Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

What Is Pronation?

Pronation is a normal, necessary triplanar motion of the foot that occurs during the early stance phase of gait — the foot rolls inward, the arch flattens slightly, and the lower leg internally rotates. This motion absorbs impact and allows the foot to adapt to ground surface irregularities. Without pronation, walking on varied terrain would be dangerously rigid. Pronation is not inherently pathological.

What Is Overpronation?

Overpronation describes excessive magnitude, duration, or speed of the pronation motion — the foot rolls too far inward, for too long, or too rapidly. This creates abnormal stress patterns throughout the lower extremity: excess tension on the plantar fascia, abnormal tibial rotation contributing to shin splint and knee pain, increased load on the posterior tibial tendon that can contribute to tendinopathy and progressive flatfoot, and altered forefoot mechanics that contribute to bunion formation and metatarsal stress fractures.

When Overpronation Becomes a Clinical Problem

The critical distinction: anatomic flatfoot (a flat-looking foot) is not synonymous with symptomatic overpronation. Many people with flat-looking feet have no pain or functional limitation — their flat foot is their normal. Overpronation becomes clinically significant when it produces symptoms: plantar fasciitis, posterior tibial tendinopathy, shin splints, or knee pain that correlate with the biomechanical pattern. Treatment is indicated for symptomatic overpronation — not for the appearance of a flat foot.

What Actually Helps

Custom orthotics — fabricated from a precise mold of your foot — are the most effective intervention for symptomatic overpronation. They control the excessive motion without eliminating the necessary pronation that occurs naturally. Strengthening the posterior tibial muscle (the primary dynamic arch support) and the hip abductors (which control lower extremity alignment during stance) addresses the muscular component. Appropriate motion-control footwear provides additional support. Generic over-the-counter arch supports may provide partial relief but are not equivalent to custom orthotic devices for significant biomechanical correction.

Evaluation at Balance Foot & Ankle

If you’ve been told you overpronate, or if you have foot, shin, or knee pain with activity, a gait analysis and biomechanical evaluation at Balance Foot & Ankle in Howell or Bloomfield Township provides objective assessment of your specific pattern. We distinguish symptomatic overpronation requiring treatment from anatomic flat foot that is simply your normal — and provide targeted interventions when treatment is indicated.

Foot or Ankle Pain? We Can Help.

Balance Foot & Ankle — Howell & Bloomfield Township, MI

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Overpronation Causing Pain? Get a Biomechanical Assessment

Overpronation is one of the most common causes of foot, ankle, knee, and hip pain. Dr. Tom Biernacki performs gait analysis and biomechanical evaluation to determine if overpronation is contributing to your pain and prescribes the right corrective solution.

Learn About Orthotics for Overpronation | Book Your Appointment | Call (810) 206-1402

Clinical References

1. Nigg BM, et al. Effect of shoe inserts on kinematics, center of pressure, and leg joint moments during running. Medicine and Science in Sports and Exercise. 2003;35(2):314-319.
2. Neal BS, et al. Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta-analysis. Journal of Foot and Ankle Research. 2014;7:55.
3. Cheung RT, et al. Association of footwear with patellofemoral pain syndrome: a systematic review. Sports Medicine. 2006;36(3):199-205.

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.