Blog |Treating excessive pronation or supination of the foot

What does it mean when your child has a very low arch and it appears that their ankles lean in toward the other foot? This condition is known as pronation.

Some degree of pronation is normal because it is the way your foot absorbs shock. A pronated foot is a flexible foot. When your foot strikes the ground after the swing phase of walking your subtalar joint the one that sits under your ankle pronates to act like a shock absorber. Then as your foot flattens on the ground the subtalar joint begins to supinate(the opposite of pronation) and turns your foot from flexible to rigid to create a stable structure so that you can push your body forward.

Excessive pronation and supination both cause foot problems that can also take a toll on the ankle knee and lower back.

Hyperpronation causes abnormal joint alignments improper soft tissue pulling that is proven to cause bunions hammertoes early onset arthritis ankle knee and lower back pain.

Conservative treatment for excessive pronation involves realignment of the foot with a rigid orthotic. This realigns the subtalar joint and restores proper joint position and muscle pull. The orthotic is used long term or for life.

Surgical reconstruction is an option but is complex and requires a long recovery period.

Early treatment is always best to prevent permanent changes to foot structure that will require surgery to fix. Surgery for the correction of hyperpronation can involve soft tissue correction and balancing for flexible flat feet or may need bone surgery or fusion of unstable or lax  joints to stabilize the foot. Fusion involves removing the cartilage from a joint on both sides and combining those two bones so that they heal into one to create a stable area. This fusion can take up to 12 weeks to be fully healed and for at least half that time no weight should be placed on the foot. There may be some physical therapy needed as well due to the prolonged immobilization.

Our office can create custom orthotics for children and adults and our 3D scanning technology is the latest innovation in orthotic creation.

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Ask about our custom made “Tom-Cat” orthotics.

— Dr. Bill


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