Pronation syndrome, the cause of common foot and ankle conditions

January 30, 2018


Following up on the heel pain blog, the movement impairment of pronation syndrome or excessive flattening of the foot causes other foot and ankle conditions.  In addition to plantar fasciitis, other conditions caused by this movement impairment include:

  • Tibialis posterior muscle strain or tendinitis - pain on the inside of the foot or inside of the lower leg

  • Shin splints (tibialis anterior muscle strain) or tibialis anterior tendinitis - pain at top inside of the foot near the ankle or front outside of the lower leg

  • Calf strain or achilles tendinitis or tendinosis - pain in the calf muscle or back of heel  

  • Metatarsalgia - pain in the ball of the foot by the second and third toes (the big toe is the first toe)

Expanding on the heel pain blog interventions:  



  • Stop recreational activity or exercises if pain exceeds 2/10.  Overuse, without giving structures time to heal, results in a chronic condition taking months or even years to resolve.     

  • See running styles.  The first diagram results in excessive flattening of the foot and shin splints.  The second corrects these movement impairments, and promotes heel rise or push off.  ​Heel rise or push off during functional activities reduces excessive flattening of the foot.​

  • A few tips on shoes:

    • A shoe with heel height larger than toe height helps reduce stresses on the various foot and ankle structures.​​

    • A shoe manufactured to control pronation has added firmer material on the inside of the shoe (see gray material) to discourage flattening of the foot .​​



Expanding on the heel pain blog exercises:



  • If your schedule allows little time for exercise, focus on calf stretching. Stretch the calf multiple times a day, holding each stretch for 30 seconds.  Limited dorsiflexion contributes to excessive flattening of the foot.  See below another calf stretch in addition to those in the previous blog.  Keep the knee in line with the foot (don't let the knee turn in with knee cap pointing inside of the big toe), and the foot straight (don't toe out).  

  • Standing heel raise, single or double leg, 2 sets of 10 every other day.  Progress from double leg to single leg as pain allows.​  Incorporate this motion into functional activities such as walking or running.

  • Hip, ankle and foot strategies to reduce flattening of the foot

    • Hip:  Squeeze the buttock muscles with a focus on not letting the knee turn in and foot flatten.   

    • Ankle:  Invert the ankle slightly, lifting the arch.  

    • Foot:  Curl the toes, lifting the arch.  Make sure the balls of the feet lift off the floor.   



Get in touch to diagnose your movement impairment, and learn targeted interventions to resolve your condition.

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