Pronation Problems

If you run (or know a runner), you’ve probably heard something about pronation. What you might not know is that pronation itself is neither good nor bad—it’s something that happens to every foot with every step, rotating and flattening to absorb each impact.

Problems emerge when a foot rotates too far inward, or not enough, and as a result loses its ability to soften shocks effectively. But before we get into that, let’s take a look at how pronation is supposed to work.

Explaining Proper Pronation

You may not give it much thought in your day-to-day-life, but your feet go through a fairly complicated series of motions (known collectively as the gait cycle) to keep you up and running. Pronation occurs during the time when your foot is in contact with the ground.

For “neutral” or “normal” pronation, the first part of your foot to strike the ground is the outside of the heel. As your full foot comes into contact with the ground, it “rolls” inward by about 15 degrees while the arch flattens slightly, cushioning the impact force and distributing weight evenly across the foot. The foot then rolls back outward


The most common pronation problem, by far, is overpronation—in fact, there are more overpronaters out there than “neutral” pronaters. In such cases, the feet roll too far inward by at least a moderate (and sometimes severe) amount, leading to an increased likelihood of injury.

Overpronation pulls the whole body out of alignment, put extra stress not only on the feet, but also ankles, knees, hips, and even back. It’s especially common among those with lower arches or flat feet, but can occur in any foot type. Associated injuries include many overuse conditions, such as plantar fasciitis, Achilles tendon issues, shin splints, tarsal tunnel syndrome, and pain in the metatarsal area near the ball of your foot, especially toward the base of the big toe. Overpronation also increases your risk of developing a bunion, since all the weight of push-off is concentrated toward the base of the big toe.

Mild overpronation may not cause any painful issues, but those with more severe cases may benefit from more supportive motion-control or stability footwear, prefabricated shoe inserts, or custom orthotics to better accommodate or control these excess motions and guide the feet along a more neutral path.


The opposite problem is underpronation, also known as supination. In this condition, the feet don’t roll far enough inward (or even roll outward) and the arch doesn’t properly elongate, keeping weight to the outside. Although much less common than the other types, is still affects as much as 5% of the population. People with high arches are especially susceptible.

Many of the same common overuse injuries associated with overpronation are also associated with underpronation, including plantar fasciitis, shin splints, and Achilles tendon issues. Underpronaters also tend to be at greater risk of stress fractures, as well as ankle sprains due to a fundamental lack of stability in the joint complex.

Runners who underpronate will generally want shoes that are lightweight and have extra flexibility to allow as foot motion as possible. We can also recommend the proper inserts or orthotics to address this particular gait abnormality.

Determining Your Pronation Style

Don’t know your pronation style? You’re not alone.

Although it’s not a substitute for a professional evaluation, the soles of your shoes can often provide a clue about your pronation style. Grab an old pair of sneakers and check to see which spots are wearing out the fastest—excessively low tread concentrated at the outside of the heel and the inside of the forefoot generally indicated overpronation, while underpronaters will show excessive wear along the entire inside edge.

Foot Care for Pronation Problems in Palm Desert

Really, though, if you suspect a pronation problem is causing your unexplained foot pain, or you’re worried that your pronation style will lead to future foot problems, you should visit Dr. Harvey Danciger for a full evaluation. Our office provides the resources you’ll need to deal with any painful symptoms (like physical therapy, injections, or laser therapy) and can fit you with the shoes or shoe inserts you’ll need to prevent injury and run and walk without pain.

To set up an appointment, please contact us online or give our office in Palm Desert, CA a call at 760-568-0108.

Dr. Harvey Danciger
Connect with me
Dr. Harvey Danciger is a podiatrist and foot surgeon in Palm Desert, CA specializing in the foot and ankle