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Excessive pronation, also known as overpronation, can occur in some individuals when the foot rolls inward too much or for too long after the heel strikes the ground during the gait cycle.
Supination, also known as underpronation, is the insufficient inward roll of the foot while standing or after landing during the gait cycle.
Small inward and outward rolling motion helps to distribute the force of impact as the foot makes contact with the ground and allows for shock absorption.
Pronation and Supination, with limited angles of motion, are a normal and necessary movement that helps the foot adapt to various surfaces and absorb shock during walking, running, and other weight-bearing activities.
A runner can suffer from supination and pronation at the same time because they come from different causes such as ankle instability ( pronation after the foot strikes the ground ) and improper neuromuscular activation of the foot and ankle during the landing of the foot on the ground ( supination ).
Ankle instability can be caused by weak ligaments, weak muscles, or both.
Flat feet very often are the main cause of overpronation while standing or walking and running.
When a runner suffers from supination, in combination with pronation, the most common cause is improper neuromuscular activation despite there could be other common causes of supination such as:
Runners suffer from supination or pronation when the ankle and foot have some specific angle of inclination.
While the exact angle can vary among individuals due to factors such as anatomy and biomechanics, in general, the neutral ankle position is considered to be approximately between -2 and -4 degrees. In this case for neutral ankle position, we mean the angle formed by the Achilles and the Talus bone.
Instead, we have a foot supination when there is an angle less than -2 degrees ( for example -1, 0, 1, 2 degrees ).
We have pronation when there is an angle more than -4 degrees ( such as -5, -6, -7 degrees ).
We can have supination and pronation both during the gait cycle and standing phase.
 Now we are going to analyze a case study of a runner who suffers both from running supination ( during the foot strike ) and running pronation ( after the foot strike ).
During our Running Analysis, by assessing many running parameters, we discovered that our runner was suffering from both mild running supination and pronation after the foot strike under the body’s weight load.
The initial foot supination is due mainly to the running technique fault ( neuromuscular activation ), instead, the successive pronation is very likely to ankle instability ( weak ligaments or foot muscle ).
The images below show the photos taken from the video running analysis and the 3D foot scan where are evidenced the peak of forces acting on the foot.
Running foot supination produces a peak of forces acting on the external part of the heel and foot.
Instead running foot pronation produces a peak of forces acting on the internal heel and foot.
Our Gait Analysis System can show the running supination and pronation in other running parameters as the gait lines of the right and left foot ( image below ).
The mild supination and pronation of the left foot are evidenced by the average of the foot’s forces map in our running analysis report (image below).
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