Last year I had the pleasure of meeting Karen Litzy, MSPT host of the radio show Healthy, Wealthy & Smart. She has generously offered to answer some questions here each month. If you missed the first two Q & A’s check out these posts:
Foam Rolling: Things You May not Know about Your Cylindrical BFF
Stop Ignoring Pain: 5 Signs it’s Time to See a Doctor
Today she’s teaching us all about pronation and supination.
Pronation is a rotational movement inward that occurs primarily at the ankle. When you are walking or running is it NORMAL for your foot to pronate. Pronation allows the foot to conform to the surface below it and also helps to absorb shock or ground forces. If your foot is in a pronated position, it means that when standing still, you already have rotation inward at the ankle joints. This may have the appearance of being flat footed.
It is difficult to give a specific number as to how many degrees of pronation is too much pronation. Therefore it is beneficial to look for symptoms of over pronation.
Some examples of over pronation include:
- 1) Increased pain in the big toe joint. When you pronate too much you tend to concentrate the majority of your push off (the end of the stance phase) on the first toe.
- 2) Pain behind the shin bone (posterior tibialis). The posterior tibialis helps to stabilize the foot right before the foot pushes off the ground. If you tend to over pronate, this muscle has to work extra hard to stabilize the foot.
- 3) Plantar fascitis
- 4) Knee, hip or back pain due to the lack of shock absorption by the foot. Like we said above, normal pronation in walking or running helps to absorb ground forces but overpronation makes it difficult for the foot to function properly and absorb those forces. Additionally, over pronation may lead to medial knee pain (pain on the inside of the knee) due to being in a “knocked-kneed position”.
- 5) Shin splints
***Don’t forget…there are a lot of people who have a pronated foot or who may over pronate with walking and running and they have absolutely no pain! If this is the case, I don’t think I would start putting orthotics in your shoes or change the running shoes you are using. Rather, I would add a very comprehensive lower body strengthening program that concentrates on strengthening the hip abductor muscles and the glutes. And don’t forget the muscles of the foot! A very easy exercise for this is to place a towel on the ground and try to scrunch it up with your toes while keeping your foot on the ground.
Supination is just the opposite of pronation. It is the outward rotation of the foot at the ankle joint. Just like pronation, supination is NORMAL when walking or running. Supination is necessary to change the foot into a rigid lever arm for propulsion at push off.
If you over supinate, your foot will have a difficult time conforming to the ground below it and you will not be able to absorb shock or ground forces. If your foot is in a supinated position it means that you may have a higher arch and the weight bearing may be more on the outside aspect of the foot.
Some examples of problems over supinators may have is plantar fascitis, stress fractures, or shin splints.
Great post! I discovered a couple of years ago that I overpronate after experiencing shinsplints that wouldn’t go away despite rest, etc. I now run in custom orthotics in my running shoes.. I wish I had learned about overpronation a long time ago, it would have saved me a few years of frustration and shinsplints! haha
I’m definitely the latter. Thanks for this information. I think I have the highest arches of anyone in the history of the world. It’s almost SCARY! And I’ve had all of the above problems associated with them too.