Look up the term “pronation” and it will be easy to get confused. You can overpronate and you can underpronate. You can even pronate your hands. Does pronation recall the barefoot tribes and ultra-athletes Or flat feet and fallen arches? Is good or bad? In this article, you’ll learn what pronation is and what it means for your running.
What is pronation?
Pronation refers to the rotating movement of the foot at the ankle so that weight is transferred to the inside edge of the foot (the big toe side). Imagine your ankle pushing inward.
Supination is when the foot rotates in the opposite direction, with weight transferred to the outside edge of the foot (the little toe side). Imagine your ankle pushing out.
To better understand the movement, try standing on one leg and shifting your weight from left to right. As your foot rotates to maintain balance, pronated and supine
Although pronation has negative connotations, some degree of pronation is normal and healthy when walking and running. Only insufficient or excessive pronation causes problems in our feet. Too little (low-pronation) or too much (on-pronation) is detrimental to joint health and running performance.
Like so many things, pronation is best in moderation. Pronation that improves shock absorption and running performance as part of a natural running style is known as neutral pronation.
In neutral pronation, our feet are slightly rotated inward (supinated) on contact with the ground – meaning the outside edge of the foot hits the ground first.
As our body weight moves over the foot, the foot rotates downward and outward so that the entire foot is in contact with the ground. This is pronation. At this point in midstance, the foot is now in a neutral position, neither pronated nor supinated, and flat against the ground.
This movement from a supinated position in contact with the ground to a neutral position in mid-stance is a natural part of the gait cycle. This is known as neutral pronation, essential for effective shock absorption during running.
For some, the foot turns out too much. This is overpronation and is more common than underpronation. Excessive or overpronation transfers weight to the inside edge of the foot, including the big and second toes. As the foot rolls outward in overpronation, the arch of the foot flattens. Over time, this can cause or exacerbate flat feet. This affects weight transfer and balance during running and power transfer during takeoff.
Overpronation can cause injury by increasing the risk of heel spurs (bony structures that grow under the foot from the heel) and plantar fasciitis (pain and inflammation in the band that runs from the heel to the front of the foot). A flatter foot is less rigid, which puts more pressure on other joints and muscles, including the tibialis anterior. Tension of this muscle can cause leg cramps. Overpronation also disrupts the rotation of the tibia (shin bone), which can cause various types of knee injuries through overloading.
A smaller group of people are “underpronators,” also known as “supinators.” In other words, your feet turn inward, putting pressure on the outside edge (pinky toe) of the foot. Runners who underpronate often have a pronounced high arch.
The problem with underpronation is that the forces are not distributed throughout the entire contact of the foot with the ground as is the case with neutral pronation. Instead, ground contact forces are absorbed by smaller, weaker structures in the foot, such as the little toe. This type of gait puts additional pressure on the plantar fascia, tibia, and knee, increasing the risk of Common running injuries.
How do I know if I’m overprone or underprone (supine)?
Now to the important question. What is my foot type? Am I a pronator or a supinator? Here are two simple methods to help determine if you are overpronated or underpronated.
The wet footprint test
Walk on a flat, dry surface with wet feet. Dry concrete or cardboard work well for this. Your footprints show which parts of your foot come into contact with the ground. If the footprint is wide/oval without an obvious dry area where the arch of the foot should be, this indicates overpronation and flat feet.
If the footprint shows a curved connection between the heel and toe, this indicates a neutral/normal amount of pronation, with a normal arch.
If the foot strike shows little or no connection between the heel and forefoot, this indicates underpronation (supination) and a high arch that does not touch the ground.
The wear test
The next test you can do to determine if you have underpronation or overpronation is to check the wear on the soles of your shoes.
Wear on the inside edge of the heel and big toe indicates overpronation. Wear on the outside edge of the foot from the heel to the little toe indicates underpronation, also known as supination. For neutral pronation, the wear is shown in an S shape, from the outside of the heel to the big toe.
Running gait analysis
For best results, professional gait analysis gives you accurate information about your pronation when you run. Running gait analysis is typically performed by capturing slow motion images of treadmill race from different angles. Motion analysis software is used to calculate joint angles and distances to provide accurate data.
With proper guidance, gait analysis can help you adjust your running technique and Choose the right running shoe. Running gait analysis is becoming more available and is often a free service that comes with shoe fitting.
You can perform your own gait analysis with the help of video analysis apps, although be sure to double-check your findings with a professional before making any big changes.
How do I correct overpronation or underpronation (supination)?
In most cases, overpronation and underpronation can be corrected non-invasively and inexpensively.
Well-fitting shoes with arch support can help achieve neutral pronation. A wide variety of insoles and inserts are available to correct pronation problems. These can help relieve pain and improve heel alignment when walking and running. Kinesiology tape to support the foot is also an effective way to control foot pronation.
Simple foot strengthening exercises and barefoot running can help correct overpronation by strengthening the arch of the foot. Try the exercises below as part of your training routine:
‘Crunch’ or flex your foot to bring your heel and toes together. Hold this position for two seconds. Repeat for eight repetitions and three sets.
In a standing position, lift your heels off the ground and hold for two seconds. Repeat for eight repetitions and three sets.
In more severe cases, overpronation and flat feet may require custom orthotics, pain medications, ice, physical therapy, and as a last resort, surgery. This may be the case if you have had foot problems for a long time or if an injury and scar tissue has affected the mobility of your foot.
What shoes are best for overpronation and underpronation (supination)?
Shoe choice is a big problem for runners. Running shoes are believed to be simultaneously the root of poor performance and injuries and the source of success and healing. Barefoot evangelists preach “natural” and uncushioned techniques. Podiatrists prescribe arch support and corrective braces. Both agree that achieving neutral pronation relieves pain, reduces injuries and improves performance.
A popular way to achieve neutral pronation is to wear shoes that actively encourage it. They typically incorporate motion control features, such as arch support to prevent overpronation or lateral support to prevent underpronation (supination).
While these features may relieve pain in the short term, it is unclear whether they reduce injury in the long term. In some studies on motion control footwear, injury rates were reduced.(3 4)while in others, they remained unchanged(5,6) or potentially increased.(7) To further complicate matters, one study found that pronators who wore neutral shoes without motion control had the lowest injury rates.(8)
One criticism of cushioned and supportive shoes is that they reduce sensitivity to the running surface and weaken the foot by providing support instead of bones, muscles and connective tissue. This is counterproductive from an injury perspective.
An alternative solution is to wear shoes with less cushioning or barefoot running. This can help strengthen the arch of the foot and correct overpronation naturally. Unfortunately, there is very little evidence to show whether this results in fewer injuries.
Contradictory evidence proves one thing; The relationship between foot type, performance and injury is complex. There are no one-size-fits-all solutions to pronation problems. Except maybe for the ‘comfort filter’.
Recent evidence suggests that runners intuitively select the most appropriate footwear for injury prevention and performance based on comfort.(7,8) After all, discomfort is a good indicator of when something isn’t right.
So until there is a definitive answer, choose shoes that are comfortable for you while still allowing sensitivity to the running surface.