Underpronation, also known as supination, is a foot-positioning problem encountered by runners and other athletes who run during their sport. However, according to a 2011 article from Mark Charrette published in Dynamic Chiropractic, “High-arched feet, referred to as excessively supinated feet, are not nearly as common as overpronated feet.” Though it's a defect that affects a relatively small amount of runners, it's important to understand the causes, the diagnosis and how to treat it properly so that you can more safely and efficiently.
1. Know the Difference Between Pronation and Supination
Both pronation and supination are issues signified by the way your foot hits the ground as you are running or walking. But while pronation involves and inward roll of your foot and ankle, supination is the outward rolling of your foot and ankle. In a pronated foot, the inside part of your foot and the arch absorb most of your weight as you land. A supinated foot, on the other hand, means that the outer edge (pinky-toe side) bears the majority of your weight. Neither foot position is healthy for your feet or ankles, as both can cause serious pain and injuries.
2. Find Out the Causes of Underpronation
“Underpronation occurs during running or walking when the foot does not flatten out effectively,” explains Geoffrey Alan Gray, president of Heeluxe, LLC, and biomechanics expert for Ahnu. “The causes of underpronation can come internally from our body or externally from our shoes or the surfaces we are on.”
It's important to decipher which of these factors are contributing in order to treat the root of the problem. Gray says internal causes can include rigid joints, alignment problems in the heel or the ball of the foot or strength and flexibility imbalance in the ankle. When you naturally underpronate, the muscles and joints in your feet are working to try to correct the imbalance. This can lead to issues in other joints like your knee and hip and even injuries. On the other hand, external causes may include unstable or worn-out footwear or running on uneven surfaces.
3. Avoid the Effects of Underpronation
Other issues from overcompensation include stress fractures, which is the most serious effect of underpronation, according to Gray. “Other effects include high risk for overuse injuries, such as tendonitis and muscle strains,” he says.
A 2012 study in the Journal of Foot and Ankle Research found that foot posture can be linked to increased incidence of lower limb injuries in runners. Though the study authors were not able to include foot orthotic wearers in the study, they reported “supinated feet appeared to be related to higher rates of injury than pronated feet.”
4. Learn to Spot Underpronation
Since it's hard to see how your foot lands as you run (you should be looking ahead, after all), you may want to find a professional to help analyze your gait and let you know if you underpronate. However, there are other ways to tell if your feet tend to position themselves this way.
“The easiest way to spot if you underpronate is to look at the wear pattern on the rubber on an old pair of shoes,” says Gray. “Someone that underpronates will show wear on the outside/lateral portion of the shoe, whereas a neutral striker will show wear in the midline of the shoe, and someone that overpronates will have wear on the inside/medial area of the rubber.”
When consulting a professional, such as a physical therapist, running coach or trained running store employee, it's helpful to bring in an old pair of running shoes. In addition to looking at the wear on the bottom of your shoes, they'll use their gait-assessment skills to watch you walk or run and determine if you're under or overpronating.
5. Work to Correct Underpronation
The steps you should take to correct underpronation depend upon the severity and causes of the defect. It might be as easy as changing to a new pair of shoes, should your underpronation come from external causes. However, if caused internally, it's much harder to correct.
“[If caused internally] it's typically difficult or not possible to change underpronation,” says Gray. “[This is because it's] based on your bone structure, muscle-firing patterns or running/walking stride.” Should it be due to your stride, you can work with a running coach to not only improve your stride but to get exercises that can help improve your running form. These might include ankle, calf, hamstring and quad stretches or inner thigh and calf exercises to strengthen the surrounding muscles.
What Do YOU Think?
Are you a runner? Have you ever gotten a gait analysis? Do you pronate or supinate while running or walking? What steps have you taken to correct your gait? Did you know some of these facts about underpronation? Were any surprising to you? Share your thoughts and questions in the comments section below.