strikes, such as running or walking.

Anyone with overpronation should look for shoes that offer extra support and stability so that the shoes minimize the impact of each step.

A person with overpronation looking for supportive shoes may want to do the following when selecting shoes:

  • have both feet measured
  • shop at the end of the day and end of the week when feet are a little puffy
  • wear thin socks when shopping
  • look for shoes that offer extra arch support

A running store that offers some form of walking-style analysis, a podiatrist or orthopedic surgeon can recommend good shoes.

Exercises for overpronation

Podiatrist inspecting patient's feet.
A physical therapist may be able to suggest exercises to treat overpronation.

Sometimes, a person with overpronation will be referred to a physical therapist for strengthening exercises.

These exercises can help support the arches of their feet and the muscles that help support the arches.

A physical therapist may recommend that a person with overpronation and related injuries may add the following exercises to their routine:

  • First position demi plié: With turnout from the hips, so the feet angle outward and the heels are together, bend your knees while keeping the heels on the floor.
  • Rolling the feet: While standing with feet hip-width apart, roll your weight to the outside of the feet and then back to normal position repeatedly.
  • Seated calf stretch: Tight calf muscles can put too much stress on the Achilles tendons, worsening flat feet. Stretch calf muscles by sitting with your legs extended in front of you with feet flexed. Then hinge forward at the waist and reach for your toes.

Wearing orthotics

Orthotics are special inserts that slip into shoes to offer extra arch support and help minimize the impact of the way someone walks.

More generic orthotics are available without a prescription and may provide enough support to prevent injuries due to overpronation.

In some cases, though, a person with overpronation may require custom orthotics, which a podiatrist can order based on an analysis of the person’s walking style.

Prevention

Some people cannot prevent overpronation but can reduce its effect through the use of orthotics and proper footwear.

These people can also help reduce their risk of an injury related to overpronation by doing recommended exercises.

Other people may be able to prevent overpronation from developing by maintaining a healthy weight.

Outlook

Anyone experiencing pain or repeated injury due to overpronation should see a doctor. A doctor can recommend many options for a person that can relieve pain and prevent re-injury.

People with overpronation-related injuries can take steps to prevent further injuries in the future.

For many people with overpronation, the solution is as simple as wearing orthotics or changing footwear.