Our feet are amazing appendages. Whenever we walk or run, 52 bones in our feet (that’s 25% of all the bones in our bodies!) are put to work—performing a sequence of predictable movements designed to help us put one foot in front of the other. These movements are called our gait cycle or stride.
“Your gait cycle is made up of three cycles: the heel contact cycle, the midstance or whole foot on the ground position and the propulsion cycle where the ball of the foot pushes off,” said Joseph Dobrusin, DPM, a podiatrist at Banner Health Center in Arizona.
In a normal stride, your feet should roll side to side—rolling outward a bit to inward a bit as your feet go heel to toe and back again. Sometimes, however, there are things that can throw your gait out of balance, causing us to overpronate or underpronate (supinate). Over time, these mechanical problems can cause a host of injuries that affect not only your ankle and feet but also your knees, hips and back.
Dr. Dobrusin explains the differences between overpronating and underpronating so you can see where your feet land and ensure they get the support they rightly deserve.
Has anyone ever told you that you’re flat footed? If so, you could overpronate. Overpronation is when the arch of the foot collapses excessively downward and inward with each step.
“In this case, when you push off the front of your foot, you’ll mainly use the big toe and second toe and the entire inside portion of your foot and ankle,” Dr. Dobrusin said. “Putting all the stress and weight on this area of the foot can lead to strain on the toes and instability in the foot ankle.”
Overpronation can lead to a number of injuries, including shin splints, tendonitis, heel pain, bunions, plantar fasciitis and lower back pain.
Underpronation (aka Supination)
On the other hand—or foot—supination occurs when the foot rolls to the outside edge of the foot rather than slightly inward as it should. This results in you pushing off on the outside of the foot throughout the entire gait cycle. “We often see this in patients with high arches,” Dr. Dobrusin said.
Supination can be associated with a number of injuries as well, including lateral ankle sprains (and in general, lateral foot and ankle pain), plantar fasciitis, knee pain and back and hip pain.
Diagnosing your gait pattern
Knowing whether you over or underpronate may not be as easy as you think. The best way to determine it is to visit a podiatrist or an orthopedic specialist experienced in biomechanics who can do a visual gait analysis.
“Someone skilled in biomechanics can evaluate your stride and determine if you pronate, supinate or if there are other issues at work that are causing you problems and address them appropriately,” Dr. Dobrusin said. “This can be especially helpful for those who are experiencing toe, foot or ankle pain.”
If you’re simply unsure and aren’t experiencing any pain that affects your daily life, you can also try the wet foot test. Simply wet your feet and walk over a flat surface—either the cement ground or a sheet of colored paper. If the impression is almost your entire whole footprint, you’re an overpronater. If the impression is of just your heel, the ball of your foot and a thin line on the outside of your foot, you’re an underpronator.
Put your best feet forward with proper footwear
If you have mild to moderate overpronation or supination, getting the right footwear is fundamental in avoiding injury and improving performance. If you still have pain, you may need a special insert or orthotic, but check with your podiatrist and health care provider. There are also surgical options for severe deformities that are chronic, progressive and unresponsive to conservative care.
- For overpronation: Look for motion-controlled shoes and insoles that provide proper arch support.
- For underpronation: Look for shoes that are lightweight, well-cushioned and flexible and insoles that are flat and have a deep heel cup.
Talk to your doctor or specialist
If you have any pain that keeps you from walking, running and enjoying life to its fullest, see your doctor or a podiatrist to find the best solution. To find a specialist near you, visit bannerhealth.com.