Does Over-Pronation Of The Foot Need To Have Surgery

posted on 30 May 2015 15:33 by womanlycushion45
Overview

Pronation is a turning outward of the foot at the ankle, so that one has a tendency to walk on the inner border of the foot. (Pronation is the opposite of supination). When a foot and ankle pronates to a great degree, we call it over-pronation. During the normal gait cycle, we all pronate and then rapidly recover. It is over-pronation that patients are concerned with. This is a static deformity associated with flat feet and sometimes with foot and arch pain.Overpronation

Causes

Acquired "Flat Feet" this develops over a period of time rather than at birth (unlike Congenital "Flat Feet"). In children, many different factors may contribute to the development of this condition such as the type of shoes that a child wears, a child's sitting or sleeping positions or it may occur as some type of compensation for other abnormalities located further up the leg. Compensation may occur due to the rupture (tearing) of ligaments or tendons in the foot. One common reason for this condition is that the foot is compensating for a tight Achilles Tendon. If this tendon is tight it may cause the foot to point downward away from the body. This gives the body the perception that the affected leg is longer in length and the body attempts to compensate for the perceived additional length by flattening out the foot arch in an attempt to provide balance and stability.

Symptoms

Overpronation may have secondary effects on the lower legs, such as increased rotation of the tibia, which may result in lower leg or knee problems. Overpronation is usually associated with many overuse injuries in running including medial tibial stress syndrome, or shin splints, and knee pain Individuals with injuries typically have pronation movement that is about two to four degrees greater than that of those with no injuries. Between 40% and 50% of runners who overpronate do not have overuse injuries. This suggests that although pronation may have an effect on certain injuries, it is not the only factor influencing their development.

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.Over-Pronation

Non Surgical Treatment

Get a gait analysis of your running style, this will highlight if you overpronate, oversupinate or have a neutral gait. Most podiatrists, physio's and sports therapists will offer this service, as do some specialist sports shops. Find a clinic. If you overpronate, get orthotics with extra medial support. Many running shoes have a harder material on the inside of the midsole (the thick hard foam part of the running shoe). This means the inside of the shoe will be compressed less under load and support the inside of the foot preventing it from rolling in or flattening. For people with considerable overpronation, another option is to have an orthotic device fitted. Orthotic insoles come in many types and prices. Some are pre-molded and can be bought off the shelf. These are ok for the majority of problem feet. However some cases may require specially casted orthotics from a relevant sports injury therapist or podiatrist.

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%.