Home»»Pronation and Supination?
Identify over pronation and supination and choose the right shoes to support your foot type.
by Brad Walker | First Published April 27, 2004 | Updated April 7, 2019
In this issue we are going to look at some common foot problems that not only affect athletes, but also affect the general population. The two conditions we are going to concentrate on in this issue are pronation and supination.
These two terms refer to the foots natural rolling movement while walking or running.
This motion is sometimes called the running gait, and is described at the New Balance web site as…
“A unique set of actions and reactions that your foot performs while in motion to support, cushion and balance your body.”(Video) Pronation & Shoe Selection
What is Pronation?
Pronation refers to the inward roll of the foot during normal motion and occurs as the outer edge of the heel strikes the ground and the foot rolls inward and flattens out. A moderate amount of pronation is required for the foot to function properly, however damage and injury can occur during excessive or over pronation. When over pronation does occur the foot arch flattens out and stretches the muscles, tendons and ligaments underneath the foot.
The picture on the right (used from the Diversified Integrated Sports Clinic web site) shows a view of the right foot as if looking at it from behind. As you can see in the picture the ankle is over-pronating or rolling inwardly.
What is Supination?
Supination (or under-pronation) is the opposite of pronation and refers to the outward roll of the foot during normal motion. A natural amount of supination occurs during the push-off phase of the running gait as the heel lifts off the ground and the forefoot and toes are used to propel the body forward. However, excessive or over supination (outward rolling) places a large strain on the muscles and tendons that stabilize the ankle, and can lead to the ankle rolling completely over, resulting in an ankle sprain or total ligament rupture.
This time, in the second picture to the right (used from the Diversified Integrated Sports Clinic web site), the foot is over-supinating or rolling outwardly.
Over pronation and supination may cause a number of ailments that affect the foot, ankle, knees, hips and back. Some of the more common symptoms of over pronation and supination are listed below.
- Plantar fasciitis and arch pain
- Ankle sprains
- Shin splints
- Achilles tendinitis
- Heel pain
- Flat feet
- Patellofemoral pain syndrome and other knee conditions
- Hip pain
- Back pain
Prevention and Treatment
Pronation and supination are bio-mechanical problems, and are best treated and prevented with orthotic inserts. But before you run out to buy orthotics it makes sense to get the right advice on footwear, and the best advice I can give you, is to go and see a qualified podiatrist for a complete foot-strike and running gait analysis. They will be able to tell you if there are any concerns regarding the way your running gait is functioning.
After your running gait has been analyzed, have your podiatrist, or competent sports footwear sales person recommend a number of shoes that suit your requirements. Good quality footwear will go a long way in helping to prevent pronation and supination. And, if needed, invest in a pair of orthotic inserts to further prevent over pronation or over supination.
Choosing the right shoes
That brings us to the next point. What should you be looking for when purchasing a new pair of shoes?
- Choose a shoe that suites your running gait and foot type. Money spent at the podiatrist now, for a complete foot-strike and running gait analysis, will save you much heart-ache and discomfort later. Having a shoe that suits your foot type is the best prevention for injury and pain.
- When having your shoes fitted have both feet measured to ensure you get the most appropriate size, and remember, your feet are three dimensional. The length of your foot is only one part of a proper fitting, measure your feet for width and depth to get a better fit.
- When purchasing footwear make your purchase in the later half of the day. Your feet will swell during the normal course of a day, so avoid making a purchase in the morning as you may find that your new shoes are half a size too small by the afternoon.
- When trying on new shoes always wear the socks that you will be using with your new shoes.
- Never purchase tight fitting shoes in the hope that they will stretch or wear-in over time.
Apart from good shoes and orthotic inserts, what else can you do?
- A thorough and correct warm-up will help to prepare the muscles and tendons for any activity or sport. Without a proper warm-up the muscles and tendons around your feet, ankles and lower legs will be tight and stiff. There will be limited blood flow to the lower legs, which will result in a lack of oxygen and nutrients for those muscles.
- Strengthening and conditioning the muscles of the lower leg (including balancing exercises) will also help to prevent ankle and lower leg injuries.
- Flexible muscles are extremely important in the prevention of most ankle and lower leg injuries. When muscles and tendons are flexible and supple, they are able to move and perform without being over stretched. If however, your muscles and tendons are tight and stiff, it is quite easy for those muscles and tendons to be pushed beyond their natural range of motion. To keep your muscles and tendons flexible and supple, it is important to incorporate stretches that will help to correct your biomechanical inefficiencies and imbalances.
Leaning Heel-Back Calf Stretch (1:19) Stand upright and lean against a wall. Place one foot as far from the wall as is comfortable and make sure that both toes are facing forward and your heel is on the ground. Keep your back leg straight and lean towards the wall. Make sure the toes of your back leg are facing forward. Letting your toes point to one side will cause this stretch to put uneven tension on the calf muscles. Over an extended period of time, this could lead to a muscle imbalance. Hold the stretch position for a minimum of 20 seconds and then repeat with the opposite leg.
Kneeling Achilles Stretch (1:27) Kneel on one foot and place your body weight over your knee. Keep your heel on the ground and lean forward. This stretch can put a lot of pressure on the Achilles. Ease into this stretch by slowly leaning forward. Hold the stretch position for a minimum of 20 seconds and then repeat with the opposite leg.
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Research and References
- Walker, B. (2018). The Anatomy of Sports Injuries, 2nd Edition (ISBN: 978-1623172831)
- Porter, D. Schon, L. (2008). Baxter’s The Foot and Ankle in Sport, 2nd Edition (ISBN: 978-0323023580)
- Wikipedia contributors. (2019, January 24). Pronation of the foot, In Wikipedia, The Free Encyclopedia.
- Burns, J. Keenan, A. Redmond, A. (2005) Foot type and overuse injury in triathletes. Journal of the American Podiatric Medical Association, 95(3), 235-241.
- Dahle, L. Mueller, M. Delitto, A. Diamond, J. (1991) Visual assessment of foot type and relationship of foot type to lower extremity injury. Journal of Orthopaedic & Sports Physical Therapy, 14(2), 70-74.
- Lundberg, A. Svensson, O. Bylund, C. Goldie, I. Selvik, G. (1989) Kinematics of the ankle/foot complex – part 2: pronation and supination. Foot & Ankle International, 9(5), 248-253.
- Nielsen, R. Buist, I. Parner, E. Nohr, E. Sørensen, H. Lind, M. Rasmussen, S. (2014) Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe: a 1-year prospective cohort study. British Journal of Sports Medicine, 48(6), 440-447.
About the Author: Brad Walker is often referred to as the "Stretch Coach" and has even been called the Stretching Guru. Magazines such as Runners World, Bicycling, Triathlete, Swimming & Fitness, and Triathlon Sports have all featured his work. Amazon (author page) has listed his books on five Best-Seller lists. Google cites over 100,000 references to him and his work on the internet. And satisfied customers from 122 countries have sent 1,000's of verified customer reviews. If you want to know about stretching, flexibility or sports injury management, Brad Walker is the go-to-guy.
Disclaimer: The health and fitness information presented on this website is intended as an educational resource and is not intended as a substitute for proper medical advice. Please consult your physician or physical therapist before performing any of the exercises described on this website, particularly if you are pregnant, elderly or have any chronic or recurring muscle or joint pain.
Check out these related articles…
- Plantar Fasciitis
- Patellofemoral Pain Syndrome
- Ankle Sprain Treatment
- Shin Splints
- Achilles Tendonitis Treatment
How do I know if my shoes are pronation? ›
You can also look and see how your shoes tilt. If they tilt inward then that's overpronating, outward means under.What shoes should I look for in supination? ›
The best shoes for supination are Neutral shoes. Shoes with a broad base under the foot tend to do a great job as well. Cushion is often helpful to protect the lateral area of the foot from the sustained stress that supination contributes to. Some great options are the Ghost 14 or Dyad 11.Can you have pronation and supination at the same time? ›
Yes! During gait (walking/running), your feet will both supinate and pronate at different moments of your stride. Supination and pronation are both parts of a normal stride. Supination can be experienced during gait, when a person places their body weight on the outside of the foot while walking or running.Do I have overpronation or Underpronation? ›
A good way to check your arches is by doing a wet foot test, simply wet the bottom of your feet and place them on a paper towel, or somewhere it will make an imprint. If your arch area is mostly filled, it's likely you overpronate. If you can't see an arch at all (it's a blank space) you probably underpronate.What is correct foot supination? ›
To correct supination it is important to use an insole with lateral support, or support that runs down the outside of your foot. Proper support from insoles helps ensure that the complex machinery of your feet and ankles are working at optimum efficiency.What does supination look like in shoes? ›
When there is supination, there is uneven wear on the outer part of the shoe, reflecting the stress of a person's stride. People with supination typically have ankle pain and soreness, shin splints, discomfort on the heels and balls of the feet, and can experience calluses and bunions on the outside of the foot.Do you need arch support if you Supinate? ›
Every foot supinates during motion, so to a certain extent, supination is normal. However, excessive foot supination suggests inadequate arch support. Many shoes cater to the needs of those with overpronation and flatter arches, so an arch support insole is helpful for supination or underpronation.Can supinators wear neutral shoes? ›
Runners with supination should choose a pair of neutral running shoes with lots of cushioning as supinators are particularly susceptible to shock-related injuries and commonly get stress fractures. Extra cushioning in the running shoes will help absorb some of the impact from running or walking.What is the average supination and pronation? ›
The elbow joint allows us to perform flexion–extension and pronation–supination movement. According to the literature, values for flexion lie between 130° and 154° and extension between –6° and 11°. Pronation varied from 75° to 85° and supination from 80° to 104°.Which is stronger pronation or supination? ›
Supination is stronger than pronation. In the forearm, the muscles called pronator teres and pronator quadratus are active in pronation. In contrast, muscles called biceps brachii and supination are active in supination.
Why do my feet slide sideways in shoes? ›
It could be due to a number of factors, but usually, it's caused by a muscle imbalance in the feet. If some muscles are weaker and some are tighter, you could be putting more weight on some parts of your feet than others. Supinated feet can also cause pain in the pelvis and lower part of the spine (lumbar spine).What does an over pronated foot look like? ›
Overpronation is a condition in which the foot rolls excessively down and inward. The arch may elongate and collapse (or 'fall') and the heel will lean inward.How to pick shoes for overpronation? ›
Overpronators who are shopping for shoes should also look for pairs with extra cushioning in the heel and midsole as well as medial post support.Are Birkenstocks good for Underpronation? ›
The deep heel cup in Birkenstocks gives you some stability and can also help control pronation (which contributes to flat feet), Sayed says; whereas the average sandal or flip-flop offers little to no support and have flat footbeds.Does Underpronation cause plantar fasciitis? ›
Underpronation is common for those with high arches and can cause issues such as sprained ankles, knee pain, plantar fasciitis, and Achilles tendonitis.What are the signs of supination? ›
- Your Shoes Lean to One Noticeable Side. ...
- Your Bones Fracture and Your Ankle Sprains. ...
- You're Stopped Cold by Shin Pain. ...
- Your Calf and Achilles Are Super Tight.
The anterior tibialis muscle, which runs between the inner leg and the ankle, controls the natural pronation of the foot. Other contributing structures are the extensor digitorum longus and the extensor hallucis longus. When there is weakness in these muscles, the foot begins to supinate excessively.How do I find the best shoes for my feet? ›
- Choose a shoe with a firm foundation. Shoes ground the body like the foundation of a house. ...
- Make sure it has arch support. ...
- Go for laces. ...
- Buy for your foot type and comfort level. ...
- Replace old, worn shoes. ...
- Get help when you have pain.
Excessive supination can lead to excessive strain on the ligament that connects your heel and toes, called the plantar fascia. The result is a condition called plantar fasciitis.Should you see a podiatrist for supination? ›
Supination can also lead to other problems, such as Plantar Fasciitis and Achilles Tendinitis. If you are experiencing any problems with supination, it is important to see a podiatrist for treatment.
Should you wear stability shoes for supination? ›
Avoid stability shoes, which are designed to correct pronation (where the foot rolls inwards). These are rigid on the inner side and will worsen supination. Choose a neutral category shoe instead, which will provide the flexibility you need.What exercises fix foot supination? ›
- Place hands on the wall.
- Move one leg back, a few feet behind the other. Keep both feet firmly on the ground.
- Keeping the back leg straight, bend forward at the front knee. There should be a stretch in the calf muscle and ankle of the back leg.
- Hold this stretch for 30 seconds. Repeat three times on each leg.
A supinator shows wear is mostly along the outside edge of the shoe, closer to the little toe. The change in color shows a lot of wear on the heel. At the toe, you can see almost no wear on the inside to the middle portion of the sole.Do supinators have high arches? ›
Nope, they're not. High arches are arches that are raised more than the median height while supination, also known as underpronation, is when the foot doesn't properly roll inward upon landing. Though they're not the same, supination is often caused by high arches.What does supination pair with? ›
Pronation and supination are a pair of unique movements possible only in the forearms and hands, allowing the human body to flip the palm either face up or face down.What are the benefits of supination? ›
Benefits of a Supinated Grip
The supinated grip can handle more weight due to the recruitment of the bicep and tricep muscles as it allows lifters to pull more weight down to engage the lat muscles. This grip can maximize the contraction and elongation of the lat muscles needed to build a stronger back.
Excessive supination can cause: Ankle injuries. Knee stress and pain. Back and hip pain.Which is an example of supination? ›
Supination is the movement in which a person turns their hand, wrist, and forearm upward. Turning your hand over to receive money is an example of supination.Why is pronation and supination important? ›
Pronation-supination, the rotation of the forearm around its longitudinal axis, is an important motion because it allows the hand to be oriented, allowing one to take food and carry it to the mouth, perform personal hygiene, and live autonomously.Can supination cause arch pain? ›
If you underpronate while you walk, you may notice arch pain, heel pain, and even back and knee pain because of the additional stress this abnormal gait places on the body. Over time, supination can also result in plantar fasciitis, bunions, heel spurs, sprained ankles, stress fractures, and tendonitis.
Can shoes fix pronation? ›
No running shoes or custom orthotics can eliminate excessive pronation. You need physical therapy and gait retraining. Working with a chiropractor and doing physical therapy exercises are the best ways to realign your body and correct your gait and overall movement.How should your feet look when lying down? ›
The Position of Foot Drop – The normal, relaxed position of the ankle is with the foot in a downward position, away from the body. This position is commonly referred to as foot drop and is most evident when lying in bed.What are the symptoms of supination? ›
Supination (or underpronation) is when your weight rolls onto the outer edges of your feet rather than slightly inward as it should. This results in you pushing off with your smaller toes at the end of your stride rather than with the ball of your foot and big toe. Excessive supination can cause: Ankle injuries.What does overpronation look like? ›
Overpronation means that your foot rolls inward as you move. If you overpronate, the outer edge of your heel hits the ground first, and then your foot rolls inward onto the arch. Pronation refers to the flattening of your feet. So, if you overpronate, you overly flatten your feet.What problems can supination cause? ›
Supination can create extra strain on the ligament connecting your heel and toes, known as the plantar fascia. The result? Plantar fasciitis, a painful condition characterized by a sharp stab or deep ache in the middle of the heel or along the arch of the foot.Is plantar fasciitis Underpronation or overpronation? ›
While overpronation is usually the culprit when it comes to plantar fasciitis and heel pronation, some people suffer from underpronation, or supination, which happens when the foot doesn't roll inward far enough. This condition is usually the result of high arches, rather than flat arches.Does supination mean high arches? ›
Are High Arches The Same As Supination? Nope, they're not. High arches are arches that are raised more than the median height while supination, also known as underpronation, is when the foot doesn't properly roll inward upon landing.What are the three movements of supination? ›
“Supination is a combination of three movements at the foot – known as plantar flexion, inversion, and adduction,” says Yau.How do you correct walking on the outside of your feet? ›
- Select lightweight shoes with extra cushioning and ample room in the toes.
- Wear running shoes specifically designed for underpronators or supinators. ...
- Wear orthotic insoles designed for underpronation.
Overpronation is linked to several conditions and symptoms, such as: Achilles tendinitis: This happens when you put stress on your Achilles tendon. Bunions: Bunions are painful bony lumps on the outside of your big toe. Heel pain: You can have pain behind, beneath or within your heel bone.
Can supinators wear stability shoes? ›
Avoid stability shoes, which are designed to correct pronation (where the foot rolls inwards). These are rigid on the inner side and will worsen supination. Choose a neutral category shoe instead, which will provide the flexibility you need.What movements make up foot supination? ›
In supination, the calcaneus and foot move through a combination of inversion, adduction, and plantar flexion in relation to the fixed talus.What shoe shape for plantar fasciitis? ›
Wedges are always a great option when you're looking for a lift, but they're also ideal for addressing some of the foot pain that comes along with plantar fasciitis. "Small wedged shoes can often make people feel better when wearing the shoe.What side of the foot is plantar fasciitis? ›
What is plantar fasciitis? Plantar fasciitis affects the bottom of the foot, most commonly causing pain in the centre and inner side of the heel. It's caused by damage to the strong band of tissue, called the plantar fascia, which runs from the heel, beneath the arch of the foot to the base of the toes.What is the best resting position for plantar fasciitis? ›
Consider night splints. Most people sleep with their feet pointed down, which relaxes the plantar fascia during the night and causes early morning pain when you suddenly stand up and stretch it. Night splints work by stretching your foot arches and calves while you sleep.