Excessive pronation has often been associated as a predisposing factor for several lower extremity overuse injuries. Research has investigated the causes of these injuries and their association with various degrees of pronation, finding a positive correlation with excessive pronation and injury in the lower extremity. One field of research that has not been heavily investigated is the improvement of the biomechanical efficiency of the foot and an overall reduction in excessive foot pronation with specific muscular strengthening.
Identifying abnormal foot pronation will only inform the runner of their increased risk for injury, and has no practical application of improving their biomechanical efficiency sooner or later. It has also been commonly associated that with increased work and fatigue, the degree of pronation will increase as well, indicating muscular fatigue of supporting lower extremity muscle groups. Examining the strength and endurance of those muscles may provide insight into training techniques, decreasing the amount of overuse injuries during training.
Another study examined the anatomical differences between two groups, one with an accessory navicular bone and the other with normal feet. The findings were the group with the accessory navicular bone had a tibialis posterior tendon that inserted directly into the accessory navicular bone, without any continuation to the sole of the foot. These abnormalities were not found in the control group.
The tibialis posterior assists in plantar flexion and plays a key role in supporting the medial arch. This muscle besides the peroneous muscle in the lateral leg and foot provide stability to the ankle on uneven surfaces and are also known as the "stirrup muscles." There are three basic movements targeted to strengthen the muscles surrounding the ankle and the supporting structures.
Excessive foot pronation has been associated with the risk of overuse injury in running for several years. Limiting the amount of biomechanical abnormalities in running will allow athletes and runners to train with a reduced risk of injury occurrence. That is why previous research has focused heavily on how to "control" excessive pronation through orthotics and motion control footwear. A more proactive approach to correcting overpronation concerns will be to physically alter the anatomical muscles involved in foot pronation to reduce biomechanical inefficiencies and increase overall muscle strength and endurance.
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