Pronation refers to the process that occurs when our feet hit the ground when we walk or run. Normally, our feet hit the ground in a specific way. First, the heel touches the ground. Our body weight then shifts towards the middle of the foot and the arch of the foot flattens a bit. Pronation is the medical name given to the flattening process. If the arch does not flatten or flattens too much, pronation problems occur. This can cause pain and other issues in the feet and ankles, including in some cases a bending of the ankle bone towards the centre line.
Pronation and Ankle Problems
A condition called over-pronation occurs when the arch of the foot flattens inward too much as you walk. This over-pronation may be caused by genetics, injury, improper gait when walking or running, over-exertion or wearing improper shoes. This over-pronation can cause the ankles to bend slightly inward as you walk. This can lead to ankle pain. Although it effects and creates symptoms in the ankle, the problem with the foot is the underlying cause.
Flat Feet and Ankle Problems
A condition called "flat foot" is often a cause of these ankle problems. Flat feet are a normal condition in children who are just beginning to walk; however, if the arch does not sufficiently develop as children grow, a condition called flat foot develops. The foot does not pronate properly, and ankle problems become persistent or exacerbated. Adult flat foot, if left untreated, can give rise to a condition called tibialis posterior tendinitis, which results in persistent pain in the foot, the heel and sometimes the ankle.
Pronation problems are diagnosed by a doctor who observes your feet as you walk. A doctor may also examine your shoes for signs of abnormal wear and tear that suggest a pronation problem. Examining the ankle may or may not be necessary, depending on whether the flat foot is actually affected the ankle bones or whether the pronation problems are simply causing pain in the ankle as a symptom of the issues with the foot.
The most common treatment for ankle over-pronation is the use of orthotics to correct the improper arch of the foot. Physical therapy may also be recommended, and NSAIDs (non-steroidal anti-inflammatory medicines, including some common pain killers) may be prescribed to deal with ankle pain that results from pronation problems. Taping or a brace of the foot or ankle may also be recommended. In rare cases, a surgical operation may be performed to adjust the shape of the midfoot bones to correct flat foot or to correct torn or damaged tendons in the foot caused by the flat foot or over-pronation.
Unfortunately, most ankle over-pronation can't be prevented because the underlying cause of the condition--the improper gait--can't be prevented. However, wearing orthotics in your shoes to correct the pronation problem can resolve the ankle pain and prevent the ankle bones from becoming injured.