OVERVIEW

What is Over Pronation?

Over Pronation, also known as everted foot, foot valgus deformity, or talipes valgus, refers to an imbalance in the medial and lateral forces of the foot due to congenital or acquired factors, causing the foot to tilt outward (the sole turns outward).

Over Pronation can lead to outward displacement of the calcaneus, inward subluxation of the talus, lowering of the inner arch, and even knock-knees (X-shaped legs).

Over Pronation is commonly seen in newborns, mostly due to underdeveloped or imbalanced muscle strength on both sides of the ankle joint after birth. A small number of cases may be caused by neurological factors or developmental deformities.

Most children do not require special treatment. However, if the condition persists beyond the age of 3 and affects daily activities, further medical examination is necessary to identify the cause and ensure early detection.

Treatment outcomes are generally favorable, with minimal long-term impact on daily life.

Is Over Pronation Common?

Over Pronation is clinically common.

It frequently occurs in newborns, often related to the fetal position in the womb. Most cases resolve naturally with development, though a small percentage may retain some degree of Over Pronation into adulthood.

What Are the Types of Over Pronation?

Over Pronation can be classified as congenital or acquired.

Congenital Over Pronation results from abnormal fetal development, such as imbalanced ankle muscle strength at birth or neurological damage (e.g., in children with cerebral palsy). Acquired Over Pronation is caused by later factors like disease or trauma, such as ankle fractures.

SYMPTOMS

What are the common manifestations of foot valgus?

The main manifestations include outward turning of the foot during walking, misalignment of the lower limb and foot force lines, dropped or collapsed arches, and the inner ankle being slightly lower than the outer ankle.

What are the hazards of foot valgus?

The greatest hazard is uneven stress distribution on the ankle joint, which can easily lead to localized stress concentration, causing joint wear and symptoms of arthritis.

Dropped or collapsed arches result in concentrated stress at the tibialis posterior tendon's attachment point on the navicular bone, leading to localized pain.

Additionally, uneven pressure distribution on the sole of the foot can easily cause plantar fasciitis and excessive wear on the inner side of shoe soles.

CAUSES

What Causes Foot Valgus?

The causes of foot valgus are complex, but mainly include the following factors:

Neurological Factors:

Common in children with cerebral palsy, damage to upper motor neurons disrupts control over lower motor neurons, leading to abnormal muscle tone in the lower legs. This results in poor stability of the foot and ankle joints, severely affecting weight-bearing, standing, and walking functions, often manifesting as foot valgus.

Muscular Factors:

Overactivity of the foot evertor muscles (peroneus longus, peroneus brevis, and peroneus tertius) combined with weakness of the foot invertor muscles (flexor digitorum longus, tibialis anterior, and tibialis posterior). This condition is common in newborns, and most cases resolve naturally with growth. Severe cases may require physical therapy or massage for improvement.

Growth and Biomechanical Factors:

When a child begins to stand and bear weight, the functional development of the ankle and foot is influenced by the knees, hips, and trunk, which may cause or worsen foot valgus. Conversely, foot valgus can also affect the knees, hips, and trunk. For example, paralysis of the gastrocnemius may lead to calcaneovalgus foot, while tight or contracted Achilles tendons may result in equinovalgus foot. If intrinsic foot muscles are paralyzed, weakening the arch-supporting muscles, it may cause arch collapse, forefoot abduction, and external rotation.

How Does Congenital Foot Valgus Develop?

In congenital foot valgus, the fetus adopts a foot valgus posture in the womb, so the child is born with this condition. After birth, due to imbalanced muscle strength around the ankle joint, noticeable foot valgus persists.

How Does Acquired Foot Valgus Form?

It is mostly caused by congenital or acquired diseases that lead to abnormalities in the bones, muscles, or soft tissues of the foot and ankle, or by abnormal lower limb alignment resulting in foot valgus.

DIAGNOSIS

TREATMENT

What department should I see for foot valgus?

You can visit the foot and ankle surgery department (or hand and foot surgery department), pediatric orthopedics, or rehabilitation department.

Does foot valgus require treatment?

Not necessarily.

For mild foot valgus in children under 3 years old, it is often developmental and may resolve naturally without intervention or with appropriate massage.

However, if noticeable foot valgus occurs when walking after the age of 3, especially with abnormal gait or other physical abnormalities, it may indicate neurological or lower limb developmental issues, requiring further medical examination and evaluation.

What are the consequences of not treating foot valgus?

Without timely diagnosis and treatment, permanent foot valgus deformity may develop, leading to uneven stress distribution on the ankle and sole during walking. This can increase the risk of ankle osteoarthritis and plantar fasciitis.

How is foot valgus treated?

Treatment for foot valgus includes conservative and surgical methods.

Conservative treatments include corrective foot techniques (such as stretching, massage, and targeted rehabilitation methods) and wearing foot orthoses (like arch supports or braces to correct deformity and improve walking ability).

Surgical treatments include muscle rebalancing (such as tendon release or tightening) and bony procedures (like ankle fusion or triple arthrodesis).

When is surgery needed for foot valgus?

Surgery is recommended if conservative treatments fail, symptoms worsen, daily activities are affected, or significant pain occurs.

How much does foot valgus surgery cost?

The cost depends on the patient's specific condition.

Is anesthesia required for foot valgus surgery? How long does the surgery take?

Anesthesia is required. General anesthesia may be needed for uncooperative children, while epidural or spinal anesthesia suffices for adults.

Surgery duration varies based on the condition, procedure, and surgeon's experience.

Is hospitalization required for foot valgus surgery? How long is the hospital stay?

Hospitalization is necessary.

This surgery is not an outpatient or day procedure. Detailed pre-operative assessments are required to determine the surgical plan.

Hospital stay length depends on the patient's condition.

How long is the recovery period after foot valgus surgery?

Recovery time varies. Minor procedures (e.g., soft tissue release) may heal quickly, while major surgeries require longer recovery.

Is follow-up needed after foot valgus surgery? How often?

Yes, follow-ups are required.

Typically at 3 months, 6 months, and 1 year post-surgery, then annually.

Can foot valgus be completely corrected?

Not always.

Mild cases may fully recover, but severe cases—whether treated conservatively or surgically—may not achieve 100% correction.

How long does it take to cure foot valgus?

Mild cases may recover in 2-3 months, while severe cases requiring major surgery may take longer.

Can foot valgus cause long-term complications?

It depends.

Complications vary based on cause and severity. Developmental cases may resolve without treatment, while severe neurological causes (e.g., cerebral palsy) may lead to persistent issues.

DIET & LIFESTYLE

What precautions should patients with foot valgus take in daily life?

It is best to wear sports shoes with support, shock absorption, cushioning, and motion control. Regular massage of the outer ankle can also be beneficial, or you may seek professional evaluation and appropriate treatment at a specialized rehabilitation facility. This helps promote proper foot development in children and prevents future mobility issues.

Is follow-up necessary for foot valgus?

Regular follow-ups should be scheduled based on the condition's severity.

After correcting foot valgus, can one exercise like a normal person?

Once fully corrected, individuals can resume normal daily activities and exercise without restrictions.

PREVENTION

How to Prevent Foot Valgus?

For congenital foot valgus, absolute prevention is generally not possible. The focus should be on avoiding exposure to harmful external factors during pregnancy to ensure normal fetal development. If foot valgus is detected after birth, prompt medical consultation and treatment are necessary to prevent worsening.

For acquired foot valgus, early diagnosis and treatment of the underlying condition are key to better prevention and management.

How Can Foot Valgus Patients Prevent Other Diseases?

Early detection, diagnosis, standardized treatment, and regular follow-ups are essential to minimize the risk of complications.

What Tests Should Congenital Foot Valgus Patients Consider Before or During Pregnancy?

Currently, there are no specific prenatal tests for congenital foot valgus. However, fetal 3D/4D ultrasounds during pregnancy may help detect abnormalities.