How Does Supination Affect Runners?

If you take a quick survey of all of your friends you would almost certainly find at least one runner, and why not? Running is an attractive sport because it’s easy to begin, it doesn’t require much equipment, and it’s a delightful movement that we have been familiar with since early childhood. But anyone who runs regularly will also know that the more you run the more aware you become that technique matters, and that how you run affects not only your times and distances, but it also dictates how efficiently your body moves and how often you experience pain or injury.

A common issue that runners must deal with is supination of the feet, which can not only interfere with performance levels but if left unattended can lead to injury as well.

Supination Defined

Supination refers to the feet rolling too far to the outside when making contact with, and pushing off from, the ground. It often causes the heel of the foot to strike the ground with too much force, which pushes the weight of your body primarily onto the outer portion of foot.

Note: Supination of the feet is the opposite of over-pronation of the feet. When over-pronation occurs then the feet are rolling too far inward when the foot hits the ground. While some degree of pronation is normal and necessary excessive turning in flattens the arch of the foot. This causes the soft-tissues in the feet to become overly stretched and the joints to move at abnormal angles, causing the mechanics of the foot to become overly mobile and unstable.

The first signs that over-pronation is occurring are pain and fatigue but if the condition further deteriorates it will increase tension loads on the muscles, tendons, and ligaments in the foot, which may lead to severe problems that can become permanent. Over-pronation may cause bunions, corns, deep and uncomfortable calluses, ‘hammer toe’, plantar fasciitis, heel spurs, metatarsalgia, ankle sprains, Achilles tendonitis, knee injuries and discomfort, and pes planus.

Symptoms Associated with Supination of the Feet

When our feet supinate the shock of impact when they hit the ground is not properly absorbed and it can lead to the development of the following symptoms:

  • Back, hip, knee and heel pain
  • Plantar fasciitis
  • Shin splints,
  • Sprained ankles
  • Generalized muscle pain
  • Fatigue
  • Slower running times in athletes


If you notice the development of any of these symptoms it’s best to be examined by a professional.


There are various reasons that supination of the feet can occur but one of the most common—and commonly diagnosed—factors in this condition is when the foot has an unusually high arch. If a high arch lacks sufficient support most of the body weight can land on the outside of the foot during weight bearing activities, and especially when running.

If you’re concerned that you may have high arches simply walk across a concrete surface with wet feet; you have high arches if the toes, heel and a thin line of outer foot are visible but there is little evidence of the sole of your foot. This means that your arch has very little contact with the ground when you walk or run.


The best diagnosis of supination will come from a doctor or podiatrist, as they specialize in gait analysis. They will also want to discuss your symptoms and pain levels as well, although you can go ahead and look at the wear patterns on the bottom of your shoes; if the heel and outer tread are significantly more worn out than the rest of the shoe this increases the chance that you feet supinate.

Prevention and Treatment

The introduction of foot orthoses in your trainers and /or everyday shoes can provide heel and arch support and help to control the excessive ‘roll-out’ in the foot. If you are a runner or are regularly active it may be worth having custom orthotics designed to accommodate your particular activity. While it’s easy to find standard orthotics at a pharmacy or sports store it may be worth investing the extra money to ensure a perfect fit if you are very active.

Wearing properly cushioned shoes will also help to protect your feet from the shock of impact that occurs if you land heavy on your heels, which often happens when supination is an issue.

It may also be possible to alter your gait in such a way that you minimize or eliminate supination altogether. If you practice landing on the mid-foot rather than your heels this will reduce the force of impact and prevent all of your weight from shifting to the outside.


When we talk about a ‘normal’ gait we’re referring to a gait where the outside of the heel hits the ground first before the foot rolls through the motion and pushes off of the ball of the foot again. If your gait is considered ‘abnormal’ then there is a loss of fluidity in the striking or rolling through motion, which interferes with the foot’s shock-absorbing abilities.

And while we discussed using the ‘shoe test’ to look for supination of the foot it must be stated that increased wear and tear on the heel and outer tread of the shoe is normal to some degree, so it’s unless there are other symptoms or the wear patterns are dramatically uneven it’s best not to assume that you have supinating feet. This is why consulting a professional is so important; they will be able to better analyze the data and make and accurate diagnosis.

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