Top 5 Exercises for Pronated Feet

Pronation of the ankle is a movement of the foot and ankle joint. Rolling the foot inwards and outwards allows the foot to adapt to the surface it is walking on. During walking, running, and other activities, this motion is crucial for balance, stability, and shock absorption.

To move forward after stepping onto an uneven surface, the foot must be able to adapt to the terrain. Pronation of the ankle is the foot's inward rotation, which allows the foot to absorb shock and adapt to changes in the terrain. This inward rotation of the foot also contributes to the maintenance of stability and balance by helping to distribute weight more evenly across the foot.

Ankle pronation is the normal adaption of the foot, but commonly therapists describe patients as having pronated feet. This should be more accurately termed as overpronation, because pronation is normal during gait.

Ankle pronation is often confused for flat feet. The pronated ankle is not flat if it can restore the normal arch. However, people with flat feet tend to overpronate, or roll their foot inwards excessively, so there is somewhat of a cross-over. On the other end of the spectrum, people with high arches tend to underpronate, meaning their foot does not roll inwards enough. This can result in inadequate shock absorption.

To maintain stability and balance, as well as to reduce the risk of injury, it is essential to have a healthy level of ankle pronation. However overpronation should be addressed through exercises.

Orthotics are commonly prescribed for ankle pronation, but as therapists we are often cautious with orthotics. There are a number of limitations, including the requirement to wear them for long periods of time, the rapid change in the foot biomechanics (which can have knock-on effects) when an orthotic starts to be used, and the need to keep moving orthotics to different pairs of shoes. We prefer prescribing strengthening exercises as first-approach.

Over time, the medial arch of the foot can roll excessively inward, and in such cases, strengthening exercises can be extremely beneficial for maintaining the arch's intrinsic muscular strength and stability. Balance exercises may also benefit pes planus patients. As you maintain your balance, the small intrinsic foot muscles must contract in order to stabilise your foot. Also beneficial is exercising on uneven surfaces, such as a BOSU ball or wobble board. To avoid falling, it goes without saying that you should hold onto a wall when you begin.

It's important to know that pronation is normal during the running gait. As the heel strikes the ground, the foot will pronate a small amount. So how do you know if you overpronate? There are a few ways to tell. One of the simplest is the wet foot test. Dip your feet in water and walk a few meters on a patio or some concrete, and look at the patterns. If you can see a clear arch or curve in the foot print that’s good, but more contact with the ground usually is a sign of over-pronation. A more thorough (and expensive) method is to get a gait analysis done and to walk on a force plate.

But why does over-pronation cause injuries? Opinion varies but a common thought among therapists is that the instep or arch of your foot is designed like an arch because like a bridge, an arch is very strong. This helps to absorb and dissipate much of the force from the ground when you run. But if that arch is completely lost, then two things happen. First, your foot does not absorb so much force and the force goes into the shin, knee, and hip. Second, the knee turns inwards which places uneven stress going into the shin, knee, and hip joint. This most commonly causes problems such as shin splints and Runner’s knee (ITB syndrome) but can also cause Achilles tendinopathy, hip pain, back pain, and groin strain.

Let’s look at our top five exercises for pronated feet

1. Tip Toe Walking: Walk on tip toes. Start by doing it in trainers, but when you get more confident do it in bare feet. It’s a fantastic foot, ankle and leg strengthening exercise to the ligaments and muscles. It also helps improve balance.

2. Calf Heel Raise One Leg Step: Stand on a step, hold onto a hand rail for balance if required. Slowly raise up onto your toes, and control the movement back down just below the level of the step. This exercise will strengthen the calf muscle and ankle joint, but at the bottom of the movement put a stretch through the calf as well.

3. Walking on the Outside of your Feet: Walk on the outside of your feet. You can wear trainers to start with and progress to bare foot. Be careful not to lose balance, so proceed slowly. This is a great exercise to help train the arch of your foot, and to build muscle and ligament strength around your foot and ankle.

4. BOSU calf heel raises: Standing on the curved side of a BOSU ball, raise your heels up off the cushion, onto your toes. Control the movement back down. Hold on to a wall until you get your balance, then progress by not holding on to the wall. The instability of the ball will improve your balance, as well as strengthen your hip, knee, foot and ankle muscles.

5. Outward Turn Calf Heel Raise: Stand up and place your toes towards each other, but keep your heels separated. Lift your heels up, and place your weight through your toes. Hold this position, then return to the floor. Repeat as required. This exercise is good for balance and calf strengthening.

In conclusion, pronation of the ankle is a necessary motion of the foot and ankle joint for balance and stability. It is essential to have adequate pronation in order to reduce injury risk and enhance performance. To improve pronation, individuals with flat feet or high arches may need to wear an orthotic device or choose a shoe with more cushioning. Moreover, stretching and strengthening exercises for the muscles surrounding the ankle can aid in the improvement of pronation.

If you are a therapist and like the exercises and information in this document, please go to www.rehabmypatient.com and sign up to this amazing exercise prescription software. If you are a patient and need some advice, treatment or a consultation, please go to www.surreyphysio.co.uk/bookonline. We provide virtual and face-to-face appointments with our expert team.

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You can find useful and additional information here: https://www.rehabmypatient.com/ankle/ankle-pronation-overpronation