While a small amount of pronation is normal, excessive movement causes the arch to collapse during walking or running gait cycles. This can cause pain and instability in the ankle and knee.

Loose joints and ligaments in the feet, such as flat feet or hereditary foot deformities, can increase your risk of overpronation. Physical therapy can help you correct this problem and reduce pain and injury risks.

What is Overpronation?

Overpronation happens when your gait (the way you walk or run) causes the arches in your feet to flatten more than they should. This puts strain on the muscles, tendons and ligaments that support your arch and increases your risk for foot and ankle injuries. Overpronation can also be a sign of hereditary flat feet or a medical condition called adult-acquired flat feet, which means your feet lost their natural arch as you got older.

Pronation is a natural foot movement that occurs during walking and running to absorb shock and distribute weight evenly. When it is excessive, however, overpronation can cause the arch to collapse, creating instability and a misalignment that affects the entire lower leg, hip and knee.

If you overpronate, you may benefit from stability shoes that provide extra support and cushioning to your foot. A physical therapist can help you identify your foot type and learn how to prevent overpronation-related injuries. For instance, a PT can teach you standing arch raises to strengthen the arch of your foot and improve your overall posture and gait. They can also recommend motion-control or stability shoes that will help guide your foot to a more neutral pattern of pronation. This can reduce pain and discomfort, improve your performance and increase the longevity of your footwear.

Causes

Overpronation can occur when the foot rolls inward too much, flattening the arch more than it should. This unnatural motion causes instability and misalignment that impacts the entire lower body, causing discomfort and increasing the risk of injury over time. It’s particularly common among people with flat feet and collapsed arches, but can also be caused by weak leg muscles or tight calf muscles.

A common way to test for overpronation is to examine the wear pattern of a pair of well-worn running shoes. Look for excessive wear along the inner sole, especially around the area of the shoe that connects to the arch and the ball of your foot. This indicates that you overpronate when you run or walk.

Other causes of overpronation include genetics (you may have a family history of flat feet), wearing improper footwear, or pregnancy or weight gain (which can lead to increased pressure on the feet). Tight calf muscles can also contribute to overpronation as they limit the motion of your ankles.

In some cases, overpronation can be corrected with custom orthotic inserts and stability or motion-control shoes. Physical therapy and strengthening exercises for the foot, hips, and core can improve alignment and reduce overpronation. A physical therapist can recommend the best program for you. This may include strengthening the intrinsic foot muscles, stretches to increase flexibility, and exercises that target the hamstrings and gluteus medius.

Symptoms

Overpronation happens when the feet roll inward excessively as you walk, run, or jump. This excessive inward movement shifts your foot’s landing impact from the heel’s outer edges to its inner surface, putting extra strain on the arch and big toe. It also causes the arch to flatten, reducing your foot’s ability to absorb shock.

This is a common problem for runners and walkers, especially those with low or flat arches. The collapsed arch puts more stress on the foot and ankle, increasing your risk of injury and discomfort.

You can identify overpronation by looking at the wear pattern on your running shoes. Overpronators tend to have more wear on the inner edge of their shoe, tracing a path from the big toe to the ball of the foot. You can also do a simple test by wetting the bottom of your foot and stepping on a sheet of paper. If the print shows little or no dry area where your arch should be, you probably overpronate.

Excessive pronation can also cause pain and injury in other parts of your body, including your knees, hips, and lower back. Over time, it can even affect your posture and gait. It’s important to get a foot evaluation and see if you have a pronation problem. Then, you can choose the right shoes to protect your health and improve your performance.

Treatment

While some pronation is necessary as the foot strikes the ground to absorb and distribute impact forces, excessive collapse of the arch can cause instability in the feet, ankles, and legs. This misalignment may cause pain and increase the risk of injury over time.

The good news is that overpronation is treatable! Regular stretching and strengthening exercises can improve foot flexibility, while custom orthotics can provide support for the arch and heel to help reduce overpronation. It’s also important to find a pair of running shoes that fit well and offer sufficient cushioning and stability, which can decrease overpronation.

If you suspect that you overpronate, it’s a good idea to see a podiatrist for a full evaluation and treatment plan. In addition to strengthening and stretching, a podiatrist can prescribe special inserts or orthotics for your shoes that provide additional support and correct the abnormal foot mechanics that lead to overpronation. They can also recommend the best shoes for you that have been proven to reduce overpronation and associated injuries. Lastly, a podiatrist can perform a simple test to assess your foot pronation pattern by examining the wear patterns on the inside of your shoes. Excessive pronation results in a distinct wear pattern that can be seen along the inner edge of the shoe, tracing a path from the area around the big toe to the ball of your foot.