What is supination of the foot and why does it matter? The truth is, knowing and understanding your gait can help you to avoid foot and leg problems later in life.
Supination is much less common than overpronation, and there aren’t many products geared towards people who supinate. But it’s worth knowing if you do supinate, so you can begin taking steps towards strengthening your feet and keeping them healthy.
Here’s everything you need to know about supination of the foot and how to deal with it.
What Is Supination?
Everyone pronates when they walk or run, as it’s part of the natural movement of your foot. With that being said, the level to which you pronate will determine if you supinate, overpronate, or have neutral pronation.
Supination, also known as underpronation, is when your foot rolls outwards on each step, causing you to walk on the outer edges of your feet.
While a degree of supination is natural—an inward roll of about 15 percent—during the toe-off stage, when your foot doesn’t turn inwards enough during this stage, it shifts your body weight to the outside of your foot.
This leads to excessive pressure being placed on the foot, as all the work to push off of the ground is done by your smaller toes and the outer edge of the foot.
How to Tell if You Supinate
It’s extremely difficult to tell if you supinate, overpronate, or have a neutral gait with just the naked eye. Fortunately, you can try the following to help you identify your foot’s natural rolling motion:
1. Wear Pattern on Old Pair of Shoes
The best way to determine your level of pronation is to have a look at the bottom of your old shoes.
Grab two or three pairs of your shoes that you’ve worn regularly over the last several months, turn them over, and see where the most wear is.
If you have more wear down the center of the ball of the foot and the heel, then this would indicate more of a neutral pronation.
Supinators may have shoes that show wear on the outside edges of the shoe, from where your small toe is to the outside edge of the heel. There will be little to no sign of wear on the middle or inside of the shoe.
Overpronators may have shoes with wear patterns on the inside edge of the balls of your feet of the shoe, more towards the big toe and the inside of your heels.
2. Wet Footprint Test
For this test, you’ll need to be barefoot and lay a sheet of paper on the floor that’s within easy reach.
Wet the entire underside of your foot—wet but not dripping—and then step onto the sheet of paper, placing your entire weight onto it. This will leave a visible footprint and the shape will determine your level of pronation.
If your footprint impressions show the ball of your foot, half of your arch region filled in, and your heel, then this would indicate neutral pronation.
If you can see the ball of your foot with very little to no contact along the outside edge—outside arch of your foot—but you see your heel, then you’re likely a supinator.
If the entire arch of your foot is filled in on the sheet of paper—looks like the whole sole of your foot—then you likely overpronate.
3. Gait Analysis
You can visit either your podiatrist or a sports therapist who is skilled in biomechanics and have them evaluate your gait.
They’ll be able to do an in-depth biomechanical assessment by scanning your foot as you walk over a pressure plate.
The tiny sensors help map the pressure points of your foot, which helps your podiatrist or sports therapist evaluate your gait, which will show if you supinate.
Your gait analysis will also point out any faulty foot function that could put you at risk of injury. This could also be helpful if you’ve been experiencing any toe, foot, or ankle pain.
Why Is Supination a Problem?
When you supinate, it puts pressure on the ankle, the outer side of the foot, the lesser toes, and the soft tissue that supports your foot.
Your smaller toes aren’t as effective at absorbing shock, distributing your body weight evenly, or propelling your forward. The muscles, ligaments, and tendons have to compensate for the movement, and this can throw your entire body out of alignment.
Not only does this lead to overuse of the soft tissues, but it can lead to injuries and conditions such as:
- Ankle sprains
- Plantar fasciitis
- Peroneal tendonitis
- Achilles tendonitis
- Shin splints
- Medial tibial stress syndrome
- IT band syndrome
- Weakness in the foot or ankle
Supination can also cause your leg muscles to become tight and this can lead to back and hip pain.
What Causes Supination of the Foot?
There are several reasons, as well as contributing factors, that may cause you to supinate.
The shape, structure, and mechanics of your feet and legs are inherited, which can increase your risk of supination.
It can be caused by differences between the lengths of your legs, ankle instability, or having a naturally high-arched foot.
You can also develop supination if you have weak foot muscles or if you’ve injured your muscles and tendons in the foot, ankle, or lower leg.
Wearing shoes that don’t support your foot adequately, are too rigid, too tight, or worn out can cause you to supinate.
This can also affect the supporting muscles, tendons, and ligaments in the foot, as they have to compensate by working differently when you walk.
Not only can this throw your body out of alignment, but it can cause other foot conditions to develop as well.
Over time, this can affect your posture, as other muscle groups along the kinetic change work harder, possibly leading to:
- Tight muscles, including the calves
- Overuse injuries
- Knee, hip, and back pain
To Help Treat Excessive Supination
1. Wear Good Footwear
Look for shoes that have a wide base that will help accommodate supination and reduce the strain that’s placed on the foot.
There should be adequate arch support for your shaped foot, as this will help distribute your body weight and reduce the amount of strain that’s placed on the plantar Fascia.
Consider shoes for supination that have a fair amount of cushioning that will help absorb shock and protect the outside edge—lateral side—of the foot. The shoe should be lightweight and flexible so that it allows for the natural movement of the foot during the push-off stage.
If you’re looking to get some new athletic or running shoes, then choose neutral running shoes, as they’ll help gently guide your foot through your gait cycle.
Most neutral running shoes feature firm heel counters that help reduce lateral movement of the foot, and this can help reduce the strain that’s placed on your foot when you walk or run.
Insoles and orthotics for supination are an effective way to support and protect your feet as you go about your daily activities.
There are 3 features that you should look for in insoles to provide adequate support:
- Arch support
- Cushioning and shock-absorbing materials
- A deep heel cup
The arch support of the insole should meet the height of the arch of your foot when you’re standing, to provide effective support. This will also ensure that your body weight is evenly distributed when you stand, walk, or run.
There should be a layer of cushioning to help protect your feet from the shock of impact with every step you’re taking. This will help reduce the stress that’s placed on the soft tissue and bones, which will minimize your risk of injury.
An insole with a deep heel cup will limit the side-to-side movement of your heel, stabilize your midfoot, and help keep your foot in its natural alignment.
3. Proper Form
When you exercise or participate in activities like running or cycling, make sure that your form is correct.
Pay attention to your body and tend to any tight muscles by either stretching or gently massaging them as part of your warm-up. Spend time massaging and loosening your feet, ankles, and calves before starting any activity.
4. Physical Therapy
A physical therapist would be able to identify if your supination is caused by muscle weakness or tight muscles.
Then they’ll put a treatment plant together that may include a strength and conditioning program. The physical therapist will also help to loosen any tight muscles, tendons, and ligaments, while strengthening them at the same time.
This will help to stabilize the ankle joint and correct muscle imbalances, which will reduce your risk of an injury.
5. Stretches to Relieve Pain From Supination
1. Shin Muscle Stretch
This stretch will help to release tension in the shin and you’ll be able to feel it extend from the top of your foot into your shin.
Start this stretch by taking your shoes off and then placing your hands shoulder-width apart on the wall.
Standing with your feet hip-width apart, take a step back with your left leg while you keep your right foot firmly planted on the ground.
Then, let the tops of your toes on your left foot touch the ground and slowly bend your right leg until you feel your left shin muscle stretch.
Hold for 15 to 30 seconds before switching to the other foot.
2. Plantar Fasciitis Stretch
For this exercise, you’re going to sit in a chair and then cross your right ankle just above your left knee.
Gently hold your toes in your right hand, and then pull them backward towards your shin. You should feel a stretch underneath your foot, between your heel and the ball of your foot.
Hold this stretch for 10 to 20 seconds and then repeat this movement on your other foot.
3. Standing Calf Stretch
This stretch will target the entire calf muscle and help to release any stiffness and tension.
With your hands shoulder-width apart, place them on the wall in front of you, making sure that you’re an arm’s length away from the wall.
Then extend your left leg behind you and keep your heel on the ground. Make sure to keep your right leg slightly closer to the wall, and then bend slightly at the knee.
Lean into the wall by pushing your hips forward until you feel the calf stretch in your left leg.
Hold this stretch for 30 seconds then change sides, repeat it 3 times on each leg.
6. Strength Exercises to Prevent Pain From Supination
1. Jumping Rope
Jumping rope is a great exercise that will help strengthen and improve the range of motion in your ankles and calves.
The good news is that when your body weight is evenly distributed between both feet, jumping rope has a lower impact than running!
To jump rope with proper form, you’ll need to make sure that your jumps are at least 1 to 2 inches off the ground, keeping your toes pointed slightly down on each jump.
Make sure to keep your knees slightly bent and that you land on the balls of your feet.
To help reduce the stress on the joints from jumping, try jumping on a wooden surface or a rubber mat.
2. Calf Raises
When you first start doing this exercise, you can hold onto a table, counter top, or the back of a sturdy chair to help keep your balance.
Start by planting both feet firmly on the floor. Raise yourself up onto your toes, making sure to keep your body weight on the balls of your feet.
Hold this position for 10 to 20 seconds and then slowly lower yourself down into the starting position.
Make sure that you do this exercise slowly, so that you can make sure to get full range of motion.
Repeat this exercise 10 to 15 times.
3. Front Lunge
Start by standing with your feet shoulder-width apart and your feet firmly planted on the ground.
Place your hands on your hips to help you maintain your balance. Take a step forward and slowly bend your knees as you lower yourself down as far as you can.
You should feel the stretch in your achilles and calf muscle.
Make sure to keep both knees bent at a 90-degree angle and the movement should be slow and controlled.
Hold the position for a second or two when you get to the bottom. Then, push up with the front foot and return to the starting position.
You should do 3 sets of 10 to 15 repetitions on each leg.