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Understanding pronation / supination and why it matters

Introduction

Did you know that about half runners are pronators, and very few are supinators? And you, do you know how you run?

Pronation is an essential factor in understanding your stride. But what is it? Why is it important? What are the different types of pronation? And how can you determine if you have a pronator, supinator, or neutral foot? To learn more, check out our guide on pronation below.

Definitions

Pronation movement: what is it?

Pronation refers to a complex movement of the foot and ankle during walking or running. This natural motion occurs as the foot rolls properly through its stride. It involves various internal movements that help absorb shock and adapt to the surface (Genova and Gross 2000). These movements take place during heel strike, mid-stance, and push-off. Depending on how you walk or run, these movements can vary, indicating one type of pronation over another. This is referred to as a pronator, supinator, or neutral foot.

In other words, pronation describes the rotation of the foot from the moment it makes contact with the ground to the propulsion at the end of the stride.

My foot is…

Neutral

A "normal" foot is slightly in supination at the beginning of the heel strike, in pronation at mid-stance, and once again moves into supination during the push-off phase (Kannus 1992). In other words, a neutral foot lands on the outer edge of the heel, then rolls inward to evenly distribute impact and weight across the foot.

Pronator

A pronator foot lands on the outer part of the heel when it makes contact with the ground. It then rolls inward to push off using the big toe.

Supinator

A supinator foot lands on the outer part of the heel when it makes contact with the ground. It then rolls very slightly, but the majority of the weight remains on the outer edge of the foot. The push-off is then carried out using the smaller toes.

A pronator or supinator foot is not necessarily linked to poor posture or an increased risk of injury. It simply reflects our unique way of moving. However, excessive supination or pronation, known respectively as hyperpronation and hypersupination, has a direct impact on other joints in the body and can lead to injuries (de Oliveira et al. 2013).

Hyperpronation

Hyperpronation or overpronation is described as excessive pronation (collapsing of the foot inward) during walking and running. Overpronation occurs when the foot lands on the outer edge of the heel. Instead of transferring the impact of the landing to the sole of the foot, the foot shifts the impact too far inward. It is said that the foot "collapses" during mid-stance.

Hyperpronation increases the risk of foot and leg injuries (Hreljac et al. 2000). However, hyperpronation can be corrected with muscle strengthening exercises, such as proprioception training. The use of orthotic insoles, after consultation with a specialist, can also help correct overpronation.

Hypersupination

Hypersupination or underpronation is described as excessive supination (foot orientation outward) during walking and running. Underpronation occurs when the foot lands on the outer edge of the heel. Instead of transferring the impact of the landing to the sole of the foot, the foot remains on the outer edge of the foot until push-off.

Hypersupination increases the risk of foot and leg injuries. However, hypersupination can be corrected with muscle strengthening exercises, such as proprioception training. Orthotic insoles can also help correct underpronation.

Analyse de la pose de pied

Gait analysis

Stride analysis is the best way to determine your foot type.

Pronation is difficult, if not impossible, to study on your own. In fact, this movement occurs at the back of the foot, and an angle calculation at the rear of the foot is necessary to determine the pronation style.

Ochy offers an analysis of pronation movement to determine if a foot is pronator, supinator, or neutral. All you need is a short video of your walk or run filmed from behind, lasting just a few seconds.

The “Pronation” feature of the Ochy app allows you to analyze a video taken from behind and indicates whether you are a pronator, supinator, or neutral.

The pronation analysis with Ochy objectively identifies the type of pronation based on scientific references.

Shoe Wear Guide

Wear of pronators

The wear is mainly located on the inside of the heel, under the ball of the foot, and at the big toe.

Wear of neutrals

The wear forms an "S" shape, starting from the outer edge of the heel to the big toe.

Wear of supinators

The wear is mainly located on the outside of the heel and along the outer edge of the front of the foot.

Tips to avoid hyperpronation/hypersupination

Hyperpronation and hypersupination can impact other aspects of the stride, particularly the movements of the lower limbs, and may lead to injuries. How can you avoid excessive pronation or supination?

1. Knowing and understanding your gait

Each stride is unique and complex, involving numerous joints. It is essential to identify your stride, especially when running. Indeed, poor positioning can affect other parts of the body and lead to injuries.

The Ochy app also offers the ability to analyze your running style in just 60 seconds by recording a video with your smartphone. The artificial intelligence identifies your strengths and weaknesses and provides suggestions for improvement.

2. Renforcer son pied

The foot is a complex part of the body, consisting of many bones and muscles that allow several joints to move. It is especially engaged during walking and running, and its strengthening is essential to make proper use of its functions.

There are several exercises to strengthen the foot (non-exhaustive list):

  • Proprioception: Movements that strengthen the muscles involved in balance. Barefoot practice engages the muscles and tendons of the foot more.
  • Walking barefoot: Helps the foot adopt a natural posture while strengthening it. Barefoot shoes also exist to move barefoot without injuring the arch.
  • Stretching: Improves the flexibility of the toes, which are heavily used during walking and running, especially during propulsion.
  • Muscle strengthening: For the entire body, with a particular focus on the legs. It helps with stability during movement.

3. Wearing Properly Fitted Shoes

Foot pronation is altered when wearing shoes (Silva et al. 2020). Although it has not been proven that wearing shoes suited to the type of pronation corrects the movement at the back of the foot (Silva et al. 2020), choosing the right type of running shoes remains important.

Running is a physically demanding activity for your joints. Running shoes that are adapted to your training intensity help prevent injuries (Xiang et al. 2022).

4. Consult

In the case of hyperpronation or hypersupination, it may be helpful to consult a specialist (podiatrist, sports doctor, physiotherapist). They can first analyze your stride, suggest appropriate rehabilitation exercises, and even recommend orthotic insoles.Orthotic insoles can help correct excessive pronation or supination during walking or running.

Health Risks

As mentioned above, pronation and supination can be characteristic of a stride without posing a risk of injury. However, an excessive pronation angle, leading to overpronation or underpronation, can result in injuries or changes in posture during walking or running.

Possible injuries in case of hyperpronation

  • Anterior knee pain
  • Heel pain (Willems et al. 2021)
  • Joint pain in the lower legs (Willems et al. 2021)
  • Lower back pain (Moussavi et al. 2024)
  • Achilles tendonitis
  • Shin splints
  • Toe deformities
  • Blisters

Possible injuries in cas of hypersupination

  • Bone stress injuries
  • Achilles tendonitis
  • Plantar fasciitis
  • Ankle sprain
  • Douleur au tibia

Conclusion

Pronation is a complex movement of the foot. Understanding your stride and knowing your type of pronation helps identify the areas of the body that need strengthening. The goal is to prevent injuries and optimize your movement for performance.

References

  • Genova, J. M., and M. T. Gross. 2000. ‘Effect of Foot Orthotics on Calcaneal Eversion during Standing and Treadmill Walking for Subjects with Abnormal Pronation’. The Journal of Orthopaedic and Sports Physical Therapy 30 (11): 664–75. https://doi.org/10.2519/jospt.2000.30.11.664.
  • Hreljac, Alan, Robert N. Marshall, and Patria A. Hume. 2000. ‘Evaluation of Lower Extremity Overuse Injury Potential in Runners’. Medicine & Science in Sports & Exercise 32 (9): 1635.
  • Mousavi, Seyed Hamed, Fateme Khorramroo, and Amirali Jafarnezhadgero. 2024. ‘Gait Retraining Targeting Foot Pronation: A Systematic Review and Meta-Analysis’. PLOS ONE 19 (3): e0298646. https://doi.org/10.1371/journal.pone.0298646.
  • Oliveira, Vinicius Machado de, Guilherme Cesca Detoni, Cristhian Ferreira, Bruno Sergio Portela, Marcos Roberto Queiroga, and Marcus Peikriszwili Tartaruga. 2013. ‘Influence of Slope on Subtalar Pronation in Submaximal Running Performance’. Acta Ortopedica Brasileira 21 (3): 163–66. https://doi.org/10.1590/S1413-78522013000300007.
  • Silva, Érica Q., Andreia N. Miana, Jane S. S. P. Ferreira, Henry D. Kiyomoto, Mauro C. M. E. Dinato, and Isabel C. N. Sacco. 2020. ‘The Association Between Rearfoot Motion While Barefoot and Shod in Different Types of Running Shoes in Recreational Runners’. Journal of Sports Science & Medicine 19 (2): 383–89.
  • Willems, Tine Marieke, Christophe Ley, Els Goetghebeur, Daniel Theisen, and Laurent Malisoux. 2021. ‘Motion-Control Shoes Reduce the Risk of Pronation-Related Pathologies in Recreational Runners: A Secondary Analysis of a Randomized Controlled Trial’. The Journal of Orthopaedic and Sports Physical Therapy 51 (3): 135–43. https://doi.org/10.2519/jospt.2021.9710.
  • Xiang, Liangliang, Yaodong Gu, Ming Rong, Zixiang Gao, Tao Yang, Alan Wang, Vickie Shim, and Justin Fernandez. 2022. ‘Shock Acceleration and Attenuation during Running with Minimalist and Maximalist Shoes: A Time- and Frequency-Domain Analysis of Tibial Acceleration’. Bioengineering 9 (7): 322. https://doi.org/10.3390/bioengineering9070322.

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