Knee & Ankle By Sophie Xie / July 7, 2016 Why heel pain? Do you have overpronated feet? Lots of people heard of plantar fasciitis or Achilles tendonitis. However, most feet and heel pain are closely associated with a term called "overpronation". And I just lost most people there.What is feet pronation and why you should care? "Pronation" is medical jargon referring to a particular positioning of hands and feet. When you turn your palms down, you hands and wrists are pronated. When looking at ankles and feet, this positioning is much more subtle.When we are seated, we can actively pronate our feet and ankle by rolling your ankles in so that the bottom of your feet are facing outward. Yet, the most significant feet pronation is the positioning of your ankle and feet while you are standing, walking or running. Quick Navigation Are your feet overpronated?How we got overpronated feet?Why the foot and heel pain?Treatment and prevention Are your feet overpronated?Everyone's feet pronates around 10 to 15 deg when we walk or run. It is part of our natural shock absorption system. Overpronation happens when your feet and ankle rolling inwards excessively and uncontrollably during the transfer of your body weight. Overly pronated ankle is a major sign of ankle instability This self assessment will help you look closer at your ankle pronation.Were you been told that you have flat feet? - Though flat feet and overpronation is not the same concept, they can appear very similar.While balancing on one foot, does your supporting ankle partially or completely roll inwards?Do you have reoccurring bunion and callus conditions?Do you have recurring plantar fasciitis or achilles tendonitis?Do you find your calf muscles tight and sore frequently?Examine your well-worn walking or running shoes, do you find uneven and heavier wear on the inside edge of the sole?If you find yourself answering "yes" to multiple questions above, you are likely to have ankle overpronation to various degree. How we got overpronated feet?Some people are born with excessively high or low foot arches. Although these arches are not ideal for high-impact active lifestyle, they are not likely to be the primary cause of heel and ankle pain.Overpronation, or collapse of foot arch, often happens as a result of past injury, faulty walking habit or long-term weight gain.The most frequently seen injury that often result in overpronated foot is an ankle sprain. The injury itself has little connection to foot overpronation. However, during the process of recovery, your pain and the guarding reaction may result in weakening of intrinsic muscles, tightening of calf muscles and overloading of the arch. Repetitive ankle injuries with no specific exercise to retrain muscles will increase the risk of developing overly pronated ankles.Another reason that people develop foot overpronation is through "walking wrong". Most of us do not have the "perfect walk". That means we don't always use our muscle, or distribute our weight, evenly when we stroll around. Muscle stiffness and body pains are both strong factors that influence our swagger and posture. Yet, the most simple thing that affects our walking habit is our footwear. [Recommended reading: 6 worst shoes you can walk in for plantar fasciitis].Last but not least, overweight individuals are at much high risk of developing overpronated foot simply due to the weight and pressure exerted over the foot arch over time.Why the foot and heel pain?Overly pronated ankles and feet place a significant amount of stress on the tissue and tendons around the area.Bunions and calluses tend to develop due to increased load, pressure and friction on the inside of the ball of the foot, over the first metatarsal bone and joints. Collapsed arch forces the plantar fascia to take on more loading and stretching to cushion the impacts during our movement. Over time, the plantar fascia will be inflamed and causes pain - plantar fasciitis pain.Overpronation of foot and ankle also places the calf muscle and the Achilles tendons in the very awkward and disadvantaged position as we walk. The inner side of the Achilles' tendon is strained and over stretches, leading to tissue damage and chronic inflammation pain - Achilles tendonitis pain.Last but not least, severe or chronic foot overpronation can result in uneven wear and tear on knee and hip joints, resulting musculoskeletal aches and pain spreading along the chain of the mechanism. Treatment and preventionThe good news is that you can reverse foot overpronation to some degree through proper exercises and stretches. A great place to start is through proper calf stretches. Additional exercises involve strengthening the calf muscles and intrinsic foot muscles. Targeted exercises and stretches are the most effective and permanent ways to improve your ankle and foot stabilization and painful conditions. [Recommended reading: Exercises for flat feet]You may also invest in a good pair of orthotics or inserts to provide some support for the fallen arch. Be warned that not everyone with overpronated feet is appropriate for orthotics or inserts. Ease in an orthotics or inserts by slowly increase the length of wear time over a period of few weeks. Depends on each individual's foot structure and sensitivity, materials of the orthotics and inserts plays an important role. Prepare to trial and error for best fit.You can get your "gait pattern", or walking habit, analysed by a physical therapist, chiropractor or an athletic trainer. These professionals with proper training and experience can observe muscle and postural imbalance that might contribute to your foot and heel pain. They can also assist you with better proper choices to correct any problematic gait issues and improve your overall walking performance.Thank you for reading, and I hope you find this post helpful.Like what you just read? Share this post via our social media buttons! They are everywhere on this page!Want to know more about treating your own pain with techniques from a physical therapist? Please subscribe to our newsletter!