Show Menu

Foot Hyperpronation Cheat Sheet (DRAFT) by

Presentation, management etc

This is a draft cheat sheet. It is a work in progress and is not finished yet.


Foot pronation is: Eversion, abduction and dorsif­lexion, begins at heel strike to mid stance
Limited by: Ligame­ntous and bony integrity + eccentric contra­ction of tibialis posterior
Chronic hyperp­ron­ation - causes laxity of calcan­eon­avi­cular ligament and talona­vicular joint capsule, elongated plantar fascia, posterior tibial tendin­opathy and posterior tibial nerve irritation
- Hyperp­ron­ation causes internal rotation of the tibia, resulting in internal rotation of femur (moves femoral head and acetabulum backwards, anterior tilt of the pelvis then hypere­xte­nsion of lx)
- Internal tibial rotation: Causes valgus stress on the knee, MCL and ACL stressed, causes a lateral displa­cement of the patella
- Internal femur rotation: Also causes lateral displa­cement of the patella, quads, hip adduct­ors­/ab­ductors - weakness of gluts causes excessive hip adduction, increases the foot arch during ambula­tion, also causes weakening of gluteal and abdominal muscles and tightening of hip flexors


- Look for lower chain dysfun­ction
- Excessive forefoot abduction (too many toes )
- Calcaneal eversion (bowing of achilles tendon)
- Navicular drop >10mm (6-8mm normal)
- Posterior tibial weakness (excessive calcaneal eversion when performing a heel raise)
- TTP: Posterior tibialis tendon
- Weak hip abductors (+ve Trende­leberg, single leg squat)
- Flexib­ility of soleus and gastroc


- Arch supports
- Address leg length inequa­lities
- Stretching and myofascial release in gastro­cnemius and soleus
- Streng­thening of posterior tibialis and hip abductor (posterior lunge, clam with a band and side bridge)
- Single leg and Vele's then lungers on unstable surface