To Pronate or to Over Pronate, that is the question.

 Is your foot shape affecting your health?

I see many patients who have different types of foot pain, as with all injuries/ pain it is imperative to address the mechanics causing the problem. The ankle and foot complex are very important to how the whole body moves and the forces put upon it. To help prevent foot or ankle pain and stop issues further up the body it is important to have a fully functional and well supported foot and ankle.


It is common for pronation to be used in a negative description, when you are buying your trainers and you are advised you pronate, however it is good if you pronate as it is part of the normal biomechanics of every step we take. The normal movement involves heel strike in a supinated position and the foot rolls forward and begins to pronate, multiple structures then are stimulated to control the amount of pronation and allowing the bodies forward flow into the mid stance then propulsion with toe off. The controlling structures work form the spine down to maintain ambulation.

Over pronation however is when problems can occur, if the foot rolls in stress through the foot and ankle can lead to irritation in joints, capsules, fascia tendons and muscles. The issues are not just felt in the foot e.g with plantar fasciitis, foot joints pain, but also in the ankle with achilles tibialis posterior tenoditis, further up with shin splints, knee joint aggravation and also can affect around the pelvis with trochanteric bursitis and up to back pain. So the whole system can be thrown out of balance. 

I recently treated a young man who presented with back pain, he is a hurdler and was struggling to run freely. However on assessment it didn’t look like a normal back pain, so during my full biomechanical assessment I noted his big toe wouldn’t move, we worked out he had broken it 2 years prior. I focussed on mobilising his toe joint and within 2 weeks his back pain fully resolved.

At the Twyford Clinic near Winchester a full assessment is carried out to see which parts of the chain are affected to help fully clear your aches and pains, this includes a treadmill to help analyse walking and running style.


Orthotics are provided as part of our treatment if it is indicated for your problem. The orthotics we provide are fitted perfectly for your foot, they are significantly cheaper than many orthotics around £95 whereas an equivalent can cost up to £500.  

A full programme of physiotherapy treatment and rehabilitation will sort your issues out. An important note is for children’s foot pain, as a child grows they go through periods of normal position and overpronation so care needs to be taken with their management, I have seen many instances of childhood foot pain as Head of Southampton Football Club Academy and would be happy to help with your child’s discomfort.

Biomechanics are the key and this starts from the bottom up.

If you do suffer with a foot, ankle, leg or back pain come along and we can help you.

Phillip Wilson, Specialist Physiotherapist
The Twyford Clinic, The Gatehouse, Vine Cottage,
High Street, Twyford, Winchester, SO21 1NU
01962 714979

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