Excessive pronation is a common fault that occurs with the dynamic structure of the foot. Some degree of pronation is necessary for shock absorption. Excessive pronation, or collapsing of the arch,
limits the foot?s ability to efficiently support the weight of the body. The altered position of the foot and ankle complex that occurs with high degrees of pronation also forces the rest of the
lower body out of alignment. This can cause mechanical problems in muscles and joints traveling all the way up to the back. Arch strengthening is a vital part of maintaining healthy feet.
Abnormal foot biomechanics usually causes over-use type injuries, occurring most frequently in runners. When a neutral foot pronates during walking or running, the lower leg, knee and thigh all
rotate internally (medially). When an athlete with an overpronated foot runs, this rotation movement is exaggerated and becomes more marked.
In addition to problems overpronation causes in the feet, it can also create issues in the calf muscles and lower legs. The calf muscles, which attach to the heel via the Achilles tendon, can become
twisted and irritated as a result of the heel rolling excessively toward the midline of the body. Over time this can lead to inflexibility of the calf muscles and the Achilles tendon, which will
likely lead to another common problem in the foot and ankle complex, the inability to dorsiflex. As such, overpronation is intrinsically linked to the inability to dorsiflex.
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
Over-Pronation can be treated conservatively (non-surgical treatments) with over-the-counter orthotics. These orthotics should be designed with appropriate arch support and medial rearfoot posting to
prevent the over-pronation. Footwear should also be examined to ensure there is a proper fit. Footwear with a firm heel counter is often recommended for extra support and stability. Improperly
fitting footwear can lead to additional foot problems.
The MBA implant is small titanium device that is inserted surgically into a small opening between the bones in the hind-mid foot: the talus (ankle bone) and the calcaneus (heel bone). The implant was
developed to help restore the arch by acting as a mechanical block that prevents the foot from rolling-in (pronation). In the medical literature, the success rate for relief of pain is about 65-70%.
Unfortunately, about 40% of people require surgical removal of the implant due to pain.