Pronation and Supination

Posted on 11 April 2011

During walking and running, pronation and supination normally occur in the foot. Pronation is important for optimal movement and shock absorption. During foot strike, many changes take place—the foot begins to roll inward, everting slightly, and the arch flattens. This is called pronation. It is a normal action—one that occurs in every step in every healthy foot. The purpose of this is to loosen the foot so it can adapt to the surface, especially on uneven terrain.

Following pronation, as the foot continues through its gait, supination occurs. This results in the foot turning slightly outward then changing from a flexible foot to becoming rigid so it can propel the foot and push off from the ground. During this phase the foot inverts slightly, and the arches become higher, thus enabling the foot to properly roll over the big toe.

A number of factors can disrupt a person’s normal gait. The two most common reasons are muscle imbalance and wearing stiff, over-supported shoes. Sometimes, areas above the foot, such as the pelvis or spine, can abnormally influence foot function. For example, too little or too much hip rotation can cause the foot to land in an abnormal position. In addition, injury, pain, and other problems that affect blood flow, cause inflammation, or disturb muscle function in the foot can abnormally alter the gait.

Most shoes change the gait by causing the stride length to become abnormally longer. This causes an abnormal heel strike—hitting the ground farther back on the heel. It’s especially a problem during running, as the longer stride places more shock through the foot and into the knee, and occurs despite shoe cushioning or what is commonly called a “heel crash pad.” Barefoot movement does not cause the same stress.

The notion that some people are “pronators” while others are “supinators” is a gross oversimplification that fitness magazines, shoe stores, and footwear manufacturers foist upon the public in an attempt to sell shoes.  It’s mostly all marketing hype.  Everyone pronates and supinates. The reason some people excessively pronate or supinate is more often from wearing over-supported shoes, which cause muscle imbalance. This is especially a problem in children whose feet need to properly develop without shoes.

More importantly, an attempt to “help” a poorly functioning foot with a particular type of shoe or orthotic insert is an example of treating symptoms; most cases of foot dysfunction are usually due to muscle imbalance. Keeping the foot in a rigid, immobile position can actually promote foot imbalance by not allowing the body to naturally correct the problem.  --by Dr. Phil Maffetone

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17 Responses to “Pronation and Supination”

  1. Joseph Fox says:

    I have chronic heel/arch pain and have been diagnosed with plantar faciatis. The discomfort is most pronounce upon arising from bed or from exiting a car after a drive of over 1/2 hour. However, the discomfort also occurs at other times as when I am standing in line a a market or when sitting with a book or watching tv. I have heeded advice to not go barefoot, to do stretches and to wear supportive shoes. I have had shots in both feet and have tried taping for extra support. The discomfort persists.

    Would going barefoot exacerbate my condition or do you think it may have the potential of helping?

    • Tiff says:

      going barefoot would indeed exacerbate your condition it streches the tendant. go to the walking company great shoes for plantar faciatis

  2. Kristin says:

    Joseph, if you do some research on barefoot running, you will find a plethora of anecdotal evidence regarding it’s benefits, including people who have been plagued with chronic foot problems, including PF. The idea is that the muscles in people’s feet are so atrophied from over-support, and that cushioned shoes force your body into unnatural positions and gait, that injuries and chronic pain are hard to avoid. Studies have shown that the more expensive a shoe runners wear (and therefore more cushioned and supportive), the more injuries occur.

    Read up on barefoot running, start off SLOW (switching from shod to barefoot is a huge change, ease your feet into it!), and give it a try!

  3. Marisa says:

    Right on, Kristen! PF has many root causes. If the foot is not used to being “barefoot” or close to it, it is most likely in a “weakened” state. Joseph, continue looking into why you developed PF in the first place. You’ll certainly find some answers. And as many have found…minimalism is a great treatment, so-to-speak, when one enters into it gradually.

  4. I thought I would post a question in hopes of some feedback. I run almost exclusively in Vibram Bikilas doing distances from 5k to 13.1m. I haven’t had any injuries since I switched to a more minimal shoe, but I recently saw a picture of my feet landing and noticed that I tend to supinate (at least on my left foot; I don’t have evidence of the right foot). My question is: given that I am already running in minimal footwear, is this a problem of my own mechanics? (I do have tight IT bands on both legs which I try to stretch, but no injuries since ditching conventional shoes.)

    Perhaps this isn’t even an issue, and the supination is just part of my natural running form, but having never seen myself land this way I am curious for an outside opinion. Thanks.

    • MarkC says:

      Jonathan,
      this is normal and varies from person to person. you land supinated, then pronate, and re-supinate for toe off. if happy and healthy all good.

      Mark

  5. Janet says:

    I had a partially torn achilles tendon in my right leg and apparently have less movement in my right hip due to an injury 20 years ago. There seems to be some debate as to whether I am evincing pronation or supination (!) but occasionally I have knee pain and pain at the insertion point in the foot of the tibial tendon. Does anyone have any experience of similar ?

    • stephanie says:

      hi Janet

      its a long time since your post. i am a 3rd year student of the Feldenkrais Method of Movement education and from what i have seen, felt, learnt, it may pay you to attend classes or see a Feldenkrais Practitioner who could help you understand and re-adjust your skeletal connections. this could help balance your hips and therefore your feet.

  6. marg says:

    I’m new to BF walking/running and to this site. I was plagued with PF for years. Sometimes it was so bad I could hardly put my foot down on the floor when getting out of bed in am. Taping does work, but the tape has to to stay on for a few days at a time. Orthotics or anything with arch support, in my experience, was the worse thing since the support is rubbing against an already irritated ?tendon. The most effective and by far cheapest treatment is to buy toe-spacers (used for painting toenails)and start off walking with those on for just a minute if possible. No longer than 2 minutes. Will be painful. Get the more expensive silicone type as they are more comfortable. Marg

  7. david todd says:

    Male 56 long time runner (heavyweight) – these days when I run and let my feet roll inward my knees will hurt. If I keep myweight on the outside of my feet as I run my knees seem not to hurt. Shoes vary from low cost training shoes to sometimes NB Trail shoes. Any hints?

  8. Tony says:

    I’ve tried everything. Padded shoes, vibrams, just can’t shake it. Recently I’ve used the POSE method which helps a lot but I still can”t run more than 1 or 2 times a month. I’ve wanted to get in to the military for years but could never get my run times down since it took me 2 weeks to recover. I was doing PT test for special operations jobs and could ace the whole test except for the run. I have enough cardio to muscle out a 7:30 mile but then I can barely walk for a week. If I look down when I run, my feet are sideways in the air.

    Every once in awhile, I’ll do a 5 mile trail run pain free. But after my last run it feels like someone took a knife to all the muscles and tendons around my ankle. Nowadays I mostly hit the weights and do Insanity workout which doesn’t hurt as much. I do 2 insanity videos in a row 2-3 times a week. Usually have some calf soreness but no pain unless I run.

    I don’t remember being like this as a young athlete so what happened? Sometimes if I jog across the crosswalk I get a calf burn that feels like I just ripped something. I’ve read enough running books to write my own. Vibrams have cut the pain in half but I still can’t run more than twice a month. I do have adrenal issues, (low cortisol)

    Any guesses, suggestions, experience? Thanx

  9. Ecov says:

    I injured my sesamoid bones jumping off my kitchen counter (I can’t reach my 3rd shelf!). I am still in a boot for another week while it heals but I am nervous to run as I can barely walk yet. I read that some people with chronic sesamoiditis run barefoot which alleviates pain. Any idea if this will work for an acute injury? I have flat, wide feet and a small frame. If you had to pick a shoe to run in, what might it be?

  10. TammyW says:

    I started running more than a year ago. Shortly after starting, the inside of my knees swelled so much and were painful on my run that I had to stop until it healed. Then I tried again, and knees became painful during run again. My SIL (who has ran for years) told me that I should go to a running store because it sounded like maybe I was over-pronating. I got some shoes after the sales person watched me run on a treadmill and haven’t had a problem since. If there were exercises or something I could do to fix the problem, I would be interested in learning about them. I didn’t see any advice in this article.

  11. Liana says:

    I just bought my 4th pair of running shoes in the past year because I am having extreme burning and pulling in my arches when I work out. I have never really been one to exercise so I get that my weight and lack of muscle would be a huge contributing factor however, if I take my sneakers off, the pain stops within seconds. Today them gentleman told me I have flat arches and serious pronation and fitted me in a pair of Saucony stability sneakers with Superfeet inserts and u was feeling quite hopeful but then I stumbled onto this site…please are you serious that I’m destined for chronic arch and foot pain evertime I exercise? Please help, I’m tired of wasting money…thanks

  12. Simon says:

    Reading this article one would have to wonder what kind of doctor he is. With most joints in the body you can help an injury by strengthening and stretching the muscles (ACL,MCL,LCL,Labrom,Piriformis)supporting the joint and the body will usually repair itself or compinsate, exceptions are of course complete tears. I see 40-60 patients a day most are runners and athletes, many of them are experiencing simple problems like planter fasciitis, others knee, hip, back or shin pain. Many times the cause is Flat Feet, which will not heel or be repaired. It will only cause more and more pain throughout the body because your body is not alligned properly from the feet up. Although I cannot fix the flat feet I can put them in the proper position and help eliminate the pain in the rest of the body. Unfortunately many of my patients are the result of trying Natural running.


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