Supinator Supination (or under pronation) is the opposite of pronation and refers to the outward roll of the foot during normal motion causing it to twist akwardly leading to ankle injuries and sprains. A natural amount of supination occurs during the push off phase of the running gait as the heel lifts off the ground and the forefoot and toes are used to propel the body forward. However if supination continues through to the toe off phase the weight isn’t transferred to the big toe resulting in all of the work being done by the outer edge of the foot and smaller toes placing extra stress of the foot. Supination is seen more often in runners with high, rigid arches that don’t flatten enough during the stride. Diagnosing Your Gait Pattern ? By looking at your shoe wear pattern you can determine if you are a supinator. This is the key to selecting the right running shoes. ? Follow this up by an assessment at a good quality running shoe store. ? A foot gait analysis or a foot pressure scan are methods used in specialized running shoe stores to get a full picture of your gait pattern and where you place stress on your foot. Supinators will see more wear on the outside edge of their running shoes. Causes of Supination ? Internal causes can include rigid joints, alignment problems in the heel or the ball of the foot or strength and flexibility imbalance in the ankle. ? When you naturally underpronate the muscles and joints in your feet are working to try to correct the imbalance leading to issues in other joints like your knees and hips. ? External causes include unstable or worn out footwear or running on uneven surfaces. Effects of Supination ? Issues from overcompensation includes stress fractures which is the most serious effect of underpronation/supination. ? A high risk of overuse injuries such as achilles tendonitis, muscle strains, ankle injuries, iliotibial band syndrome and plantar fasciitis. Treatment of Supination ? Wearing neutral, flexible and well cushioned running shoes that can absorb more of the impact of each stride, provide a better range of motion and improve running comfort. ? If you have a severe supination problem you should see a podiatrist for custom orthotics. ? If you have ongoing foot or ankle pain, numbness, tingling, loss of function, or an injury you should see a podiatrist to fully diagnose your foot.