What is foot overpronation? Causes, symptoms, and how to treat it

Ever notice the inside edges of your shoes wearing out faster, or feel a nagging ache inside your foot after a walk? Foot overpronation — when your foot naturally rolls a bit further inward with each step — might be a factor. “You can usually see extra wear on the inside of the shoe if you overpronate, because that part of your foot is flat when you walk,” explains Dominica Sourial, PT, DPT, a physical therapist at Hinge Health. “If you don’t overpronate, your weight stays more evenly distributed, so the shoe wear is more balanced.” 

Many people overpronate — it’s just one of many ways our bodies move. While foot overpronation is usually nothing to worry about, it can sometimes contribute to aches in your feet, ankles, and even knees and lower legs. But a few simple adjustments, like doing targeted exercises and choosing the right footwear, can help you manage your symptoms and keep you moving comfortably.

Read on to learn about what foot overpronation is, causes and symptoms, and how to treat it — especially with exercises recommended by Hinge Health physical therapists.  

What is foot overpronation?

Pronation is the natural, side-to-side movement your foot makes when you walk or run. It helps absorb shock and is a normal part of movement. 

• Overpronation happens when your foot rolls inward more than usual when you walk, causing your arch to flatten a bit more with each step. 

• Underpronation (also called supination) is when your foot rolls inward less than average, and your weight stays more on the outer edge of your foot.

These variations are all common adaptations in the ways people move. Having one of these patterns doesn’t necessarily mean you’ll have pain or develop any issues. In fact, many people with overpronation never notice any symptoms. 

Some individuals, however, do experience discomfort. Foot overpronation changes the way your weight is distributed when you walk. This extra pressure on certain parts of your foot and ankle can strain the muscles, ligaments, and joints involved in supporting your arch and absorbing shock. Over time, this may lead to aches in places like your foot arches, heels, or ankles. In some cases, this can impact your knees and lower legs. These symptoms are often most noticeable during and after activities that involve walking, running, or standing for long periods of time.

Causes of foot overpronation

Overpronation is often related to normal differences in foot shape and walking style (gait). Muscle and joint changes from muscle imbalances and injuries can also play a role. Here are some of the most common causes of overpronation:

• Fallen arches (aka flat feet). Collapsed or fallen arches occur when the tendons and muscles that support the arch of your foot become weakened or overstretched, causing the arch to flatten. Some people are born with naturally flat feet, but in many cases, “fallen arches happen over time due to factors like aging or carrying extra weight during pregnancy,” explains Dr. Sourial. Being flatfooted is not a bad thing, but it can sometimes contribute to overpronation. 

• Muscle imbalances. The muscles in your feet and lower legs work together to support your arches and control movement. However, certain factors — such as prolonged sitting, wearing unsupportive footwear for long periods, foot injuries, or not engaging your foot muscles enough in daily activities — can lead to muscle imbalances over time. As a result, these imbalances may cause your foot to roll inward more than usual.

• Tight calves. Tension or stiffness in your calf muscles — whether from inactivity, overuse, or a lack of stretching — can impact the way your foot moves as you walk. “If your calf is tight, it can make it harder for you to push off the ground effectively with each step. This restricted movement can throw off your walking pattern and, over time, contribute to muscle imbalances,” explains Dr. Sourial.

• Unsupportive footwear. Shoes that lack support — like flip-flops, high heels, or worn-out sneakers — may not provide enough stability for your arches and the rest of your foot. Over time, this can allow your feet to roll inward more than usual as you walk. 

• Injury or trauma. Injuries like a sprained ankle can weaken the ligaments and muscles that support your foot and ankle. When these structures aren’t as strong, it’s harder for your foot to control how much it rolls inward. As a result, your foot may overpronate during walking or running. 

• Gait style. Gait refers to the way you typically walk. Changes in your walking pattern — caused by injury, muscle weakness, or structural differences — can lead your body to compensate by rolling the foot inward more than usual. This can help you maintain balance when you move, but over time, it can contribute to overpronation.

Symptoms of foot overpronation 

A common sign of overpronation is shoes that show more wear on the inside edge of the soles. While some people with overpronation have no symptoms at all, others may notice discomfort in different parts of their legs or feet. Possible overpronation symptoms include:

• Achy or sharp pain in the foot arch

• Heel pain

• Ankle pain or frequent ankle sprains

• Shin splints

• Bunions

• Knee pain

• Hip pain

• Lower back pain

These exercises are recommended by Hinge Health physical therapists to address foot overpronation. By building strength and coordination in key areas of your feet, they help support your arches and minimize symptoms related to overpronation — so you can move with more comfort, ease, and confidence in your daily activities.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for foot overpronation

Managing overpronation usually involves a mix of foot, ankle, and leg strengthening exercises, supportive footwear choices, and self-care strategies. Physical therapy and targeted movement build strength and flexibility, while proper shoes and activity modifications help reduce stress on your feet. At-home care — like using ice for soreness or medication for pain — can offer extra relief and keep you moving comfortably as you address symptoms. Here are the treatments for foot overpronation Hinge Health physical therapists recommend: 

• Try physical therapy and targeted exercises. Targeted exercises help strengthen the muscles that support your arches and ankles, improve balance, and increase flexibility in your feet and lower legs. This helps address overpronation and reduces the chances of symptoms returning. You can do exercises at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Stay active. It might seem counterintuitive to keep moving when you’re experiencing discomfort, but Dr. Sourial notes that adding gentle activity to your routine is one of the best ways to strengthen your arches, ankles, and calves. Low-impact exercises like walking, yoga, or tai chi can help improve mobility, build strength, and support healthy movement over time.

• Wear supportive footwear. Wearing shoes with good arch support can help keep your feet stable and comfortable if you overpronate. Look for supportive shoes or consider using in-shoe inserts (orthotics) to provide extra stability and help distribute pressure more evenly as you move. Replace worn-out shoes regularly, since old or broken-down footwear can lose their supportive features and make overpronation symptoms worse.

• Modify painful activities. If certain movements or exercises make your discomfort worse, try switching to lower-impact options temporarily while you build strength in your feet and ankles. For example, swap running for walking, cycling, or swimming to reduce stress on your feet while staying active and giving your body time to recover.

• Use ice or heat. Both can be effective for soothing foot or ankle discomfort. Applying an ice pack to sore or swollen areas for 15–20 minutes at a time can help reduce pain and inflammation, while using a warm compress or heating pad can relax tight muscles and ease discomfort. For targeted relief, try rolling the bottom of your foot over a frozen water bottle to massage the arch. 

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease foot pain so you can perform your targeted exercises and stay active. Other options include topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are ‌safe to take.

How to prevent foot overpronation 

For some people, overpronation is something they’re born with. For others, it can develop over time. To prevent overpronation, focus on lifestyle changes that keep your foot arches healthy and strong. 

• Maintain a healthy weight. Weight is just one aspect of overall health, and everyone’s body is different. However, carrying extra weight can add stress to your feet and arches, which may contribute to overpronation or discomfort over time. Finding enjoyable ways to stay active can help reduce that stress and strengthen your body.  

• Regular stretching and strengthening. Maintaining strength and flexibility in your feet, ankles, and calves can support your arches and promote healthy movement. Physical therapy exercises, along with regular, gentle exercise, are great ways to build mobility and keep your lower body feeling its best.

• Wear supportive shoes. If you spend time running, walking on hard surfaces, or doing other high-impact activities, wearing shoes with good arch support and stable soles can help keep your feet and ankles comfortable and protected. Supportive footwear can make a big difference in how your feet feel during and after activity.

PT tip: Small changes make a big difference 

Simple adjustments to your strength routine, footwear, or daily activity level can bring real relief if you have pain or stiffness related to foot overpronation. A physical therapist can help pinpoint what changes could have the biggest impact for you, so you can keep moving comfortably and confidently.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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2. Moisan, G., Griffiths, I., & Chicoine, D. (2023). Flat feet: deformities or healthy anatomical variants? British Journal of Sports Medicine, 57(24), 1536–1537. doi:10.1136/bjsports-2023-107183

3. Brijwasi, T., & Borkar, P. (2023). A comprehensive exercise program improves foot alignment in people with flexible flat foot: a randomised trial. Journal of Physiotherapy, 69(1), 42–46. doi:10.1016/j.jphys.2022.11.011

4. Kim, E.-K., & Kim, J. S. (2016). The effects of short foot exercises and arch support insoles on improvement in the medial longitudinal arch and dynamic balance of flexible flatfoot patients. Journal of Physical Therapy Science, 28(11), 3136–3139. doi:10.1589/jpts.28.3136

5. Mousavi, S. H., Khorramroo, F., & Jafarnezhadgero, A. (2024). Gait retraining targeting foot pronation: A systematic review and meta-analysis. PloS one, 19(3), e0298646. doi:10.1371/journal.pone.0298646