Over-pronation (flat feet)

Pronation is the tendency of the ankle bones to lean inwards, towards the foot’s centre line. If this leaning is too pronounced, it is called over-pronation – something that often leads to flat feet. 

In babies and very young children (pre-walking stage), the arch is not developed and flat feet are normal, though an arch will appear when children begin standing on their toes. The arch will continue to develop throughout childhood, and by adulthood most people have developed normal arches.

While many people with flat feet do not experience pain or other problems, there are some who do – in which cases (especially with children) the condition should be evaluated by a specialist.

In some cases, a tendon in the foot called the tibialis posterior can become inflamed, stretched, or torn, leading to a painful condition known as progressive flatfoot (or adult-acquired flatfoot), technically known as tibialis posterior tendonitis. Left untreated, this may lead to severe disability and chronic pain. People are predisposed to tibialis posterior tendonitis if they have flat feet or an abnormal attachment of the tendon to the bones in the midfoot.

Common treatments for painful progressive flatfoot include nonsteroidal anti-inflammatory medications, icing, physical therapy, supportive taping, bracing, and orthotics. In some cases, surgery may be required to repair a torn or damaged tendon and restore normal function.