Pronation, Overpronation & Underpronation (Supination)
What is Pronation?
Pronation is the inward roll of the foot which occurs when your foot transfers the forces of your weight from your heel to the middle and arch of your foot. Your foot arch collapses downwards to a degree as it flexes to distribute the pressure from your weight through the midstance. The collapse of the arch causes the foot to rotate towards the inside edge. This is pronation.
What is Overpronation?
Overpronation is the term given to excessive pronation where the normal inward rotation of the foot is extended beyond normal. This is most commonly caused by arches that flatten too much when taking the force of your weight midstance. There are other causes.
What Problems can Arise from Overpronation?
Overpronation means that the foot rotates inwards too far and is also called eversion. When the foot over-rotates the component parts of the foot take abnormally high stresses that they were not biologically designed to take.
How Can I Correct Overpronation?
The aim is not necessarily to correct your natural gait but rather reduce the additional and unnatural stresses it creates. The best way to do this so far as walking is concerned is to purchase the correct shoes.
The correct shoes are ones which offer additional support under your arches, especially if you are flat-footed, which help distribute the pressures more evenly across the foot and reduce the stresses on the various component parts of the foot and help maintain a better alignment for the leg bones and muscles thus reducing stress in the knees, hips and back.
Once your shoes begin to wear out you should not be slow to replace them since worn shoes no longer offer the support your feet need and will twist the foot out of your natural alignment.
Is Supination the Same as Underpronation?
Supination and underpronation are similar terms. However, supination naturally occurs with most people as weight begins to be transferred from the heel to the midfoot before the flexing of the arch causes the opposite rotation, called pronation. Supination also occurs as the arch springs back as weight is transferred to the ball of your feet and toes as you push off. Underpronation is the term used when a persons foot fails to roll inwards enough midstance, resulting in the weight being taken by the outside of the foot.
What is Excessive Supination (Underpronation)?
Excessive supination occurs when your weight remains on the outer side of your foot through your stride and sufficient pronation is not made. This is often caused by high and inflexible arches but flat footed people can also be supinators. Apart from high arches, the alignment and interaction of the leg bones, muscles & joints can contribute. Conscious effort & habit can also be factors.
What Problems can Arise from Excessive Supination?
Excessive supination can cause a multitude of problems. The construction of the foot, leg and joints up to your hips as well as posture all affect the alignment of each component part. If the foot does not pronate the leg bones are forced out of alignment causing unintended stress on the knees and in turn the hips and back.
It is important to see the whole picture and not just what is happening in the foot. The result of supination may be a pain in the foot especially Plantar Fasciitis or pains in the legs such as shin splints, pain in the knee and hips as well as back pain because the body is not properly aligned as you walk.
What Can I Do to Cure My Supination?
Supination in itself naturally occurs through the cycle of your stride. The issue is not to ‘cure' supination but rather to reduce the stresses excessive supination will produce whilst walking. If the stresses are reduced, any resulting pain is decreased and the body can gradually realign itself naturally in most cases.
It should be understood that our brains interact with pain to try to lessen that pain. So it is often the case that a habit is formed by continual mental correction of your gait when an unnatural gait is not arrested.
Getting the right shoes with targeted support will reduce the stresses on your foot, leg bones & muscles, knees, hips and back which all become affected by a misaligned gait. In turn this will reduce pain, stop the need for your brain to try to continually compensate and gradually help reduce the problem.
Aside from correction from your shoes and orthotics, your physician will be able to advise you on additional steps you can take to help address the problem. The first thing you should do with any pain should be to see a specialist and have your gait videoed and analyzed.
What is Plantar Fasciitis?
Plantar Fasciitis is a painful stabbing pain that occurs in the plantar fascia which is the ligament that connects your heel and toes. The pain most commonly occurs nearest the heel and is the result of too much strain on the ligament often coming from supination.
There are other causes of pain in this area that affect the ligament including Ledderhose Disease which is linked to Depuytren's Contracture that occurs in the hand ligaments. Ledderhose is the thickening of the tissue in and around the plantar fascia and is often associated with plantar fasciitis. The causes are not the same.
What are Heel Spurs?
Heel Spurs are a hard calcium deposit that occurs around the underside of the heel bone and around the area where the plantar fascia connects to the heel.
This hardened lump causes discomfort and inflammation with corresponding pain and also aggravates the plantar fascia and Plantar Fasciitis. You will be able to feel the bony lump that is the Heel Spur and thus distinguish it from Plantar Fasciitis occurring from other causes.
What is Metatarsalgia?
Metatarsalgia is inflammation of the joints of the metatarsal bones which include the toe bones where they join the main part of the foot. This is within the ball of your foot area.
It is caused by repetitive impact forces on the joints such as when you push off with your toes whilst walking and tends to occur more in people doing more strenuous exercises. So track athletes are higher risk than runners, and runners are higher risk than walkers. Power and Fitness walkers will be higher risk than casual walkers and so on.