Überpronation

Überpronation, often referred to as overpronation, describes excessive inward rolling of the foot during the stance phase of gait. In a normally pronating foot, the subtalar joint allows controlled eversion to absorb shock; überpronation occurs when this motion is exaggerated, leading to flattening of the medial longitudinal arch and medial rotation of the tibia.

Causes are multifactorial and include structural foot types such as flexible flat feet, ligamentous laxity, weakness of the tibialis posterior, and repetitive overuse. Biomechanical factors like forefoot abduction and excessive hindfoot eversion can contribute, sometimes in combination with weight, footwear, or training changes.

Biomechanical consequences include navicular drop and medial arch collapse, altered foot alignment during stance, and increased medial loading. The change can affect knee alignment and hip mechanics and is associated with conditions such as plantar fasciitis, posterior tibial tendon dysfunction, metatarsalgia, and sometimes bunion progression.

Evaluation typically involves clinical observation of gait and foot posture, along with targeted tests such as navicular drop, footprints, and formal foot posture indices; imaging and dynamic pressure analysis may be used in specialized settings.

Management is usually nonoperative and focuses on reducing excessive motion and restoring arch support. This includes custom or prefabricated orthotics, motion-control or stability footwear, stretching and strengthening programs for the foot and ankle, and gait retraining. In persistent or severe cases, surgical options exist, including procedures to address tendon function or alignment.

Prognosis depends on the underlying causes and adherence to management; many individuals improve pain and function with shoe modification and exercises, although overpronation may recur if etiologies are not addressed. See also pronation, flat feet, overuse injuries.