Underpronation, also known as supination, is when the foot doesn’t optimally hit the ground when walking or running. It’s often associated with high arches and being bowlegged. Underpronators put weight on the outside of the foot, causing pain in the arch or heel. Proper footwear with added cushioning and shock absorption can help prevent foot damage.
Underpronation is a condition in which the foot does not optimally find the ground when walking or running. Also called supination, underpronation can be thought of as walking on the outside of the foot to an individually determined degree, although the intensity of the outward roll may be almost imperceptible to the observer at any one time.
Since it’s not always obvious to the layperson, a simple test of looking at the wear and tear of old walking or running shoes can be used to roughly diagnose undervaluation. An underpronator’s shoes will have more wear on the outside edge, particularly towards the rear, which shows the location of the impact when running. It is generally believed that underpronation is not fatally linked to foot shape or anatomy, but rather is highly associated with having high arches and being bowlegged.
Pronation is the rolling movement of the foot when riding a bicycle. This movement is responsible for distributing impact forces and shock absorption. Another way to think of it is that pronation controls where and when your weight hits the ground through your foot. With normal or neutral pronation, the entire foot makes contact with the ground. Underpronators put weight on the outside of the foot, which is too stiff a surface to efficiently absorb shock.
Normal pronation is characterized by initial contact on the outside of the heel, an inward turn of approximately 15 percent with full ground contact, and then an even push off from the ball of the foot. Underpronation, on the other hand, begins with the outside of the heel making contact with the ground. Instead of rolling in 15 percent as it would in neutral pronation, the foot instead rolls in less than 15 percent, placing more weight on the outside of the foot. At the end of the gait cycle, the smaller toes must do all the pushing work, putting excessive pressure on those toes.
Underpronators may experience pain in the arch of the foot or heel, and more rarely pain in the lower body. Excessive pressure or strain on the foot due to underpronation can cause heel spurs if left untreated. While foot damage is unlikely due to low cushioning, it is important to wear proper footwear for both personal comfort and protection against injury.
There are shoes specifically designed for underpronators, usually with added cushioning, increased shock absorption, and increased stability. Proper shoes are the most commonly recommended method of coping with pain caused by the condition, as well as preventing foot damage. Underpronation rarely requires surgery, and can be considered a relatively benign condition that only becomes a concern when optimal use of the foot is required.
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