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Foot Supination: Causes, Orthotics, And Other Treatments

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Foot supination and other conditions of the feet can affect your movement during exercise. It comes as no surprise that our feet play a rather important role in performance. Sure, they act as extensions of the leg and provide support to prevent us from falling on our face (most of the time). But they also bear our body’s entire weight and allow us to move in most every direction.

Composed of an intricate network of tendons, ligaments, and bones, our feet act as our body’s base. From the big toe to the heel, every feature of the foot must operate in harmony to get us from point A to point B. Unfortunately, however, this balance doesn’t always take place.

Think for a moment about what takes place in your foot each time it hits the ground while walking or running. Your toes spread outward for support, the heel absorbs impact, and your foot rolls slightly inward to keep you moving in the direction you choose.

But sometimes this natural movement isn’t so, well, natural. Your foot may, in fact, experience what’s commonly referred to as underpronation, or foot supination, and your risk of experiencing an athletic injury will increase as a result.

Before we get ahead of ourselves, let’s start with the basics. Here’s everything you need to know about supination and what you can do to ensure it doesn’t influence your athletic pursuits.

The Basics of Foot Supination

Let’s begin by getting you up to speed on the natural movement of your foot as you walk or run.

When your foot makes contact with the ground, the arch flattens to provide shock absorption, thus lowering the physical stress placed on your foot and leg. Your body’s weight then shifts to the outside of your foot, and a rolling action takes place that ends at your big toe. We refer to this process as pronation.

To produce a force that propels you forward, the arch of your foot grows stiff and lifts from the ground. Your foot will then lift up and again roll back to the outside of the foot. We refer to this process as supination.

It’s normal for the foot to undergo pronation, as the inward roll of the foot acts like an anatomical shock absorber — large amounts of force are absorbed by your foot instead of traveling up your leg. Forces of such magnitude could easily spell trouble for your shins and knees if they weren’t absorbed by your foot (so thank your feet for all they do).

A foot that over supinates, on the other hand, is moving in an unnatural and unhealthy way. Over supination occurs when your foot ignores that natural tendency to roll inward toward the big toe.

If you have too much supination, you may land on the outside of your foot and ride along the outside edge throughout the entire stride. Your weight is never transferred to your big toe, and the little toes must work under extreme pressure to help you push off (even though they aren’t designed to handle that extra stress).

So, Why Does Any of This Matter?

You may now be wondering why this is such a problem. Why does it truly matter if your foot doesn’t roll inward as it should? In truth, this becomes an issue simply because those small toes can’t handle the added impact and stress of propelling you forward — this is a task best-suited for the big toe. And as we’ve discussed in the past, injury during workouts often occurs when the body compensates for such adverse movements.

Injuries due to foot supination often include knee pain, ankle sprains, and foot problems of varying degrees. Shin splints may also occur due to your foot’s inability to absorb impact. And even stress fractures can occur if injuries are left untreated.

While overpronation —  the process by which your foot rolls too far inward — is a more common concern, it too produces similar injuries that can render you unable to athletically perform. This movement puts added stress on your arch and spells disaster for your tendons over time.

Why Do You Supinate?

Let’s start by noting that supination and excessive supination are by no means a rare occurrence. If you happen to be over supinating, you’re neither a weirdo nor an anatomical anomaly. But those who over supinate often share a few key features that are outlined in further detail below.

Prior Injuries

Ever experience a foot or ankle injury that you assumed was in the past? Previous athletic injuries, such as soft tissue damage, ankle sprains, and stress fractures, can cause structural weakness in the foot that impacts the likelihood of oversupination.

Because the ankle is so complex, many athletes suffer from what is called functional ankle instability (FI) — the subjective feeling of ankle instability or recurrent ankle sprains. Oversupination is more common in athletes that suffer from FI because the normal motion of the foot while running is impacted by the original injury.

Athletes who have a history of plantar fasciitis (an inflammation of a thick band of tissue called plantar fascia that connects the bone in the heel to the toes) also have a limited range of motion, and may compensate during movement, which can cause oversupination.

The Wrong Sneakers

Athletes rely on proper footwear to perform at their best, but poor-fitting running shoes can lead to oversupination. Running or athletic shoes that are too tight may restrict the foot’s range of motion, and shoes that implement arch support can be harmful for athletes who don’t need a reinforced arch. Supinated runners often have rigid arches, and therefore don’t require more structure.

Supinators perform best when utilizing shoes with extensive cushioning or neutral shoes that allow the foot to freely roll inward.

Foot Structure

Just as a majority of foot structures are inherited, so too is your tendency to supinate. Variables that include foot length, ankle stability, foot width, and poor form can cause supination or oversupination. Having flat feet or high arches may also predispose you to oversupination, as high-arched or stiff feet can alter foot biomechanics by preventing pronation.

Diagnosing Foot Supination

It doesn’t take invasive tests or extensive research to determine if you over-supinate. Monitoring the motions of your foot while standing, walking, or running is an easy and inexpensive process. While more severe issues that result from oversupination, such as compartment syndrome, may warrant a trip to the physical therapist, simple at-home tests are often enough to diagnose supination in any form.

Gait and Foot Analysis

The more technical and professional diagnosis requires the use of foot biomechanics (which can be found at a podiatrist’s office or specialty running store), especially if you’re looking to correct such issues with help from a professional.

Many specialty running stores will monitor your feet while walking or running via a process known as gait analysis. This visual analysis can determine if you supinate or over supinate, and a specialist can even determine if you’re wearing the correct pair of running shoes. If you aren’t, they can recommend a different fit or model that properly accommodates your foot and stride style.

Wear Patterns

Evidence of whether or not you supinate can be found in the soles of your shoes. Take a look at the bottom of your running shoes and attempt to determine if a distinct wear pattern is present. Those who supinate will feature a prominent “wear and tear” pattern on the outer edge of the shoe.

You can also perform what is called a “tilt test” by placing a pair of athletic shoes on a flat surface. If your shoes tilt toward the outside edge, this may indicate a supinated foot. Conversely, shoes that tilt inward may indicate overpronation, the opposite and more common condition described earlier.

Treating Foot Supination

Disrupting the normal movement of your foot is not advised unless working under the supervision of a healthcare professional. However, correcting indirect causes of supination, such as poor running shoes or muscular weakness, is a simple process that can improve the motion of your foot without causing drastic changes in your running form.

Finding the Right Running Shoes

We’ve already discussed that supinators benefit from lightweight and flexible sneakers containing a reasonable amount of cushion. These allow for sufficient ankle motion, and foot and arch flexibility by providing adequate support.

But “over intervention” is a serious risk as well. You may consider purchasing a new pair of orthotic inserts to combat over supination, but often this form of mediation isn’t advised. In reality, high-arched people who are placed in orthotic inserts or insoles are actually at a greater injury risk than those who aren’t.


It’s no surprise that stretching is a healthy and worthwhile activity capable of influencing supination. Because supination is a result of overly tight calf muscles and a tight Achilles tendon, stretching can release these areas that may be contributing to supination. Utilizing a foam roller is a dynamic means of stretching muscles pre and post-exercise while specific recovery supplements can reduce any short-term swelling.

Strength Training

Building strength in the inner thigh muscles via exercises like lateral thigh leg raises or calf raises can help correct gait patterns. Exercises that strengthen the entire leg will benefit your gait and lower your risk of experiencing stressors related to excess supination.

Living With Foot Supination

The foot is composed of a complex array of tendons, ligaments, and bones that work together in harmony throughout every single step. While supination and oversupination may impact your ability to athletically perform, in reality these are treatable afflictions that affect millions the world over.

Talk with a licensed healthcare professional or physical therapist to discuss your treatment options, take advantage of workout recovery opportunities, and take control of foot supination so you can continue to lead a healthy, active life.

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