Connecting Pronation and Pain: What to Know

You don’t have much control over the feet you inherit—and the benefits or problems that come with them. If you are one of the lucky ones, you have normal arches and the way your foot moves propels you forward efficiently and without pain. We say lucky, because most people don’t have perfect feet, and many of you have pronation issues that can lead to stress and pain all the way up into your back and neck.

Flat Feet FrontWhen Your Gait Goes to the Extremes

A certain amount of pronation is a normal part of every step. Each stride begins when your heel strikes the ground and your foot naturally rolls a bit to the inside to balance your weight evenly over your sole, until you lift the heel and push off for the next step. This maneuver gives your feet a little extra stability and allows you to account for uneven surfaces without losing your balance and falling.

Problems occur when your foot goes to either extreme. If your foot rolls too far in—overpronation—your arch flattens too much, putting a lot of stress on your plantar fascia and basic arch structure. On the other hand, if your weight stays on the outside edge and your foot rolls out even farther—underpronation or supination—you put more stress on the heel, ball of your foot, and the outer foot bones.

Why Your Feet Overreact

Inheriting a low arch or flat feet often leads to overpronation, but other factors contribute to it as well, such as an injury that damages the bone structure, arthritis in your joints, tendonitis, being overweight, or even just the normal aging of the tissues. Pregnancy can also loosen the ligaments in your feet so the arch becomes too flexible and flattens out.

On the other hand, inheriting high arches or a tight Achilles tendon are more likely to cause supination.

What Extreme Pronation Does to Your Feet and Body

Flat feet and overpronation are frequent causes of plantar fasciitis, an inflammation of the ligament under your foot that leads to heel pain. Because it puts more force on the inside of your foot, it may also cause you to develop calluses and bunions (misaligned big toe joints). Rolling your feet too far inward means your legs and knees twist in when you walk, throwing your whole upper body out of alignment.

With supination, the rigid arch cannot effectively absorb the force of your steps. Hammertoes, Achilles tendonitis, ankle sprains, and pain in your joints are common problems with underpronation. Shin splints and stress fractures may also be more frequent, and the force of your heel strike can travel all the way up to your spine, causing back problems.

Help for Your Leaning Feet

Good footwear is essential in preventing injury and pain from either pronation extreme. Overpronators should look for a motion-control or stability shoe with firm insoles and soles that aren’t too scooped out, but wide enough in the arch to keep you from rolling in too far. Underpronators need shoe lasts that are curved to allow their feet to lean in farther, and flexibility on the inside of the sole. Extra cushioning at the heel and ball of your foot can also be helpful.

For more help in evaluating your pronation pattern or finding solutions to your foot pain, contact Dr. Matthew Paden, Dr. Brett D. Sachs, and Dr. Dustin Kruse at Rocky Mountain Foot & Ankle Center in the west Denver area. Simply call (303) 423-2520 to schedule an appointment at our Wheat Ridge, Golden, Evergreen or Granby, CO, locations, or request a visit online using our website.

From gait analysis and diagnosis to stretches, exercises, and custom orthotics, we offer what you need to make your feet feel better and carry you proudly, whichever way they lean!