What role does pronation play in running?

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Plop, plop, plop – if that’s the sound your feet make when you run, then you’re probably a pronator.

We train endurance. The strength. Our core muscles. The muscles in the legs anyway. But hardly anyone thinks about the feet.

Actually, every foot has a longitudinal and a lateral arch – but it requires muscles to maintain them. To keep your feet in shape, you need well-trained muscles in your calves and feet – and many athletes lack the latter.

As a result, your forefoot becomes wider because the lateral arch flattens. It becomes flatter because the longitudinal arch flattens. And it “tilts” inward or outward. The result: a buckling flat foot, which can lead to overloading of the fascia on the sole of the foot (plantar fascia), to irritation of the Achilles tendon, to knee pain and even to pain high up in the spine

Run barefoot!

Such feet – and such problems – are not the exception, but rather the rule. Because our feet are enclosed in shoes from morning till night and most of the time we walk on tarred, hard floors – how should the foot muscles be trained there?

The answer is: running barefoot! Because nothing trains your foot as well as walking on different surfaces. You can also take the opportunity to look at your footprint in the sand or any other soft surface: If your footprint is very flat and especially if the longitudinal arch is flattened, then you belong to the “pronators”.

It is normal for the foot to yield slightly inward when touching down and rolling off, and this serves to absorb shock. In pronators, however, the foot “tilts” inward more, so that both the inside of the heel and the inside edge of the foot are subjected to greater stress than the outside edge every time the foot rolls. This is also referred to as “overpronation”.

The opposite is the case with “supinators”. With them, the foot tends to “tilt” outward, they put more weight on the outer edge of their foot, and their footprint therefore looks more like a crescent. Supinators have “underpronation”.

Most are overpronated

Your old running shoes can also give you an indication of whether you are an overpronator or an underpronator: Are they worn more on the outside edge or on the inside edge? The majority of runners belong to the “pronators”: they walk and run through life with a more or less pronounced overpronation. Their arch lacks the natural tension.

There are good exercises to improve this: Toe walk, toe stand, picking up small balls or cloths with your toes – and walking barefoot! This helps to straighten the longitudinal and transverse arches. Individually fitted shoe insoles can also support the foot.

Many soccer players, on the other hand, are supinators. Typically, they have a hollow foot with an excessively high arch because their feet have (too) much tension. Exercises are then important to reduce this tension, for example “rolling out” the foot over a ball and stretching the calves.

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How to find the right shoe

To prevent overloading of the musculoskeletal system, suitable shoes are essential for both pronators and supinators. They have to fit your foot! A shoe for pronators is more supported on the inside of the foot, one for supinators on the outside.

You can’t tell if a shoe fits your foot just by slipping it on and walking in it a few times. Even if the shoes feel very comfortable, that doesn’t tell you anything about whether they are really suitable for your foot.

It’s best to have a gait analysis and a stance analysis done at a specialized store. The stance analysis measures the pressure distribution in the area of the sole of the foot. The gait analysis is ideally done with video and the trained eye of the salesperson.

Be sure to test the shoes in running mode! Because when you run, the forces acting on the foot increase. By the way, all these tips also apply to amateur runners. Because if the basis, i.e. the shoe, is not right, you can train and do as much as you want – sooner or later it will lead to problems with the musculoskeletal system. The color of the shoe and how it looks on your foot should – for the sake of your body – be irrelevant.

Tips

  • Run on different surfaces. Your foot will get completely different inputs on a track, on a meadow or on a forest path.
  • Changing your running style to load your feet differently is very difficult and takes a long time. If you change your running style too suddenly, this usually leads to overloads, for example on the Achilles tendon.
  • If you run a lot of kilometers in a day (even walking in your daily work routine), change your shoes in between.
  • A cheap shoe will hardly provide the same running performance as an expensive one. Still, a good running shoe doesn’t have to cost a fortune.

Medbase-Zueger

Author:

Michel Züger, Dipl. Physiotherapist FH, Sports Physiotherapist SPT, MAS Health Service Management, Head of Therapies and Complementary Medicine, Medbase St. Gallen Einstein


 

Who is Medbase?

Medbase is the largest multidisciplinary sports medicine network in Switzerland and offers specialized sports medicine services for athletes, clubs and sports associations of all activity levels in the areas of sports medicine, sports physiotherapy, performance diagnostics and training advice.

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