Pronation

What is pronation?

Pronation is a term commonly used in the running world. It is the inward rolling of the feet after the heel strikes the ground. While pronation is normal, the degree of pronation for every runner varies. This depends on whether a runner has flat feet, high arched feet or normal arched feet.

When standing, pronation occurs as the foot rolls inwards and the arch of the foot flattens. Pronation is a normal part of the gait cycle (walking/running) which helps to provide shock absorption at the foot.

The opposite movement to pronation is supination. This is also a normal part of the gait cycle and can be excessive (oversupination)

Pronation is necessary for shock absorption. It also prepares the foot for proper take-off. In some cases, pronation may require you to use custom orthotics. Pronation can be classified into three types depending on the degree of pronation that occurs while you run.

• Normal pronation

• Overpronation

• Underpronation

Each of these terms is explained in detail below:





Is where the rolling in of the foot optimally distributes the forces of impact. This movement is called "pronation," and it's critical to proper shock absorption. The outside part of the heel makes initial contact with the ground. The foot "rolls" inwards about five percent, and comes in complete contact with the ground, this movement supports your body weight without any problems. The rolling in of the foot optimally distributes the forces of impact. This movement is called "pronation," and it's critical to proper shock absorption. At the end of the gait cycle, you push off evenly from the front of the foot.

As with the "normal pronation" sequence, the outside of the heel makes the initial ground contact. However, the foot rolls inward more than the ideal five percent, which is called "overpronation." This means the foot and ankle have problems stabilizing the body, and shock isn't absorbed as efficiently. At the end of the gait cycle, the front of the foot pushes off the ground using mainly the big toe and second toe, which then must do all the work.

Again, the outside of the heel makes initial contact with the ground. But the inward movement of the foot occurs at less than four percent (i.e., there is less rolling in than for those with normal or flat feet). Consequently, forces of impact are concentrated on a smaller area of the foot (the outside part), and are not distributed as efficiently. In the push-off phase, most of the work is done by the smaller toes on the outside of the foot.

How Does this Cause Injury?

Excess pronation usually causes over-use type injuries, occurring most frequently in runners. When a neutral foot pronates during walking or running, the lower leg, knee and thigh all rotate internally (medially). When an athlete with an overpronated foot runs, this rotation movement is exaggerated and becomes more marked.

Excess stress on the inner surface of the foot through over pronation can cause injury and pain in the foot and ankle. Repeated rotational forces through the shin, knee, thigh and pelvis also place additional strain on the muscles, tendons and ligaments of the lower leg.

How can i tell what degree of pronation occurs when i run?

Go to a local running specialist that provides a video gait analysis of your running style, this will highlight if you overpronate, oversupinate or have a neutral gait. Other options also involves:

• Firstly, look at your feet in standing, have you got a clear arch on the inside of the foot? If there is not an arch and the innermost part of the sole touches the floor, then your feet are overpronated.

• Secondly, look at your running shoes. If they are worn on the inside of the sole in particular, then pronation may be a problem for you

• Thirdly, try the wet foot test. Wet your feet and walk along a section of paving and look at the footprints you leave. A normal foot will leave a print of the heel, connected to the forefoot by a strip approximately half the width of the foot on the outside of the sole. If you’re feet are pronated there may be little distinction between the rear and forefoot, shown opposite

What can you do?

• Get a gait analysis of your running style, this will highlight if you overpronate, oversupinate or have a neutral gait. Most podiatrists, physio's and sports therapists will offer this service, as do some specialist sports shops.

• If you overpronate, get a running shoe with extra medial support. Many running shoes have a harder material on the inside of the midsole (the thick hard foam part of the running shoe). This means the inside of the shoe will be compressed less under load and support the inside of the foot preventing it from rolling in or flattening.

• For people with considerable overpronation, another option is to have an orthotic device fitted.

• Orthotics and insoles come in many types and prices. Some are pre-molded and can be bought off the shelf. These are ok for the majority of problem feet. However some cases may require specially casted orthotics from a relevant sports injury therapist or podiatrist.