Overpronation: Causes, Treatment, And Exercises

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Medical News TodaySubscribeYour guide to understanding overpronation

Medically reviewed by Angela M. Bell, MD, FACP — Written by Jenna Fletcher — Updated on November 27, 2024

Overview
Causes
Treatment options
Exercises
Contacting a doctor
Diagnosis
Prevention
Injuries
Summary

Overpronation is when the arch of the foot collapses excessively downward or inward. A doctor may call this “pes planus” or “flexible flatfoot.”

Experts often associate overpronation with flat feet.

Various lifestyle and treatment strategies can help people manage overpronation.

What is overpronation?

A line of footprints in the sand on the beach to represent overpronation. -2 — Ivan Kuzel/Getty Images

Pronation is the side-to-side movement of the foot that occurs when a person walks or runs. It results from the transfer of weight from the heel to the ball of the foot as a person goes through their walking or running stride.

Pronation also occurs while a person is standing. In this case, pronation is the amount that the foot rolls inward toward the arch.

When overpronation occurs, the foot rolls too far inward toward the arch. In contrast, with underpronation (also called supination), the foot rolls outward.

The way a person’s foot strikes the ground can affect the rest of their body. People who overpronate may have a higher risk of certain injuries than people with normal pronation.

Flat feet are common in children but usually resolve over time without treatment. The arch of the foot does not usually develop until a person is 5 years old or older.

Causes of overpronation

Overpronation can happen if the arch is very flexible.

Some people are born with flat feet. However, some conditions and activities can increase the risk of developing flat feet or weakened arches, which can lead to overpronation.

Adult-acquired flat foot can occur if a person:

has inflammation or damage to the tendon that connects the calf muscle to the arch of the foot
has obesity
plays a high impact sport such as basketball
has arthritis that affects the cartilage and ligaments in the foot
has an injury that affects the alignment of the joints in a foot
has a nerve problem that prevents them from feeling when the arch is collapsing (for example, due to diabetes)

Overpronation can also occur during pregnancy but usually resolves after delivery.

Treatment options for overpronation

Most people do not need treatment for flat feet, but the following options may help people manage pain and reduce the chance of injuries:

choosing supportive or motion-control shoes, also known as overpronation shoes
using orthotics
managing pain with nonsteroidal anti-inflammatory drugs (NSAIDs)
managing weight through diet and exercise, if appropriate
surgery (in some cases)
doing exercises that strengthen the arches and the muscles around them

Footwear

A person with overpronation should choose supportive shoes, especially for activities that involve repeated foot strikes, such as running or walking.

The person should choose shoes that offer extra support and stability to minimize the impact of each step.

Features of supportive shoes for people with overpronation include:

a strong and inflexible heel counter (the hard piece in the back that stops the foot from moving from side to side)
a dense midsole, which will uphold the arch
a wide base of support for the middle of the foot to prevent the arch from collapsing inward

Here are some other tips for buying shoes:

Ask the sales associate to measure both feet.
Shop for shoes at the end of the day, when the feet are more likely to be a little puffy.
Wear thin socks when shopping for shoes, as thick socks can lead to choosing shoes that are too tight.
Choose a specialty walking or running store, which is more likely to have equipment for assessing gait.

Some running stores have equipment that highlights which part of the foot touches the ground when a person walks. This can help store employees determine whether a person needs shoes with a specific type of support.

A person can also look at the soles of their shoes to see which areas have the most wear and tear. Wear on the inside edge can be a sign of overpronation.

A podiatrist or orthopedic surgeon can recommend suitable shoes, such as anti-pronation shoes, which may help reduce physical fatigue due to overpronation.

Orthotics

Orthotics are special inserts that slip into shoes to offer extra arch support and help minimize the impact of walking.

Generic orthotics are available without a prescription and may provide enough support to prevent injuries due to overpronation.

However, in some cases, a person with overpronation may need custom orthotics, which a podiatrist can order based on an analysis of the person’s walking style.

Exercises for overpronation

Sometimes a physical therapist may recommend strengthening exercises for people with overpronation. These exercises can help strengthen the arches of the feet and the muscles that help support the arches.

Here are some exercises that may help:

Heel stretches

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Stand with both feet flat on the floor.
Step forward with one foot, so it is around one pace in front of the other.
Keep the spine straight, bend the front leg, and push forward so that all your weight is on the front foot.
Feel the stretch in the back leg and Achilles tendon.
Hold for 30 seconds.
Change feet and repeat.
Repeat 4 times with each foot.

Tennis ball rolls

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Active Body. Creative Mind.

Sit with both feet flat on the floor.
Place a tennis ball or golf ball under one foot.
Keeping the spine straight, roll the ball back and forth under the foot for 2 to 3 minutes.
Repeat with the other foot.

Calf raises

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Stand with both feet on the floor.
Lift both heels as high as possible, hold for 5 seconds, and then lower them.
Repeat 15 to 20 times.
Alternatively, use a stair or exercise step and allow the heels to rise above and sink below the step level.

Toe raises

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Stand with both feet on the floor.
Press the right big toe into the floor and lift the other toes of the right foot.
Hold for 5 seconds.
Press the four smaller toes into the floor and raise the big toe for 5 seconds.
Repeat each exercise 5 to 10 times.
Repeat with the other foot.

Marble pickups

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A 2020 study looked at various therapeutic foot-strengthening exercises for overpronation and found that they were effective in improving foot posture in adults.

In one exercise, participants picked up small glass marbles with their toes and moved them somewhere else.

To do this exercise, a person can assume a standing position, pick up marbles from a pile with their toes, and release them into another pile.

There is no time limit for this exercise, but about 10 minutes per day (5 minutes with each foot) may be efficient.

Hip abductions

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The 2020 study also found that hip abductions were a good exercise for improving foot posture.

To do this exercise, a person can:

Lie on their side, bending the leg that is in contact with the floor.
Keeping the upper leg straight, move it up and away from the other leg for 8 seconds.
Lower the leg back down for 8 seconds.
Repeat on each side 5 to 10 times.

Band resistance movements

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1415670249 Adult Latin American woman exercising at home using a resistance band – fitness concepts Hispanolistic/Getty Images

Another exercise that the 2020 study found to be beneficial for overpronation involved moving the feet against an elastic exercise band.

To do this exercise, a person can:

Sit on the floor with one leg pointed out straight.
Hook an elastic exercise band over the foot of the outstretched leg, with the band resting in the arch of the foot.
Move the foot from side to side, turning it inward and outward, while pulling against the tension of the band.
Repeat 5 to 10 times on each foot.

When to contact a doctor

Most people do not need treatment for flat feet, but a specialist can offer advice on orthotics and other strategies for maintaining foot health.

A person should seek medical advice if they:

have ongoing pain, weakness, numbness, or stiffness in their feet
often have injuries to the feet or ankles
have difficulty with walking or balance
did not previously have flat feet
have only one flat foot

If a child has persistent pain or has not developed an arch by their teen years, they may need to consult a doctor. The doctor may check for an underlying problem, such as tightness in the Achilles tendon, or assess for a more serious condition, such as rigid flatfoot.

Diagnosing overpronation

Many people who overpronate know that they have flat feet without consulting a doctor.

If a person thinks they may overpronate, they can self-assess first using one of these three methods:

Look at the feet while standing. If there is no clear space between the foot and the floor where the arch should be, the person likely overpronates.
Check the soles of a pair of shoes. If most of the wear is on the inner edge, a person may be overpronating.
Check a footprint after taking a few steps with bare, wet feet. A person with normal pronation will notice that their heelprint connects to their toeprints with about half of their foot width. A person who overpronates will notice that their heelprint connects with the full width of their foot.

A person can also check with a specialty running store, a podiatrist, or an orthopedic surgeon. At some specialty running stores, the sales associates are trained to check for overpronation.

A podiatrist, orthopedic surgeon, or physical therapist can make a definite diagnosis of overpronation. People who are experiencing pain or chronic injury should consult a specialist, especially if they have tried to self-correct the problem in the past.

If a doctor suspects an underlying problem, such as a ligament injury or sensory neuropathy, they may recommend tests such as an MRI, a nerve conduction study, or a radiograph.

Other conditions that can resemble overpronation include:

a prominent fat pad, which can occur in children
fluid retention, which can cause the bottom of the foot to touch the floor
a benign or malignant growth or tumor affecting a structure under the foot

Preventing overpronation

It is not always possible to prevent overpronation, but people can reduce its impact by using orthotics and supportive footwear.

Following a recommended exercise plan may strengthen the foot and lower the risk of injury.

Making efforts to avoid excessive weight gain, or losing weight if needed, can also help reduce the risk.

Overpronation and injuries

Overpronation can increase a person’s risk of developing specific injuries because it can disrupt the body’s natural alignment and increase the impact when the foot strikes the ground.

Athletes with overpronation, particularly runners, have a higher chance of developing overuse injuries.

Injuries that frequently occur in people with overpronation include:

shin splints
bunions
heel pain
plantar fasciitis
iliotibial band syndrome, an inflammation of a ligament on the outside of the knee
chronic lower back pain
stress fractures in the foot or lower leg
patellofemoral pain syndrome
Achilles tendonitis

Summary

Overpronation occurs when a person’s foot leans too much toward the center when they are walking, running, or standing. Medical professionals often associate overpronation with flat feet.

Many people are born with overpronation, but it can also develop over time as a result of obesity, tendon damage, and other conditions.

A doctor can advise on suitable footwear and orthotics to help support the feet. If necessary, they may recommend options to help relieve pain and prevent injury.

Body Aches
Genetics
Rheumatology
Bones / Orthopedics

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Adult feet. (n.d.). https://www.footcaremd.org/foot-ankle-health/adult-feet
Flat feet. (2022).https://www.nhs.uk/conditions/flat-feet/
Flexible flatfoot in children. (2022).https://orthoinfo.aaos.org/en/diseases--conditions/flexible-flatfoot-in-children/
Jafarnezhadgero AA, et al. (2019). Effects of anti-pronation shoes on lower limb kinematics and kinetics in female runners with pronated feet: The role of physical fatigue.https://pmc.ncbi.nlm.nih.gov/articles/PMC6516670/
Overpronation & underpronation correction. (n.d.).https://pedorthic.ca/services/foot-health/pronation/
Progressive collapsing foot deformity (flatfoot). (2023).https://orthoinfo.aaos.org/en/diseases--conditions/posterior-tibial-tendon-dysfunction/
Raj MA, et al. (2023). Pes planus.https://www.ncbi.nlm.nih.gov/books/NBK430802/
Sánchez-Rodríguez R, et al. (2020). Modification of pronated foot posture after a program of therapeutic exercises.https://pmc.ncbi.nlm.nih.gov/articles/PMC7697388/

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Medically reviewed by Angela M. Bell, MD, FACP — Written by Jenna Fletcher — Updated on November 27, 2024

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What is overpronation?

Causes of overpronation

Treatment options for overpronation

Footwear

Orthotics

Exercises for overpronation

Heel stretches

Tennis ball rolls

Calf raises

Toe raises

Marble pickups

Hip abductions

Band resistance movements

When to contact a doctor

Diagnosing overpronation

Preventing overpronation

Overpronation and injuries

Summary

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