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Flat Feet / Excessive Pronation


Pronation is a normal motion in the foot as the foot rolls inwards just after it lands on the ground. It is part of the natural gait movement that helps the lower leg to adapt to different ground surfaces and absorb shock.


Some people pronate more (overpronation) or less (underpronation) than others. And flat feet are very common at our younger age - all of us are born with almost no arch in the foot but as we grow up, the arch will gradually develop as the soft tissue along the bottom of the foot tightens. We can classify flat feet into two main type - congenital flat feet and acquired flat feet.

(Picture ref. https://www.spinalandsportscare.com.au) When your feet do not form arches as you grow and you tend to overpronate your feet in your adult life, it is not normal. Overpronation can cause increased stress on the ligaments and muscles of the feet, leading to great discomfort and many painful, serious, long term pathologies in your ankles, knees, hips and back.


How do I know if I have flat feet or overpronation? The word “flat feet” can be a misnomer. When your feet roll in excessively, the feet will appear with a loss in arch contour. During sitting or non-weight bearing position, most of us, even with really pronated feet, do usually appear with an arch. However, as we bear weight, the arches tend to collapse.


People with severe flat feet or overpronation generally complaints of pain, discomfort or symptoms in their feet, ankles, knees, legs, hips or lower back. During static standing, the feet usually appeared rolled in with collapse or flatten arches. You will also generally wear out the heels of your shoes very quickly.

There are few conditions that usually found to be associated with over pronation:

  • Foot fatigue

  • Aching or painful feet, particularly in the heels and arches

  • Swelling of the inside bottom of the feet

  • Ankle pain

  • Shin splint

  • Knee pain

  • Lower back pain

Why do I get flat feet or overpronation? There are many causes of overpronation, these include:

  • family history or genetic factors

  • hypermobility (low muscle tone)

  • health conditions such as arthritis and diabetes

  • foot or ankle injury

  • damage, dysfunction or rupture of the tendon (tibialis posterior)

  • nervous or muscular diseases such as muscular dystrophy, cerebral palsy or spinal bifida

  • pregnancy

Does flat foot condition requires treatment? Children with flat feet do not usually require treatment if there is no pain or difficulty with walking. The arches of the feet generally developed as they grow older. With older individuals, it is not uncommon to see asymptomatic flat feet which require no treatment. For cases in which people are experiencing pain and discomfort, treatments are strongly recommended to prevent further complications. Common treatment for overpronation include:

  • Strapping / Taping - help reduce abnormal pronation

  • Exercises - to improve strength and flexibility of associated lower limb muscles

  • Supportive footwear

  • Orthotics - these medical shoe inserts, either accommodative or functional can help controlling abnormal pronation and support the foot. A podiatrist can recommend the best orthotic device for you based on a thorough assessment of your foot structure, symptoms and biomechanics (See link to orthotics)

  • Proper weight management - can improve symptoms considerably in obese patients

What are the risks for no treating my painful flat feet? Flat feet affect an individual’s manner of walking, standing and running. The risk for pain in the ankles, knees, legs, back and hips become higher in person with flat feet. For individuals with existing foot problems, flat feet can worsen symptoms or contribute to these symptoms, increasing your risks for Achilles Tendonitis, Bunions, Plantar Fasciitis, Lesser Toe Deformities, Knee Pain and many more.


As foot care expert, we understand how flat feet causes discomfort and some might disrupt a person daily routine. At passion podiatry, we strike to provide the most suitable solution for your feet. Click here to book an appointment with us today. .

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