Flat Feet and Foot Pronation


Do I really have flat feet?.

Foot pronation is the type of motion which can be observed when you see the feet "rolling in" in relation to the leg. Pronation of the foot is normal to a certain degree but there are times when this type of motion may be excessive and contribute to forces causing pain in the feet and legs. An excessively pronated foot can give the appearance of a flat foot where there appears to be a reduction or loss of arch height. 

If both feet are rolling in excessively this motion can produce the appearance of "flat feet". Flat feet in their true sense are very rare. However, excessive pronation is estimated to be present in approximately 50% of the population.

foot pronation, flat feet, orthotic

Most feet when studied in the sitting or non-weight bearing position have an arch. Only during weightbearing do the feet collapse, hence these so called "flat feet" are said to be compensating for a particular condition and display PRONATION. The foot on the right in the above diagram is pronating or "rolling in" excessively when compared to the left foot.

So when feet pronate (roll-in) excessively, they appear to be flattened through the arch and are therefore often mistakenly termed "flat feet".


There are many causes of abnormal pronation which gives rise to the appearance of flat feet. The most common being:

  • Hereditary bony or soft tissue conditions within the foot that distort normal walking patterns.

  • Abnormal muscle length or muscle tone.

  • Abnormal leg rotations

  • Poor pelvic alignment causing leg length differences

  • Spinal conditions (e.g. scoliosis)

  • Poor foot loading

  • Muscle spasticity (e.g. cerebral palsy)

    Once your Podiatrist determines the cause of your excessive pronation, appropriate treatment options can then be discussed.


    The result of either short or long term excessive foot pronation can vary a great deal from patient to patient, but it should be noted that this abnormal force on the body is a major contributor to a myriad of bony and soft tissue problems and therefore - PAIN.

    Symptoms can occur in a range of areas including the:

  • Feet (e.g. bunions, hammer toes, calluses)

  • Heels (e.g. heel spurs, plantar fasciitis, achilles tendonitis)

  • Shins (e.g. shin splints, posterior tibial tendonitis)

  • Knees (e.g. Patellofemoral syndrome, chondromalacia or cartilage damage to the kneecap)

  • Thighs (e.g. Iliotibial band syndrome)

  • Hips (e.g. greater trochanter bursitis or inflammation near the hip joint)

  • Upper and lower back (e.g. Sciatica)

  • Neck and head (e.g. migraines)

    Not only is excessive pronation a major pain contributor in the adult body, but it is also a common factor associated with so called "Growing Pains" in children.

    So eliminating this source of aggravation when undergoing knee, hip, back and neck treatment is important. Once more true excessive pronation is the problem here, not "flat feet".


    If you have flat feet without excessive pronation, you should not experience painful symptoms.

    Your Podiatrist will carry out a detailed assessment of your feet, legs, pelvis and back to identify the cause of your pronation or flat feet.

    S/he may then draw lines on you and take specific measurements with respect to different angles of your joints in the feet and legs.

    An analysis of your walking pattern is then performed on a treadmill with the use of digital video and computerized imaging.

    A plaster cast or foot scan is then taken of your feet in what's called the neutral position and a detailed prescription is drawn up for you, from which a pair of prescription orthoses can be made.

    A prescription orthotic device is then produced by a professional laboratory. These orthotic devices fit inside your footwear and assists you in addressing your condition.

    Obviously different conditions will require integrated therapy with other health professionals, which your Podiatrist will discuss with you when necessary. This may involve exercises, manipulation, massage, footwear evaluation or other therapy depending on each individuals requirements.

    To find a Podiatrist specialising in the treatment of flat feet and pronation Click Here.

    So remember! Having something in your shoes to simply "roll onto" is not the answer.

    Setting up a clear, concise and detailed treatment program targeting why the pronation exists and compensating for specific conditions and foot problems is what Podiatrists aim to achieve.

    WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist, your Doctor or your foot specialist.

    Still have a question about your foot problem, leg pain or you just need some footwear advice?

    Visit our Foot Problems page and ask us a question about your specific problem. We'll do our best to help.

    To find a Podiatrist or Foot Doctor near you visit our Find a Podiatrist page and click on your country.

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