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Pronation, Supination and choosing the right footwear

Brad Walker explains the foot conditions, prevention and treatment of pronation and supination

These two terms refer to a foot's natural rolling movement while walking or running. This motion is sometimes called the running gait and is described on the New Balance website as: "A unique set of actions and reactions that your foot performs while in motion to support, cushion and balance your body."

What is Pronation?

PronationPronation refers to the inward roll of the foot during normal motion and occurs as the outer edge of the heel strikes the ground and the foot rolls inward and flattens out. A moderate amount of pronation is required for the foot to function correctly; however, damage and injury can occur during excessive pronation. When excessive pronation does occur, the foot arch flattens out and stretches the muscles, tendons and ligaments underneath the foot. The picture right shows a view of the right foot as if looking at it from behind. As you can see in the picture, the ankle is overpronating or rolling inwardly.

What is Supination?

Supination Supination is the opposite of pronation and refers to the outward roll of the foot during normal motion. A natural amount of supination occurs during the push-off phase of the running gait as the heel lifts off the ground, and the forefoot and toes are used to propel the body forward. However, excessive supination (outward rolling) places a considerable strain on the muscles and tendons that stabilize the ankle and can lead to the ankle rolling completely over, resulting in an ankle sprain or total ligament rupture. This time, in the second picture right, the foot is over supinating or rolling outwardly.


Excessive pronation and supination can cause several ailments that affect the foot, ankle, knees, hips and back. Some of the more common symptoms of excessive pronation and supination are listed below.

  • Arch pain
  • Heel pain
  • Flat feet
  • Corns and calluses
  • Ankle Sprains
  • Shin Splints
  • Achilles tendonitis
  • Knee pain
  • Hip pain
  • Back pain

Prevention & Treatment

Pronation and supination are bio-mechanical problems and are best treated and prevented with orthotic inserts. But before you run out to buy orthotics, it makes sense to get the right advice on footwear, and the best advice I can give you is to go and see a qualified podiatrist for a complete foot-strike and running gait analysis. They will be able to tell you if there are any concerns regarding the way your running gait is functioning. After your running gait has been analysed, have your podiatrist, or competent sports footwear sales person recommend several shoes that suit your requirements. Good quality footwear will go a long way in helping to prevent pronation and supination. And, if needed, invest in a pair of orthotic inserts to further prevent excessive pronation or supination.

Choosing the right footwear

That brings us to the next point. What should you be looking for when purchasing a new pair of shoes? Choose a shoe that suits your running gait and foot type. Money spent at the podiatrist now, for a complete foot-strike and running gait analysis, will save you much heart-ache and discomfort later. Having a shoe that suits your foot type is the best prevention for injury and pain. When having your shoes fitted have both feet measured to ensure you get the most appropriate size, and remember, your feet are three dimensional. The length of your foot is only one part of a proper fitting, measure your feet for width and depth to get a better fit. When purchasing footwear, make your purchase in the latter half of the day. Your feet will swell during the day, so avoid making purchasing in the morning as you may find that your new shoes are half a size too small by the afternoon. When trying on new shoes always wear socks that you will be using with your new shoes. Never purchase tight-fitting shoes in the hope that they will stretch or wear-in over time.

Apart from good footwear and orthotic inserts, what else can you do?

Firstly, a thorough and correct warm-up will help to prepare the muscles and tendons for any activity or sport. Without a proper warm-up the muscles and tendons around your feet, ankles and lower legs will be tight and stiff. There will be limited blood flow to the lower legs, which will result in a lack of oxygen and nutrients for those muscles.

Secondly, flexible muscles are essential in the prevention of most ankle and lower leg injuries. When muscles and tendons are flexible and supple, they can move and perform without being overstretched. If however, your muscles and tendons are tight and stiff, it is quite easy for those muscles and tendons to be pushed beyond their natural range of movement.

To keep your muscles and tendons flexible and supple, it is vital to undertake a structured stretching routine. And thirdly, strengthening and conditioning the muscles of the lower leg will also help to prevent ankle and lower leg injuries.

Article Reference

This article first appeared in:

  • WALKER, B. (2004) Pronation, Supination and choosing the right footwear. Brian Mackenzie's Successful Coaching, (ISSN 1745-7513/ 18 / December), p. 8-9

Page Reference

If you quote information from this page in your work, then the reference for this page is:

  • WALKER, B. (2004) Pronation, Supination and choosing the right footwear [WWW] Available from: [Accessed

About the Author

Brad Walker is a prominent Australian sports trainer with more than 15 years of experience in the health and fitness industry. Brad is a Health Science graduate of the University of New England and has postgraduate accreditations in athletics, swimming and triathlon coaching. He also works with elite level and world champion athletes and lectures for Sports Medicine Australia on injury prevention.