Foot pronation

Pronation is a natural movement of the foot that occurs during landing. It’s extremely important while running or walking. As the body weight is loaded onto it, the arch of the foot flattens out and the heel moves outward.

Foot pronation is defined as the inward rotation of the foot about its subtalar joint axis. However, it’s hard to assesment pronation during dynamic task. Therefore, variables such as forefoot abduction, rearfoot eversion, and ankle dorsiflexion are often used as surrogates for foot pronation. [1]

Range on pronation should be between 15° to 30°. If the movement is less than this range, subluxation of various tendons is possible, with the fibularis tendons being particularly prone to subluxation, evident in eversion. Weakness in the fibularis group can also affect pronation. [2] When the range of pronation exceeds this limit, it is termed overpronation. Overpronation is commonly associated with many overuse injuries, especially in running. There is a risk of injuries such as shin splints, knee pain, and medial tibial stress syndrome. [3]

Supination is also natural and refers to movement in which the arch of the foot rises and the heel moves inward. With this motion foot becomes more rigid, which helps to propel the body forward efficiently. It is the opposite of pronation and involves inversion, adduction, and plantar flexion of the foot and ankle. Supination occurs when the foot impacts the ground, transferring most of the weight to the outer edge of the foot during walking.

The proper range of supination is between 45 to 60 degrees. Oversupination refers to an excessively supinated foot, which cannot adapt to the surface it walks on. Supination can be impaired, if the tibialis anterior muscle is weak.[2]

  1. Behling, Anja-Verena, i in. „Pronation or Foot Movement — What Is Important”. Journal of Science and Medicine in Sport, t. 23, nr 4, april 2020, s. 366–71. DOI.org (Crossref), https://doi.org/10.1016/j.jsams.2019.11.002.
  2. Magee, David J. Orthopedic Physical Assessment. Sixth edition, Elsevier Saunders, 2014.CloseDeleteEdit
  3. Tweed, Jo L., i in. „Biomechanical Risk Factors in the Development of Medial Tibial Stress Syndrome in Distance Runners”. Journal of the American Podiatric Medical Association, t. 98, nr 6, 2008, s. 436–44. PubMed, https://doi.org/10.7547/0980436
arch of the footfootfoot pronationpronationsupination
Anatomy