‘Poor Foot Pronation can cause Foot & Knee Pain’

Many people suffer from Foot pain or Knee pain when jogging, walking or running that causes them to stop such activities. If there is no injury that has caused injury to the foot or knee then the common question asked is what is causing my pain? One answer is that the problem can be caused by an excessive pronation of your foot. Pronation of the foot naturally occurs when the heel rolls inwards once the heel strikes the ground when walking or running. Excessive or abnormal pronation occurs when the foot rolls inwards for too long a duration. This leads to instability and fatigue within the joints of the foot eventually causing overuse injuries such as the following conditions;

  • Heel Pain such as a) Achilles tendonitis, b) Plantar Fasciitis,

  • Foot pain – c) Stress Fracture of 2nd metatarsal bone of foot, d) Bunions due to excessive mobility of the 1st metatarsal of the big toe, e) Callus formation under the 2nd metatarsal of 2nd toe

  • Knee pain – Medial Collateral Ligament & Patella Femoral Pain Syndrome

  • Shin Splints

  • Inside Arch Pain

Excessive Foot Pronation is caused by abnormal structural deformities of the foot such as inward or outward angulations of foot structure when weight-bearing. In addition tight calf muscles which restrict the foot bending upwards (dorsiflexion) leads to over-pronation to compensate for limited dorsiflexion.

Signs of Excessive Pronation Foot

  • Erosion of sole of the shoe underneath the 2 metatarsal which adjoins 2nd toe.

  • Prominent bulging of the Talus head bone on inside of ankle

  • Flattening of inside (medial) foot arch when standing

  • Excessive internal rotation of the tibia bone when walking / running

  • Ankle joint bows inwards when standing

Treatment & Management of Excessive Pronation

I commonly meet patients in my clinic whose foot or knee pain is caused by excessive foot pronation. To treat this biomechanical abnormality the following elements would need to be addressed:

  • Wearing of straight shoe type instead of a curved type shoe.

  • Strengthening of Posterior & Anterior Tibial muscles of the foot.

  • Stretching of the tight Calf muscles

  • In some cases insertion of wedges to elevate medial arch or a custom made orthotic is incorporated.

Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy (MIAPT) and is based in Thurles.

Contact Number: 0504 26672

Email your queries to: info@tipp-phyiscaltherapy.ie

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Physiotherapy & Injury Rehabilitation Clinic in Tipperary

0504 26672


The Surgery, Fianna Road, Thurles


Riverside Medical Centre, 7 Upper

Irishtown, Clonmel

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