Overview
Over-pronation, or flat feet, is a common biomechanical problem that occurs in the walking process when a person's arch collapses upon weight bearing. This motion can cause extreme stress or
inflammation on the plantar fascia, potentially causing severe discomfort and leading to other foot problems.
Causes
Over-pronation occurs when the foot collapses too far inward stressing the plantar fascia (the area underneath the arch of the foot.) Normally, one pronates every time he or she walks, but excessive
pronation is called over-pronation. When this occurs it can cause pain in the feet, knees, hips, low back and even the shoulder. Decreasing over-pronation, which is very prominent in runners, will
help add endurance, speed and efficiency to your run and ultimately place less stress on your body.
Symptoms
Symptoms can manifest in many different ways. Here is a list of some of the common conditions associated with over-pronation in children. Achilles Pain. Ankle pain. Arch Pain. Low back pain. Heel
Pain. Knee Pain (Runner's knee and Chondromalecia of the patella) Osgood Schlatter Disease (pain below the knee) Shin Splints (pain in the front of the lower leg) Over-pronation does not necessarily
mean your child has "flat feet." Even though children's arches may be relatively high when they lie down or sit, over-pronation may not be seen until your child is standing. A certain amount of
pronation is normal. During normal walking or running ("gait cycle"), the heel strikes the ground and the foot rolls inward to absorb shock and adapt to the surface. This gait cycle is even more
important if the running surface is uneven.
Diagnosis
To easily get an idea of whether a person overpronates, look at the position and condition of certain structures in the feet and ankles when he/she stands still. When performing weight-bearing
activities like walking or running, muscles and other soft tissue structures work to control gravity's effect and ground reaction forces to the joints. If the muscles of the leg, pelvis, and feet are
working correctly, then the joints in these areas such as the knees, hips, and ankles will experience less stress. However, if the muscles and other soft tissues are not working efficiently, then
structural changes and clues in the feet are visible and indicate habitual overpronation.
Non Surgical Treatment
The way a foot orthotic works is by altering the weight-bearing surface of the foot. The simulated foot improvement is only possible when standing still with full weight applied. Orthotics are of
little help through most of the actual walking cycle. observationPatients may experience some symptom relief, but the orthotic cannot correct the internal osseous misalignment. Over-the-counter foot
orthotics are usually of little help and wear out quickly. Custom-made foot orthotics, obtained through your doctor's office, are generally expensive. Though they last longer and have less chance of
ill-effects than OTC brands, they still need to be replaced often. Over a lifetime, an individual can spend several thousands of dollars in total costs associated with orthotics and see little or no
results. This is because orthotics only work when you are wearing them and do not treat the cause of the problem. In many cases, the external pressure points created by orthotics can cause more
problems than solutions. Blisters, sore feet, sore joints and many other long-term complications can arise as a consequence of wearing orthotics.
Surgical Treatment
HyProCure implant. A stent is placed into a naturally occurring space between the ankle bone and the heel bone/midfoot bone. The stent realigns the surfaces of the bones, allowing normal joint
function. Generally tolerated in both pediatric and adult patients, with or without adjunct soft tissue procedures. Reported removal rates, published in scientific journals vary from 1%-6%.
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