By Dr. Steven Gershman, DPM
So, you are about to purchase new shoes and have heard about neutral vs. overpronation shoes. Which do I buy? Which is better? What do I need? Does it really matter?
Let's start with a short tutorial on what exactly is pronation, what causes overpronation, and why it even matters.
What is pronation?
Pronation is actually a 3-plane motion of the foot that begins at the sub-talar joint under the ankle. Mainly it involves the heel rolling inwards or medially, the arch drops and the foot becomes looser or more flexible. It is an important and normal component of the gait cycle, beginning when the heel contacts the ground. When there is too much pronation (as in many things too much can be bad for you), too little or abnormal pronation, problems can arise.
What is the reason the foot pronates?
There are two main reasons for pronation.
When the foot pronates, it provides natural shock absorption. This is the most important reason the foot pronates. Pronation makes the foot go from fairly stiff as it hits the ground, to looser and more flexible as it fully contacts the ground. This provides shock absorption so the back, knees and feet aren’t hit with the full impact of the body weight hitting the floor. This loosening of the foot also allows the foot to be able to adapt to uneven surfaces as we walk or run.
What causes overpronation of the foot?
By far the number one cause of overpronation is loose hypermobile feet. Basically, if you start with loose joints in your feet you will pronate too much. Loose feet are generally a result of loose ligaments. Ligaments go from bone to bone crossing joints and are what hold the foot together. When they are too loose or stretched out, they allow too much motion throughout the foot. The foot becomes almost like a loose bag of bones. Loose ligaments are usually something you are born with but can also occur after pregnancy or certain injuries. In addition, overpronation can occur with some congenital foot deformities or after an injury that damages bones or joints.
What are the consequences of overpronation?
Sometimes nothing! Many people overpronate and never even know it or suffer any damage or symptoms of it. On the other hand (or foot), some people suffer multiple injuries including:
- Tendon overuse injuries
- Inflammation pain
- Joint damage
- Ankle sprains
- Slow chronic changes in foot structure leading to bunions and hammertoes
- Nerve injuries
How to treat overponation?
Assuming you are suffering from pain caused by overpronation, reducing it should be very helpful. The best way to diagnose whether your foot, leg or back issues are from overpronation is via a trained professional evaluation. Any of these problems could be from overpronation, but they could also be due to something else entirely.
The best treatment for overpronation related pathology is orthotics for overpronation which are specially made insoles that are inserted inside the shoe. To truly stop overpronation and treat the associated problems arising from it is best to couple the orthotics with a men's or woman's overpronation shoe. In reality you are not just treating overpronation but controlling the underlying cause and the associated injury or pathology. This requires a well-made shoe and an orthotic. They work synergistically.
Orthotics for overpronation should have the following features:
- Anatomical arch support that aligns the body and keeps the foot in a ‘neutral position’
- Deep heel cup that cradles the foot and reduces pressure under the heel
- Ample cushioning to absorb and disperse shock forces from heel to toe
Orthofeet, an orthopedic footwear brand, specially designs orthotics for overpronation. Click here to learn more about Orthofeet orthotic insoles.
What are the best overpronation shoes? Well to start with what is an overpronation shoe? Generally, it is a shoe that first and foremost is a motion controlling shoe, as pronation is motion. The shoe needs to be stable and firm with a solid heel counter (the piece in the back of the shoe) to control heel motion that is a major component of pronation. In addition, the midsole (the material between the outer sole and the shoe itself) needs to be firm and usually have extra firm material on the medial side or inside. Many companies have their own unique patented add-ons to better control motion. All these add-ons are geared to stopping the overpronation while still allowing normal amounts of pronation.
Orthofeet shoes are biomechanically designed with an orthotic insole that provides the optimal level of arch support and helps prevent the foot from excessively rolling inwards. This fundamental feature positions the foot correctly which in turn aligns the hips, knees and legs, minimizing injuries and providing total body pain relief. Constructed with a thick layer of foam, Orthofeet overpronation shoes provide exceptional cushioning from the ball-of-foot through the heel area for all day comfort and protection. The lightweight ergonomic sole improves mobility and smooths every step you take.
After 30 plus years of practice and years of marathon running with loose overpronating flat feet I believe that motion control or pronation controlling shoes can be very useful. Combined with orthotics they provide the best control of motion even with severe flat foot. It is also important to remember to replace your shoes often as the shoe ages it loses its motion control ability. Shoes should be replaced at least once a year or more often in hard use.