How many of you runners out there have been labeled with a foot type? Perhaps you have been told you are a pronator or even worse, an overpronator!!? How many of you have been assigned with special shoes in order to control this “excessive” and “dangerous” movement? And what if you don’t have the right shoes? Are you at more risk of injury?

The purpose of the following article is to clarify the much talked about topic of pronation and dispel any fears you may have about your feet!

Would you be surprised to hear that pronation is a NORMAL movement of the foot? Yes everyone does it- even you! Pronation describes the inward rolling of the foot after it hits the ground. Pronation is important as it is the foots natural shock absorption mechanism and trying to stop it is not a good idea. Pronation also allows the big toe to reach the ground. Our big toe provides a huge percentage of primary support in our foot so getting it to the ground is vital! Your foot doesn’t just collapse as you pronate, structures in your foot (such as your planter fascia and toe flexor muscles) should stabilize your arch.

Picture 1: Pronation (left) Supination (right)

Supination is the opposite of pronation (Picture 1). When we land on our foot, it tends to be in a supinated, rigid or locked position. As the foot is loaded the foot pronates, and arch height begins to drop. When we push off, the foot supinates again, becoming a rigid lever and helping to propel us forward (Picture 2).

Picture 2: The Gait Cycle- left leg

There really is no such thing as “normal” foot alignment. Everyone’s feet are different. Some people have more motion available in their foot than others. It has been shown that measuring pronation in static positions such as standing (often performed by store clerks in running stores), is not a good predictor of what happens in the foot when one runs. For example, someone who looks like they have a very floppy,flat arch when they stand may have perfect foot control when they run. Its all about how well the muscles in your foot work when you are in action! Strengthening your foot is therefore very important.

It is a commonly held belief that pronation will increase the risk of lower extremity injury.  However (perhaps surprisingly) this belief is not well supported by the literature, with very few studies which actually show pronation increases injury risk. Instead, there are numerous pieces of work which have shown there is no association with foot type and injury. If there is no proof that pronation causes an increased risk of injury, why do we need shoes that stop our pronation?

Specialist running stores seem to have adapted their footwear to 3 categories of feet: a flat or pronated foot, a neutral foot and a high arch or supinated foot. (Where these categories have actually originated from isn’t clear). Runners with high arches have been recommended cushioned shoes (since it has been assumed that people with high arches don’t pronate adequately and therefore cannot dissipate force), runners with flat feet  or overpronation are assumed to need motion control shoes (to control excess motion) and a neutral footed runners are offered neutral or stability shoes.

So what evidence is there out there that this matching of foot type to footwear can actually help us? The short answer: Not much.  In this article published in the American Journal of Sports Medicine researchers found almost no correlation at all between wearing the “right type” of running shoes for your foot and avoiding injury.

So just to summarise:

Pronation is a normal natural movement of the foot.

There is no link between pronation and injury

People who seem to have excess motion in their foot in standing can often have good control when running

And there is minimal evidence that wearing the shoe that matches your foot type will do anything to prevent injury

So where does this leave us all?

My advice is as follows:

Dont get hung up on your foot type. We don’t yet have enough information about why it is that so many runners get injuries, but pronaton doesn’t seem to be the culprit.

When you are deciding about what shoes to buy comfort is the most important thing. Always try a few pairs of shoes and try and run a little in them before buying them.

Strengthen of your feet. Strengthening certainly wont harm and may even improve your foot control when you run.  (See exercise 1 and 2 in this article for two good exercises that you can start doing to improve foot strength)

For more information about us visit our website: http://www.physiotelaviv.com

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