Over pronation

In keeping with the idea that we're going to update you with things we see, we thought this was appropriate.

Some people get very excited when pronation gets mentioned. First of all lets clear up a few things.

Pronation is normal.

There....we said it.

It is a normal movement which allows your foot to adapt and subsequently allows your body to pass over the top of it in order for you to take a step. To clarify, pronation and supination are normal movements which occur around primarily one joint although others are involved. Biomechanics is a complex discipline and this isn't a lesson in biomechanics, but just to clear up some issues we've been asked about over the past few weeks.

While pronation is normal, a person can have an excessive amount of pronation. In lay terms, this is where the foot 'rolls' in too much during gait. The image shows a person with substantial excessive pronation. This places stresses on the tissues of the foot and limb that they were never designed for and in some cases can lead to pain and discomfort. Interestingly though, some people who have excessive pronation report no symptoms at all. The reasons behind this are still unclear.

Biomechanical evaluation will help a podiatrist determine the cause of your pain or discomfort. He/She will assess your foot structure, how it moves and importantly the rest of your leg and body. Podiatrists will look at how you move in general looking for tell-tale signs of a problem such as head tilt and spinal curvature along with hip or knee misalignment. By forming a complete picture of your non-weight baring function combined with a gait analysis they will formulate a clear picture of why you feel the way you do.


In some cases, the use of orthotic devices can help. Sometimes clients think this means they will need to spend lots of money. This isn't always the case. It is true that having something made for you, in the form of a custom or bespoke orthotic device will be more expensive than a mass produced device. Here at the clinic we would only recommend a custom insole if we believed it was the appropriate treatment. Even then, the choice is yours. Various prefabricated devices are available and prices will vary. We always explain the range of options available along with the pro and cons of each device.

Some research shows that in some cases, prefabricated devices work equally well as custom devices. It is important to note however that this doesn't apply to every case and indeed in some cases, the best option will be to have an bespoke orthotic made.

If you have a painful condition such as shin splints, plantar fasciitis or any other foot or limb problem a biomechanical assessment could reveal the causes behind the pain. Treatment with pain killers and anti-inflammatory medication is effective but does not address the cause, they merely treat the symptoms. Orthotic therapy directly influences the cause.