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For people with Down syndrome, family members, caregivers and professionals.


March 2023 | Brian Chicoine, MD - Medical Director, Adult Down Syndrome Center

What is overpronation of the ankle?

In short, when we walk, typically the outside of our heel strikes the ground first and then the rest of our foot rolls to come in contact with the ground. Then our foot rolls further inward so the push-off comes primarily from the big toe. When a person overpronates, the foot continues to roll inward too far.

The American Academy of Orthopaedic Surgeons has a helpful video that explains overpronation opens in new window

Overpronation is often associated with flat feet, and it seems to be more common in people with Down syndrome. It can cause foot, ankle, knee, hip, and even back pain.

A physical exam is usually all that is needed to make the diagnosis. Treatment consists of supporting the foot to prevent it from rolling in too far and can include:

  • Wearing shoes designed for overpronation

  • Putting inserts in your shoes

  • Using custom orthotics usually obtained from a podiatrist, orthopedic surgeon, or orthotist

I usually recommend going to a shoe store with a salesperson knowledgeable about overpronation who can make a recommendation. Alternately, you can look up which shoes are best for the condition before going to a store and looking for those particular shoes. For example, Asics has a Pronation Guide opens in new window with recommendations for underpronators, neutral pronators, and overpronators on their website. Brooks has a Shoe Finder opens in new window guide that walks you through questions to make a shoe recommendation. Some shoes for overpronation can be a little clunky and difficult for people with Down syndrome to walk in. I recommend trying the shoes on to make sure they don’t feel too heavy or clunky.

An arch support to put inside your shoe may also help. A few over-the-counter brands to consider are Spenco opens in new window or j1 insoles opens in new window, but those are just a couple of many possible choices. Custom orthotics provided by a podiatrist, orthopedic surgeon, or orthotist can also be used. They are more expensive, but they are made specifically for the individual.

Support of the foot and ankle for an overpronator can prevent injury and help optimize function (walking, running, etc.). Additional information about foot support for people with Down syndrome can be found on the Mann Method PT and Fitness website opens in new window


**Please note: We share information from specific brands for educational purposes only. The Adult Down Syndrome Center does not receive financial support or compensation for sharing information about products.

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