Pronation is the natural movement the foot makes to absorb the impact of walking or running. Once the heel hits the ground, during the rolling motion, the foot disperses the energy of the impact by lengthening and flattening the arch.

Some degree of pronation is absolutely physiological and is necessary for the foot to function properly. However, when the arch of the foot becomes too flat and the foot rotates too far inward, excessive pronation, also called Hyperpronation, can occur. This medical condition can result from continuous exertion of the feet and from wearing footwear that does not have sufficient arch support.

Hyperpronation is characterized by excessive inward rotation of the foot into the ankle and subsequent flattening of the arch during gait movements. Although this condition is sometimes described as flat feet, Hyperpronation is not actually a dysfunction of the tissues of the arch of the foot, but rather a joint problem in which multiple bones of the foot simultaneously rotate in the wrong direction relative to each other. In addition, the calf and foot muscles may become unbalanced in an attempt to compensate for the gait adjustment caused by this condition, which can trigger a chain reaction that disrupts the function of other muscles involved in locomotion.

What happens to the foot during Hyperpronation.

Visible as the flattening of the inner part of the foot toward the ground, Hyperpronation actually consists of a series of movements that occur simultaneously in different joints of the foot during gait movement.

• One such movement is calcaneal eversion, in which the calcaneus, or heel bone, strikes the ground at a slightly inward angle so that the underside of the heel tilts outward.
• Another involves the head or anterior surface of the talus, the one above the heel bone and just below the ankle joint, tilting too far inward and downward. This causes the joint between the talus and the navicular bone, a small foot bone in front of the talus, to be supinated, meaning that the midfoot rotates laterally or outward and superiorly or upward.

What to do in case of Hyperpronation

To treat Hyperpronation, it is recommended that sufferers avoid tight shoes, minimize the use of high-heeled shoes, or use custom orthopedic insoles.

• Orthopedic insoles: these are devices that are placed inside shoes to provide greater stability and arch support. It is generally recommended to use custom insoles made by a technician although there are still generic over-the-counter insoles on the market.
  Over-the-counter insoles only provide arch support by helping to reduce the discomfort of Hyperpronation. Orthopedic insoles have a more profound action as they perform an active action by helping to properly distribute body weight between the heel and forefoot in addition to the supportive function.
• Proper shoes: shoes with a sturdy heel and medial and arch support are highly recommended. For example, for running, stable shoes (A4) that help the foot counteract this excess movement are preferred.

Stretching for the calf muscles and Achilles tendon, walking barefoot to strengthen the foot and ankle muscles and stretch the Achilles tendon , as well as strengthening exercises for the deep flexor muscles of the big toe and posterior tibialis are also recommended. These may include, for example, picking up objects with bare feet or walking on bare toes.

This article was originally written in Italian and translated English via deepl.com. If you notice a major error in the translation you can write to [email protected] to report it. Your contribution will be greatly appreciated