If you’re a runner or participate in any other active sports, you may have heard about underpronation, also known as supination. Although it’s not as prevalent as overpronation, underpronation is somewhat common abnormality in the walking cycle that affects walking and running form, and while it doesn’t necessarily mean you will have problems, it can often lead to pain and a higher incidence of certain kinds of sports injuries.

Pronation and the Gait Cycle—What Is Underpronation and What Causes It?

Walking is second nature to most of us, so we don’t think there’s much to it. But your body actually goes through some fairly complicated maneuvers with each step you take. We won’t go too heavily into the details, but the Cliff’s Notes version of the part we’re particularly interested in for this article goes something like this: after your foot makes full contact with the ground (starting with the heel), the arch flattens and the foot has to roll inward about 15 degrees in order to cushion the impact and handle the full force of your body weight. This is what we mean when we say “pronation.”

The thing is, not everybody’s foot rolls inward by that ideal amount. Many feet roll too far inward, which is overpronation. A smaller number of people have feet that don’t roll enough (if at all), which is underpronation.

Why Pronation Matters

The proper amount of flattening and roll is crucial to distributing impact forces evenly across your foot and providing proper support and cushioning. If you supinate, impact forces tend to be harder, the stresses stay on the outside of your foot when you land, and your push-off occurs from the weaker little toes rather than the big ones. The harder impacts also transfer to extra stress on your leg muscles, ankles, knees, and hips. Because your body isn’t working efficiently and absorbing more stress than it should, injuries such as muscle strains, shin splints, stress fractures, plantar fasciitis, lower back pain, and joint pain in the ankles, knees, and hips are common.

Checking for Underpronation at Home

Although you’ll need a professional gait analysis to be sure, a couple of quick home tests can help you get a rough idea if you’re likely affected:

  • The Wet Test: Although there’s not a 100% correlation, many people who underpronate also tend to have naturally high arches. The wet test involves get your feet wet and pressing it against a surface (such as a paper grocery bag) that will reveal a footprint. If you see less than half your arch in the print, you probably have high arches.
  • The Wear Test: If you have an old pair of athletic shoes, check the wear pattern on the treads. Underpronators will tend to see the most significant wear on the outside edge of the shoe along the full length from heel to toe.

Managing Your Underpronation to Reduce Pain Prevent Injuries

If you suspect you underpronate and are experiencing any pain or discomfort in your feet, legs, or lower back, corrective and adaptive measures are available to help you regain the ability to walk, run, and train without pain.

It will be important to pick a running or athletic shoe with the right set of characteristics, if not specifically and specially designed for underpronators. You will want to select a neutral running shoe that is both lightweight and flexible to encourage greater inward rolling of the feet. A good specialty store can help you find what you need.

Our office can also provide you with a set of shoe inserts or full custom orthotics to help compensate for any gait abnormalities. Custom orthotics (which fit inside your regular shoes) are made from a mold of your feet and are precisely tailored to provide the exact amount of additional cushioning and ankle support you’ll need to reduce painful loads on your feet, legs, and back.

Schedule an appointment today with Harvey Danciger, DPM in Palm Desert, CA for an analysis of your walking gait and any additional advice or treatments you may need to eliminate underpronation pain and regain a healthy stride. You can contact us online or call at 760-568-0108.
Dr. Harvey Danciger
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Dr. Harvey Danciger is a podiatrist and foot surgeon in Palm Desert, CA specializing in the foot and ankle