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Understanding Foot Supination

Overview

Supination of the foot occurs when your weight rolls onto the outer edges of your feet. Another name for supination is underpronation.

In a normal stride, your foot should roll inward a bit (pronate) so that your weight is on the ball of your foot. Then you push off the big toe. If you supinate, most of your weight falls on the outside of your foot and you push off from your outer toes instead.

If the mechanics of your foot are a little bit off, it can throw off the alignment of your entire body. Excessive supination of your feet can lead to:

  • back and hip pain
  • stress on the knee
  • ankle injuries
  • inflammation of the sole, called plantar fasciitis

If you supinate, you’ll need to do some exercises to strengthen and stretch the muscles and tendons affected by the improper foot position.

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Causes

What causes supination of the foot?

Supination is usually a result of an inherited problem with the structure of your foot. In other words, it may run in families. Supination may also be caused by weakness in certain muscles of your foot, ankle, and leg. The lack of strength may be a result of:

  • improper shoes
  • misalignment of the body
  • prior injury to the foot that damaged your tendons or muscles

Wearing rigid, tight shoes all the time can cause problems. And since your feet are the foundation of your body, foot problems can throw your whole body out of alignment. An excessively supinated foot can’t adapt to the surface it’s walking on. This means that the surrounding bones and muscles have to work differently to maintain your posture and balance. Over time, this can lead to tension in various parts of your body, including the calves, knees, hips, and back. Prolonged tension often leads to injuries.

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Treatment

Supination treatment

If you suspect that you’re supinating when you walk or run, or you’re suffering from unexplained pain in the lower back, hip, shin, ankle, arch, or heel, it may be a good idea to get a gait analysis to determine if supination is the reason. Treatment depends on the severity of your case but is typically aimed at correcting the supination to prevent future injuries.

To help treat excessive supination of the foot:

  • Select lightweight shoes with extra cushioning and ample room in the toes.
  • Wear running shoes specifically designed for underpronators or supinators. Be careful because most running shoes cater to people who overpronate, as overpronation is more common than supination.
  • Wear orthotic insoles designed for underpronation. You can buy these insoles in stores, although a podiatrist will likely recommend custom-made insoles.
  • Work with a physical therapist to strengthen the muscles in your legs and feet and to loosen tight tendons.

Surgery is not usually done to treat supination.

Read more: Shoes and stretches that can help if you work on your feet »

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Exercises and stretches

Supination exercises and stretches

Light stretches and exercises can help with issues caused by excessive supination. The stretches are designed to relieve some of the tension in the feet and calf muscles.

Jumping rope

Jumping rope helps retrain your body on how it interacts with the ground. Try jumping rope barefoot on a carpeted or soft floor. Light jumping rope is also an excellent warmup for other activities.

Calf and Achilles tendon stretch

Supinators tend to have tight calves and Achilles tendons.

How to do the stretch:

calf stretch
  1. Place your hands on the wall or a table or chair.
  2. Step one leg back a few feet behind you, with both feet planted on the floor.
  3. Keep your back leg straight as you bend your front knee until you feel a stretch along your back leg’s calf muscle and along the back of your ankle.

Plantar fascia stretch

Excessive supination can lead to excessive strain on the ligament that connects your heel and toes, called the plantar fascia. The result is a condition called plantar fasciitis.

How to do the stretch:

  1. Sit in a chair and cross your right ankle just above the knee of your left leg.
  2. Grab your toes with your right hand and slowly pull the toes back toward the front of your ankle.
  3. Hold for 10 seconds and then repeat on the other side.

Tibialis anterior (shin muscle) stretch

The tibialis anterior muscle is located right at the front of your lower leg next to your shin bone. Tightness or pain in this muscle, often referred to as “shin splints,” could be caused by tension of the foot and crunching of the toes often seen in people who supinate.

How to do the stretch:

  1. Take off your shoes and place your hands on a wall.
  2. Bend your front knee slightly. Keep that foot firmly planted on the ground.
  3. Place the other foot a little behind you with your toes pointed down, so the top of your toes lightly touch the ground.
  4. Slowly bend your front leg until you feel your shin muscle begin to stretch.
  5. Hold for 20 seconds and then switch legs.
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How to tell if you supinate

How to tell if you supinate

You can use the following methods to help you determine if you’re experience excessive supination of the foot:

Examine the wear pattern of an old pair of shoes

Normal wear on shoes goes from the outside edge of the heel toward the center. If instead your shoes are more worn out on the outer edge of the sole, you may be a supinator.

Get your feet wet

Take off your shoes and socks. Wet your feet and with your entire weight, step on a surface where you can see your foot print. If you can’t find a good surface, use a brown paper bag. If about half of your arch is showing on the surface, then you most likely have a normal foot pattern. However, if very little or none of the arch is outlined, you are likely a supinator.

Have a gait analysis performed by a podiatrist or sports therapist

The best way to know if you’re a supinator is to undergo a gait analysis by a podiatrist or a sports therapist who is trained to diagnose issues with the feet. It will usually involve walking or running on a treadmill.

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