“Your ankles and feet overpronate… you need ‘x, y, and z.’” X, Y, and Z typically reference to a strengthening program, shoe change, or orthotic prescription. Overpronating is a term that is thrown around loosely, whether it be a clinician’s office (PT, Ortho Doc, Podiatrist), in print publication, online, or at your local shoe shop. If in fact you do overpronate, is it something that you can change?
Being classified as an overpronator is fairly subjective. There’s no criteria to classify you as a runner who overpronates. The subjectivity of the term is likely the exact reason that it’s thrown around so loosely. In truth, overpronation is dependent on your anatomy. For example, if you have 15 degrees of pronation and use all 15 you’re likely an overpronator, whereas a strong runner may only pronate 5 degrees through available range– more on this below.
As previously discussed here, pronation is completely normal. Pronation allows your foot to unlock and distribute force up the chain (leg). Pronation that fails to occur, whether it be due to an orthotic, bony structure (high arch), or motion control shoe, may actually increase ground reaction forces (impact). It should make sense, too. Blocking your foot from pronating disengages the first anatomical system for absorbing impact forces.
“Over” insinuates that you pronate too much, but who gets to determine what’s considered normal? We have values that are deemed “normal,” but varying foot structures complicate the situation. Varying degrees of high, neutral, and low arches all affect this “normal” pronation number. “Normal” pronation numbers will simply be out of reach for rigid arches, while flexible feet with surpass the numbers. To dilute the situation further, your strength, habits, and flexibility can all influence how much you pronate. It’s not uncommon for a runner with plantar fasciitis to run on the lateral or outside portion of their foot, essentially compensating to avoid a painful inner heel. In this instance, pain avoidance limits pronation. Weakness in your pronation control muscles will also cause you to drift further into your range of motion, overpronating. As we can see, overpronation is multi-factorial and typically requires some evaluation.
For the sake of keeping it simple, let’s assume you’re running pain free with no relevant past medical history. Whether you have a flat, neutral, or high arch we can say you have an available amount of range into pronation. Overpronation equates to working closer to your end range while running. A 2013 study found that injured runners use more of their available range, leaving 4.21° of buffer to end range, whereas healthy runners maintained a 7.25° buffer. 1 The study evaluated runners with anterior knee pain–note how the foot is causing problems up the leg. The ultimate cause of overpronation is a lack of strength or poor movement (toeing out). It’s more than strengthening your feet, though. Muscles that control pronation include the buttock (glutes) and inner shin. Strengthening and balancing the entire limb can stop you from falling towards end range pronation. Building strength to control pronation can take time. Enter orthotics or stability shoes. Adding external support via an insert or stability shoe can assist in controlling pronation while you’re waiting for your strength to develop. A 2007 study by Cheung & Ng found larger pronation angles in neutral footwear when compared to motion control shoes.2 Simply put, the less external support the greater the chance for over pronating. Good strength in the glutes and foot can better control pronation while running and maintaining your buffer to end range motion.
It’s not uncommon practice to support a weak runner with orthotics; however, it seems to be the answer all too often. The other end of the spectrum characterizes support shoes and orthotics as a cancer to the running community. Like most things, the answer lies somewhere in the middle. I use orthotics or shoe changes to supplement treatment. Some runners wean their feet as strength and balance improve, while others are long-term or life users. A natural progression for descending external shoe support looks like this: motion control, light stability, neutral. Each category has varying degrees of stiffness and break at the toe box. Depending on the strength and foot type you’re bringing to the table your starting part will likely be different than others. A strong foot paired with a low or neutral arch can work well with a neutral shoe. It’s really about the overlap. Overpronation is rooted with a lack of either internal (muscle) and/or external support (shoes).
Remember, overpronation is usually a product of strength, flexibility, and foot type. For most the answer is always about pairing strength and shoe selection with your foot type. A good clinician and knowledgeable shoe store rep are your best path to a good fit for your current foot status. Strength and flexibility are moving targets, while foot structure can be static.
1. Rodrigues P1, TenBroek T, Hamill J. Runners With Anterior Knee Pain Use a Greater Percentage of Their Available Pronation Range of Motion. J Appl Biomech. 2013 Apr;29(2):141-6.
2. Cheung, R. T. H., & Ng, G. Y. F. (2007a). A systemic review of running shoes and lower leg biomechanics: A possible link with patellofemoral pain syndrome? International SportMed Journal, 8(3), 107–116.