You might have heard flat foot; other word pronation, where foot rolls inwards while standing. It’s normal to foot pronate or supinate (opposite to pronate) in certain points during gait cycle. But when pronation happens during stance phase where most of the body weight is right above the foot, problems might occur. Pronation is foot’s triplanar movement, so this means if pronation occurs it affect three cardinal plane; subtalar eversion, dorsiflexion of the angle and forefoot abduction. Also as the foot is rolled inwards it increases rotation of the tibia, when it causes pressure to joint and ligament which can lead many other problems.

Pronation often cause knee pain, medial tibial stress syndrome know as shin splints, calf, shin and foot muscles soreness and pain as the muscles are pulled wrong position. When muscle is pulled wrong position long period of time it shortened while its opposite muscles lengthened. Often the lengthened side start to show symptom of pain as it strengthens all the time, body tend to find posture which feel comfortable, for example in the bad upper body posture, where shoulders are turned front, you feel tightness back of your body (muscles are lengthened) but often your front side is more painful (muscles are shortened) when you start to do something or go get a massage.

How to treat or prevent pronation?

Shoe types:
While running is recommended use orthotics shoes which support foot to correct angle. If we think that while running our lower body joints take our body weight three times greater each step, which is huge impact to legs, so you might not want to do this a long time. Using right shoes prevent extra pain and problems, but I don’t recommend use this kind of shoes all the time because it makes your feet muscles lazy. For example walking and light running can be performed with normal shoes if your legs feeling okay with it, while doing this put extra concentration on your feet and try to step correct position.

Training of correct posture of foot
As I just mentioned muscle laziness, it’s good to consider training your foot posture as you train running. You may have heard all kinds of pen and paper rolling of toes, etc. These are good as they activate foot’s little muscles, but these do not teach correct way to stand.

One good method is to take two coins, place each of them under the outer balls of feet. Take two pens and place the head of them under of arch of feet on medial side (big toe side). Now try to raise arch of feet so they don’t touch pens, but keep balls of feet ground and toes relaxed. Coins are there so you know if you lost the touch of it and raise your foot wrongly. This might feel difficult first, but if you continue and try to do these raises at least couple hundreds of day and raise amount while it gets easier. This way you learn the right way to stand, and it began to be more natural.

Can tight hips cause pronation?
There are some studies which found that hip weakness and tightness causes pronation, as the hips are tight it rotates thighs and forward shins. The same way the foot pronation rotates shins.

You can make hip test by performing single leg squat. Take one foot off the ground behind you and make regular squat, keep back straight, avoid tilting your pelvis forward. Think straight line from your hip to the toes of standing leg. If your knee falls inwards and you struggle to keep straight line while standing, you have weakness in your hip. Stretching and strengthening help fix this problem.

If you are unable to identify or unsure which cause your pronation, ask from professional. They can examine your body and give advice what to do.