Overpronation vs. supination: What they mean and why they matter

When you walk, do you know if your feet overpronate or supinate? Furthermore, do you know why this type of information matters?

Pronation defined

Pronation refers to how your foot rolls when you walk or run on it. If you have normal pronation, when you step, the outside area of your heel touches the ground first, your foot rolls slightly inward (around 15 percent), and you use the entire front of your foot to push off the ground. As explained by Runner’s World, if your foot arch is normal (not too flat and not too tall), it is likely that you are a normal pronator.¹

On the other hand, if you overpronate, your heel still touches the ground first, but your foot rolls in more than is normal, causing your big toe and second toe to carry a brunt of the responsibility for finishing the walk movement. This puts excessive pressure on your foot and ankle as they try to balance you and most often occurs when the arch in your foot is too flat. If you overpronate, you may notice that your inner ankle bone sticks out much further than your outer ankle bone.¹

Finally, supination, sometimes referred to as underpronation, involves your foot rolling in less than the normal 15 percent and your push-off being handled primarily by your little toes as opposed to the entire front of your foot. This puts undue pressure on the outside of your foot, and typically is found with people who have excessively high foot arches.¹

Why pronation matters

In an article published by Podiatry Today, David Levine, DPM, CPed, wrote, “Everyone pronates and everyone supinates. It is a matter of how much and when each occurs that determines whether lower extremity problems will occur.”²

The Department of Orthopaedic Surgery at the University of California, San Francisco indicated that the damages of overpronation or supination can be twofold. First, the improper pronation can cause your body’s weight and landing force to be unequally distributed across your foot, creating greater amounts of pressure on certain areas of your feet. Second, your muscles are required to work harder due to your abnormal foot function, potentially creating issues by increasing the stress placed upon them.³

Improper foot pronation can result in foot problems and injuries such as shin splints, Achilles Tendonitis, plantar fasciitis, heel spurs, bunions and more. It can even be the cause of pain in your knees, hips, back, and shoulder areas.³

The solution

If you have foot-related issues and suspect that your foot pronation may be to blame, making an appointment with your podiatrist is the first step to finding both the cause and the cure to your problems. With a few custom made orthotics, your foot’s biomechanical function can be normalized, potentially providing you with some much-needed relief.³

For overpronation or supination that is relatively mild, functional orthotics are typically recommended to help your feet progress through the walk cycle normally. However, if your overpronation or supination is moderate to severe, then functional orthotics are probably necessary to ease any foot-related issues you may be currently experiencing, as well as to help prevent further damage to your feet and other areas of your body.³

References

¹ Runner’s World. “Pronation, Explained.” RunnersWorld.com. http://www.runnersworld.com/running-shoes/pronation-explained?page=single. Published February 2005. Accessed February 2015.

² Levine D. How to address pronation-related pathology. Podiatry Today. 2006:19(6)

³ Department of Orthopaedic Surgery. “Pronation and orthotics.” University of California, San Francisco Medical Center. http://orthosurg.ucsf.edu/patient-care/divisions/sports-medicine/conditions/ankle-and-foot/pronation-and-orthotics/. Accessed February 2015.