Supination and Orthotics

 

People are often attracting to running because it’s a natural movement that we’re all familiar with, it doesn’t require much gear, and you can run almost anywhere. As you spend more time running, however, you become much more aware of the ways in which your technique, form, and breathing patterns affect your performance. Unfortunately, you may also get a painful lesson in the ways that improper technique and biomechanical imbalances can cause injury to both body and performance.

Supination of your feet not only affects your performance when you run, but it can also lead to injury if this issue is not addressed.

Definition

Supination occurs when the foot rolls outwards as it strikes the ground and lifts off again. This motion forces the heel of the foot to hit the ground first and forces your body weight onto the outside of the foot. Supination of the foot is the opposite of pronation of the foot.

Note: Pronation of the foot refers to the way that the feet ‘roll inward’ toward each other on impact, and some pronation is necessary and healthy. When the foot turns in excessively (over-pronation) the arch of the foot flattens or collapses. When this occurs the soft tissues in the get over-stretched and the joints are forced to function at unnatural angles which causes them to become hyper-extendable and very unstable.

Excessive pronation will initially cause discomfort and fatigue but as it worsens it can put even more strain on the muscles, tendons, and ligaments of the foot and eventually cause permanent damage. Excessive pronation had also been linked to the development of bunions, corns, calluses, ‘hammer toe’,  ‘frozen’ toes, plantar fascia irritation, heel pain, metatarsalgia, sprained ankles, shin splints, Achilles tendonitis, knee pain, and flat feet.

Symptoms

By landing and pushing off from the outside in this fashion the foot is much less able to absorb the impact of striking the ground. When this situation occurs it often leads to back, hip, knee and heel pain as well as the development of plantar fasciitis, shin splints, and sprained ankles.

Causes

One of the most common contributing factors to supination is having a foot with a high arch; if the arch if left unsupported this can cause the runner’s body weight to be pushed to the outside of the foot during impact.

How to check if you have high arches: Take a few steps on concrete when you have wet feet. If only the toes, heel and a thin wedge of the outside of your foot are visible then you high soles and they will not be predominantly visible in your footprint.

Diagnosis

Your doctor or podiatrist will be able to diagnose supination by analyzing the way that you walk and by talking to you about any symptoms or discomfort that you have been experiencing.

You can check for evidence of supination by looking at the soles of your running shoes; if the outside rim and the heel of your shoe are the most worn out part of the tread then it’s time to make an appointment with a specialist.

Prevention

If you have supinating feet orthotic inserts can provide the support you need and will help to correct over-rotation to the outside of the foot. If you are a runner suffering from injuries caused by supination it’s best to speak with a podiatrist about the possibility of having custom orthotics designed to fit your feet precisely. Orthoses are easily found at the pharmacy but a custom design ensures the best comfort and correction possible, both of which are especially important to runners.

Thickly padded running shoes will also help cushion your feet from the impact of landing heel first and may help reduce the injuries that often occur due to supination of one or both feet.

Considerations

You can also work on correcting your gait in order to prevent or limit over-supination of your feet. In this case you would want to focus on your mid-sole striking the ground first, with your heel landing afterwards. This reduces the impact of your stride and will prevent the over-rotation of your feet to the outside. Supination begins with the heel striking the ground first, so if you can correct this motion you can exert more control over the rotation of your feet.

Conclusion

A gait that is considered ‘normal’ strikes the ground with the outside of the heel first before quickly rolling through the foot and pushing off at the ball of the foot. With an abnormal gait this cycle gets ‘stuck’ or thrown off kilter somewhere and this shock-absorbing motion isn’t properly followed through.

One of the problems with the ‘shoe test’ when checking for supination is that it’s normal to see extra wear and tear on the outside of the heel; but because excessive heel strike patterns and over-rotation are common with supination many people will wrongly conclude that they suffer from this condition. This is one of the main reasons why a professional should be consulted before purchasing orthotics.

Ironically, the more you land and on the outside of your foot the more inward rotation and gait instability you suffer as the subtaler ankle joint will eventually become overly flexible. This means that excessive wear patterns on the outside of the shoe actually indicates supination.

View Orthotics to treat Over Supination

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