One of the most effective ways to correct abnormal pronation is to wear supports known as orthotics. Pronation occurs when the heel strikes the ground first while walking, twisting slightly to transfer weight across the flat of the foot and eventually to the ball and toes. Some pronation is normal and desirable for successful weight transfer, but too much can be problematic, as can too little. A doctor can recommend some techniques to correct pronation if it is causing problems for a patient.
Before a doctor will discuss options to correct pronation, it may be necessary to have a brief exam. The doctor typically asks the patient to walk on a flat surface, which allows the care provider to look at the patient's gait. In addition to checking for ankle rotation, doctors can look for other gait issues like favoring one leg over another. These may change the treatment recommendation. Some doctors may also inspect shoes to look for abnormal wear patterns that may provide more information about gait problems.
One way to correct pronation is to prescribe special orthotic shoes or inserts. These provide support to the foot and arch, prevent the arch from falling too much while walking, and limit overpronation. Patients may need some practice to get used to the orthotics, but should experience a reduction in pain and stress over time. It is especially important to wear properly fitted shoes for running and other athletic activities, where poor foot support can increase the risk of injuries.
Another option can include exercise and physical therapy. Some patients have weak joints and ligaments in their feet as a result of prolonged pronation problems. In addition to bracing to correct pronation, they may also need some exercises to develop strength and flexibility. These exercises can often be performed at home after a physical therapist instructs patients. As long as they are done regularly, patients should start to develop a more stable, comfortable gait.
In extreme cases, a doctor may recommend night braces to correct pronation. Worn while patients relax and sleep in the evening, these can pull the structures of the foot into alignment. These are also typically combined with exercises for strength, agility, and flexibility. It is important to follow medical recommendations while wearing braces and other equipment, as improper wear can cause injuries. The patient may need to attend periodic checkups to allow the doctor to examine the feet and ankles and assess the response to treatment, to determine if any adjustments are necessary.