Understanding Your Feet: A Beginner's Guide to Pronation and Supination

April 18, 2019

The way you stand, run and walk may be hurting your back.
Renée Bacher

If your low back hurts, there's a chance it is being caused by a problem with the natural movement of one or both of your feet and how they hit the ground when you walk or run. Understanding what is supination and pronation can help you remedy the problem and may even make your back feel better.

What Is Over Pronation?

Pronation is the tendency for the foot to roll too far inward as you take steps. According to this study of older adults, those who over pronated were more likely to report difficulty walking across a small room, and those with flat feet had difficulty balancing. Foot pain, flat feet and over pronation were all associated with these older individuals reporting difficulty with common weight-bearing tasks. Improving foot posture, the study said, was one thing that may help older adults to have more mobility.

What Is Supination?

When your feet land on the ground in a neutral position, you should be spared any associated foot or back pain. With supination, the foot has a tendency to roll too far outward as you take steps. According to Medical News Today, it's less common to over supinate than to over pronate. However, wearing old shoes that don't support your arches can cause your feet to supinate, as can wearing shoes that are too tight or otherwise have little flexibility. Pain or swelling in the ankles may be a sign of over supination.

Your Gait Matters

Pronation and supination is an imbalance of a proper foot posture as you move throughout the day. Since the feet are the foundation of your body, this foot posture, and the way you land on your feet, can have a big effect on how your spine absorbs the shock of your weight, particularly if you jog or run for exercise.

A knowledgeable shoe salesperson may be able to watch you take a few steps away from him or her and a few steps back to determine whether you have over pronation and supination. A good place to find a salesperson who has this expertise is in a boutique that specializes in selling running shoes and apparel, as these people may be runners themselves and know quite a bit about keeping the feet healthy. Of course a podiatrist, or Doctor of Podiatric Medicine (DPM), specializes in treating problems with feet and is the gold standard, along with an orthopedist, in giving you this information during an appointment.

What Can You Do About It?

Studies are inconclusive as to whether wearing custom orthotics in your shoes can help neutralize foot posture, but talk to your doctor about whether it can help. Regularly stretching your knees, calves and the muscles that run along the bottom of your feet can help you maintain a neutral gait. And runners be aware: According to the American Podiatric Medical Association, if you have flat feet or low arches, you may be inclined to over pronate, so choose a supportive shoe designed to control the motion of your foot and keep it stable.

When Should You See a Podiatrist About Pronation or Supination?

If your feet or ankles hurt just from walking around, or if your back hurts and you have ruled out other causes, see a podiatrist or orthopedist. These types of doctors can examine your feet for any abnormalities as well as analyze your gait while walking or running on a treadmill. If needed, they can send you to be fitted for custom orthotics to put in your shoes, or alert you about the types of footwear you should or should not be wearing for your particular situation.

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