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Supination, also known as underpronation, is the excessive outward roll of the foot when walking, or running.
Running supination is the opposite condition of running pronation which is an excessive inward roll of the foot.
Foot supination can occur during a standing position but it is more rare condition.
The best way to assess supination while standing is through a postural assessment ( stance analysis ) with a camera system and/or force plate that senses the forces your feet produce on the ground.
Instead, the best way to assess your supination during a run is through a running analysis system.
If you are not a runner, but you want to find out if you suffer from supination during a walk, the best way to assess it is through a gait analysis system.
Different causes can lead to the supination of your feet. The most common causes that can determine a foot’s supination are:
When runners suffer from supination, their feet land on the external part of the heel-midfoot or forefoot. For this reason, there is extra stress on the outer side of the foot.
When a supinator runs, the outside of the heel of their foot hits the ground first. So the force of impact remains concentrated on the outer part of the foot, loading the entire body weight on it during the landing phase of running.
An easy way to tell if you are running like a supinator is if your running shoes wear out quickly and unevenly, with more breakdown on the outer side of the shoe.
In turn, this uneven wear of the shoe can make supination even worse because there is less shock absorption where you are landing, and this can further increase the landing forces acting on the outer foot.
If you want to check precisely by yourself the entity of your supination, please follow the tips in our blog post( The 3 Best Running Parameters To Improve Your Running Performance ) where we explain how to make a homemade video running analysis system to check some parameters of running techniques such as running supination.
In our running lab in London, we have been analyzing many runners with supination.Â
Our high-tech running analysis system records many data about running supination. These data are both analytical data and video analysis data.
The four images below show the moments when our video analysis system caught the landing phase of the runner’s feet. The images show how the foot is in excessive supination landing with the outer side of the feet.
The video running analysis below shows all the running biomechanics and the feet pressures map that runner produces interacting with the ground. From the 3d running scan, you can see how the first peak of forces is located on the outer forefoot (4th-5th metatarsal ), and after shifts in the middle of the foot and first metatarse.
The other image below shows the butterfly parameters of running. These parameters include the single gait line of the right and left foot and the butterfly graph.
The butterfly graph includes all the gait lines and the center of forces of the body’s runner.
The first image on the left-hand side comes from a runner with supination, instead, the one on the right-hand side comes from a runner with quite good running technique and without a supination issue.
Furthermore, the runner with supination is affected by excessive forefoot running as the gait line is distributed only on the upper part of the forefoot.
The supination is evidenced by the almost horizontal gait line running from the outer foot to the first metatarsal.
The first image below shows a 3D foot scan during the running analysis of a runner affected by running supination. The foot lands with an excessive outward roll of the right foot with a peak of forces acting on the outer heel (red spikes on the 3D foot scan).
The second image below shows the average and maximum forces acting on the foot. You can see that there are peaks of forces ( red spots ) acting on the outer heels, more on the right foot as the supination is made worse from excessive external foot rotation.
The runners who are affected by supination have a higher risk of getting injuries.Â
The most common injuries from supination are:
Because supinators place more pressure on the outer part of their feet, stress fractures can occur on the fourth and/or fifth metatarsals which are the large bones in the middle of your foot connected to your fourth and fifth toes.
Supinators may also develop a stress fracture of the fibula, the outside bone of the lower leg as the pressure of the outer foot transmits the landing forces up on the outer part of the leg.
The extra pressure on the outer part of the foot can diminish ankle stability and increase the likelihood of spraining an ankle. For this reason, supinators are more likely to experience lateral ankle sprain.
As supinators absorb less shock through the feet they transmit more force and pressure up to the shin ( Tibia bone ) increasing the possibility of getting shin splints. As supinators run with the majority of their weight on the outer part of their feet, they are more likely to experience anterior shin splints with pain localized on the front outside part of the leg.
Supination can create extra stress on your plantar fascia, the ligament connecting your heel and toes. For this reason, the supinators are more likely to get plantar fasciitis.
Calves and foot’s plantar flexors muscle stiffness can be both a cause or a consequence of supination.
Now I am going to show you some data about our high-tech running analysis of a runner who was suffering from chronic outer calves and knee pain.
The data show the link between excessive supination and forefoot running and calves and knee pain.
The camera system of our high-tech gait analysis system has shown how the runner was landing with an extreme foot supination with both a front and back view of the feet landing.
In the images above are shown all the analytical data provided by our high-tech running analysis system.Â
The first image shows the gait lines that are not linear but with an L shape indicating a foot landing with the outer part of the forefoot. this is an extreme running supination case where the landing forces are concentrated on the outer fore foot and are transmitted up to the outer knee mainly through the fibula bone.
These gait line parameters evidence a forefoot running too as there is no midfoot-heel strike. Forefoot running continuously activated calves’ muscles without rest and it was the main cause of chronic outer calves pain in this runner.
The second and third images show the 3D foot pressure scan of a single step during running analysis. In this particular case, the peaks of forces are concentrated on the outer forefoot.
Running shoes for supination can do very little to fix foot supination as it is a foot biomechanics condition which occurs mainly during the swing phase of the leg and foot ( no contact between foot and ground ).
If the foot supinates when the foot is not in contact with the ground no special shoes can modify that!
What the running shoes for supination can do is to decrease the initial peak of forces during the first contact between the heel and the ground.
But the effectiviness of this reduction is very personal and should be analysied for each single runner and not generalised.
The success of correcting or reducing the running supination depends on how severe or rigid the supination may be. In fact, supinated feet that are “flexible” are easily corrected, whereas supinated feet that are “rigid” are much harder to fix.Â
The flexibility or rigidity of your supination could be determined by different factors such as genetics, age, the body’s postural issues, or neuromuscular activations.
For example, the supination study case evidenced above is quite a flexible supination as there is a certain rolling inward of the foot after the landing that distributes the forces in the middle of the foot. So the foot is not too rigid concentrating the landing forces only on the outer foot.
Supination, very often, is linked with excessive external foot rotation that can increase the risk of running injury.
There are some things you can do to address your running supination:
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During our running assessments, we often found weak pronator muscles and/or stiffness of the supinator muscles of the foot.
This muscle imbalance induces excessive foot supination at rest too.
The foot’s pronator muscles are located on the front external part of the lower leg ( shin ) and they are:
So strengthening the foot’s pronation muscles can help to correct foot supination.
Excessive foot supination muscle can be the cause of foot supination both during running and at rest ( supine position of the body ).
The foot’s supinator muscles are located both on the front and back of the lower leg and are:
The foot’s Supinator Muscles on the shin:
The foot’s Supinator Muscles on the Back Leg:
The best way to reduce muscle stiffness by yourself is to do stretching exercises.
On our website, you find a complete visual stretching guide and a specific page dedicated to calf and foot stretching that is specific to engage the foot supinator muscles.
Self-massage technique and foam rolling both on the front and back leg can help to reduce muscle stiffness too.
Asking the help to your trusted sports therapist to get a Sports Massage can help ease the foot supinator muscles more specifically.
Sometimes, the most important cause of running supination is the neuromuscular activation of the foot supination muscles.
This excessive activation of foot supination muscles can be corrected with neuromuscular running training.
It consists of stimulating the runner to correct its foot supination by activating the foot pronation muscles.
You can train yourself with this neuromuscular training system following the tips of our blog post about how to make a homemade video running analysis system already mentioned above.
Otherwise, we can help you with that as in our running lab in London, we have designed a specific Running Technique Training service that, thanks to a real-time video and 3D feet scan feedback, is able to train the runner to correct all the running technique issues.
As supinators stress more the outer part of the feet, their running shoes wear out quickly and unevenly. This diminishes the padding function of the shoes increasing the forces acting on the outer foot and the inclination in supination of the landing foot.
For this reason, runners affected by supination should change their shoes earlier than normal. Check the condition of your shoes after 200-300 km of running.
Our last tip, despite not strictly related to running supination, is to consider seriously the health of your feet, as they are the pillars of our body’s posture, and they could be the cause of many other musculoskeletal issues.
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