What is pronation and supination?

Biomechanics defines supination and pronation as rotational movements of any limbs, which arise as a result of the work of special muscle groups with similar names - supinators and pronators. Essentially, these are two opposing concepts: supination is responsible for the outward rotation of the legs and arms, while pronation, in contrast, controls inward rotation. By studying the effects of foot position when running, the training process can be adjusted so that it does not adversely affect health.

Pronation of the foot, like supination, helps distribute the load of running when the impact force is applied to the foot when it comes into contact with a hard surface. In this way, the pronators help the athlete maintain balance during both push-off and landing. This function of the feet can be compared to the effect of car springs, in which the suspension spring absorbs shocks and vibrations when driving on a bumpy road.

There are various abnormalities that affect the basic functions of the musculoskeletal system. The result is additional strain on the entire leg muscles, which leads to knee and joint pain, shin splints and Achilles tendon bruising. The risk of serious injury is very high in such a case.

How the foot moves during movement can be understood using the so-called 'foot'. The step cycle, which takes into account two phases: lifting and supporting. During the step, all leg muscles work, including the supinators and pronators - the level of their fitness affects the degree of fatigue from the effort. To better understand the differences in foot position, it is worth taking a closer look at the main types of pronation:

How do you recognize the pronation type?

Supination and pronation are diagnosed by an orthopedist in the clinic using special tests. The doctor can not only determine the type of pronation, but also give important recommendations to improve the situation. If you can't go to the clinic, you can do the tests yourself at home. The tests are simple and straightforward, but can still help determine the degree of pronation:

This method is often used at home because it allows you to easily determine the pronation of your foot. All you need is water and a piece of paper. If necessary, the liquid can be colored or colored to clarify the result. Instead of using thin paper, use thicker paper, and if possible, cardboard. To begin, wet or paint your foot, then place the paper on a flat surface and stand on it. It is not necessary to turn the foot from side to side, it is better to stand in a normal position, so the effect will be more correct. When the print is ready, it's worth taking a closer look at it:

The pronation of the foot in this case is considered excessive. There is no gap in the arch area, and the width of the foot is almost the same.

In most cases, the footprint is practically divided into two parts, there is a narrowing towards the outside and the cavity is quite large. This position of the foot indicates hypopronation.

The width of the arch of the foot is about half the width of the foot. Such pronation is called neutral. If you have this impression, there is no need to worry because it means that the foot is normal.

To obtain more comprehensive information, this test should be performed on two feet. There are cases where pronation may vary slightly from foot to foot, but it's still worth checking.

Types of foot pronation and selection of running shoes

The main reason for choosing shoes is that people with severe pronation (overpronation) should use running shoes with increased support on the inside of the sole and possibly with wedge insoles and special insoles. However, if there is insufficient pronation (hypopronation), running shoes should be chosen that provide better cushioning of the inner heel. There are also some design changes elsewhere on the sole, as the 'exit' occurs via different zones of the foot.

The goal of all these tricks is to compensate for the natural inability to absorb shock and avoid possible injuries. A severe misalignment of the ankle also leads to unnatural stress on all other joints and to back pain, headaches, etc.

This is especially the case if you have a stiff, incorrect heel-landing running technique.

If you run with hyperpronation for a long time (which is the most common case) without compensating for this through shoe design or running technique, this can occur, for example. B. lead to excessive displacement of the kneecap and the formation of runner's knee. This leads to wear (erosion) of the kneecap cartilage (chondromalacia patella).

What to consider

In order not to confuse others, sometimes only two terms are used - e.g. b. hyperpronation i hypersupination. In between, of course, is the neutral foot type, which is considered normal.

Many activities occur during a single step, including a dynamic balance position between pronation and supination. The main muscle that controls all of this is the tibialis posterior muscle. It works in both extension (when the foot touches the ground) and compression (to push off strongly during supination).

There are also other factors, such as the X or O curvature of the foot. This can also have a major influence on the alignment of the foot (varus or valgus). So find out about the intricacies of the biomechanics of your foot by any means possible, preferably from a sports doctor or a specialized running center. Don't skimp on your running shoes if you have special foot structure.

Types of foot pronation

The degree of pronation is determined by the angle that forms between the foot and the heel when the foot lands on a surface.

Neutral pronation occurs when the ankle is almost straight and forms an angle of approximately 90 degrees with the ground.
The footprint of such a sole is moderately curved. The load is distributed evenly, with the outer part of the heel taking on the main load-bearing function.

Hyperpronation (hyperpronator) – when landing on a surface, the foot is tilted inward and the inside of the ankle forms an angle of less than 90 degrees with the surface. Common situation.
The footprint is almost complete and has no curvature. Possible X-shaped footprint: when the knees are together and the feet are spread apart.
Valgus, flatfoot and hyperpronation are related but not the same thing. Flat feet and valgus refer to the alignment of the foot, the flattening of the arch. Hyperpronation has to do with rotation, the tilting of the foot during movement.

In combination with physical activity and appropriately selected footwear in our store, flat feet will help avoid various muscle, ligament and joint problems in the future.

Hypopronation is a less common position of the foot. The angle between the inside of the ankle and the surface is more than 90 degrees and the foot is tilted outward.
The footprint in hypopronation is strongly curved. An O-shape is possible: the feet are together and the knees are spread. The outer arch of the foot and the fifth and fourth toes are emphasized.

Choosing shoes for hyperpronation

Choosing the right shoes for hyperpronation improves the quality of daily life and prevents musculoskeletal complications. It is important that the shoes fit well on the foot and cannot fall over. In other words: Walgus shoes can often be recommended for hyperpronation.

And the most important thing is that, with a few exceptions for complex deformities, orthopedic shoes must be comfortable! They should not hinder the movement and development of the foot.

Supinating insoles can also help prevent the foot from twisting. The presence of these insoles should not cause any discomfort and should not restrict the movement of the foot. The result is not only optimal foot alignment, but also greater distance covered and less back pain.

pronation of the foot

Pronation is the natural movement of the foot that occurs when the foot lands while running or walking. It is composed of three elements of the cardinal plane: subtalar extension, dorsiflexion of the ankle and adduction of the forefoot. These three different movements of the foot occur simultaneously during the pronation phase. Pronation is a normal, desirable and necessary part of the gait cycle. Pronation represents the first half of the stance phase, while supination initiates the progression phase when the heel begins to lift off the ground.

Illustration of the pronation and supination of the foot from an anatomy textbook

species

The normal biomechanics of the foot absorb and control events throughout the gait cycle, with the foot being flexible (pronation) and rigid (supination) in the different phases of the gait cycle. Plantar extension, ankle dorsiflexion, and forefoot adduction occur during loading of the foot. Pronation should not occur after the final phase of metatarsal alignment as the normal foot must then supinate in preparation for separation.

Abnormal pronation occurs when the foot enters when it should supinate or when it pronates excessively during the normal phase of pronation. For correct forward movement of the foot, approximately four degrees of pronation and supination are required. In the neutral position, the foot is neither pronated nor supinated. If the foot pronates or supinates during the support phase of the gait cycle when it should be in the neutral position, there may be a biomechanical problem.

To simplify the selection of corrective shoes, three types of pronation are distinguished: neutral pronation, excessive pronation and insufficient pronation.

Neutral pronation

Some pronation, also known as eversion, is natural to normal body movements. Neutral pronation occurs when the foot experiences normal, healthy pronation rather than excessive or inadequate pronation. During a healthy movement, a larger part of the toe area is involved in the push-off than during an unhealthy movement. With neutral pronation, the body weight is distributed relatively evenly across all toes, with slightly more strain on the big toe and second toe, which can carry a greater load.

overpronation

People with overpronation tend to push off almost exclusively from the big toe and second toe. As a result, the footprint is not evenly distributed across the entire foot and the ankle has difficulty stabilizing the rest of the body. In addition, an unnatural angle forms between the foot and ankle and the foot protrudes unnaturally. People with normal pronation also often have an angle between their foot and ankle, although not to the same extent as people with overpronation. With normal pronation, the body weight is evenly distributed across the entire foot.

What movements are possible in the foot?

The following movements are possible in the foot:

Flexio flexio and extensio extensio (dorsiflexion and plantar flexion).
Adductio adductio and abductio abductio,
Deviation of the foot from the midline outwards (eversio) and inwards (inversio).
But there are also compound movements of the foot that combine all of these movements. These are pronation (pronatio) and supination (supinatio).

Of all the biomechanical processes that occur in the human foot during running and walking, complex movements such as pronation and supination are the most important. Pronation is a universal cushioning mechanism that nature created for human movement on two legs. What is the essence of this process? As the foot hits the ground, the arch of the foot flattens, absorbing the impact (medically known as dorsiflexion). The effect is comparable to that of a car spring. Schematically, this can be represented as follows: In addition to the work of the arch of the foot, the shin bone is also involved, moving inwards (eversion) and rotating the foot (abduction), which also increases cushioning. The overall enlarged contact area provides additional stability and improves the impression. Diagram below: When the additional energy is used up and the runner's or walker's center of gravity moves forward in the movement, the second phase of the stride cycle occurs. Supination - at the same time as the body's center of gravity shifts, the foot and shin muscles begin to intensify their work and 'switch on'. From a moving system, they become a rigid but elastic support that stores energy for future thrust. Supination has phases opposite to pronation, namely: inversion - the return of the lower limbs to their normal plane of movement; the adduction - the foot stops overcoming its inner surface and its support moves towards the metatarsal bone (i.e. forward); and supination itself – the tension of the muscles and ligaments of the arch of the foot, which restores flexion. While pronation aims to weaken and correct the alignment of the foot, supination contributes to the active phase of push-off. It is very important not to confuse these two terms as they are opposites. However, many sources omit the term supination and simply refer to all phases of the step as pronation. The main function of the foot is suspension. Pronation and supination are processes and movements that occur in the foot during walking and running and serve to absorb the shock load that occurs when the foot comes into contact with a surface. It is the process of shock absorption.

What is a Supinator?

Now we're back to the question 'What is a supinator?'. The supinator brings the foot into a supinated position and fixes it in this position. The pronator brings the foot into a pronation position and fixes it in this position. Why is this necessary? It is necessary for corresponding foot deformities, such as: B. in the case of a valgus deformity of the hindfoot, when the heel is turned inwards and has to be brought back into a physiological position with the help of a support. In this case, a heel bandage or a full foot bandage is required.

It should be noted that the natural arches in insoles that follow the physiological relief of the foot are not supinators. It is correct to call them arch supports. Corrective elements in the form of supinators are therefore not necessary in normal footwear. When the arch of the foot functions normally, supinators are more likely to cause discomfort than help.

Orthotic insert made from an individual footprint. The terrain of the foot is highlighted. All arches of the foot are visible: longitudinal and transverse arches.

causes

genetic predisposition.
Weak arches may not bother the sufferer when they are sitting, but as soon as they stand up, they may fall over.
trauma
Inflammation of the ankle joint of the foot
Tear of the posterior tibial tendon
pregnancy
Diseases of the nervous system or muscles – such as: B. infantile cerebral palsy, muscular dystrophy or spina bifida.
Tarsal bone fusion can lead to thickening and flat feet. It is most commonly diagnosed in childhood.
diabetes
Age-related changes. Prolonged exertion (running, jumping, walking) can have negative effects. A possible consequence is flat feet. The tendon of the tibialis posterior muscle may be weakened after repeated microtraumas. The tibialis posterior tendon is the primary structure supporting the arch of the foot. The tendon can become inflamed (tendinitis) or even tear after strain. The arch of the foot may flatten after a tendon injury.

Flat feet in childhood are not uncommon because the development of the foot ends with the development of the musculoskeletal system. In other words, having flat feet as a child doesn't mean you'll have flat feet as an adult. People with low arches or no arches at all may not have any problems for some time.

diagnosis

People who suffer from flat feet may not have any symptoms and may not need to see an orthopedist. However, if certain symptoms occur, such as a visible flat foot, pain in the ankles or lower limbs, a feeling of tension in the feet and a feeling of heaviness in the legs, especially after physical exertion, then a visit to the orthopedist is appropriate.

Diagnosing flat feet The diagnosis of flat feet is not difficult for a well-trained doctor to make because he can make this diagnosis based on an examination of the patient. The doctor assesses the person's gait, the position of the foot relative to the ground, and the functional status of each foot.

In some cases, the doctor may recommend X-rays, CT scans, or MRI scans, especially if the cause of the flat feet needs to be clarified. Podography is also suitable, among other things, for assessing the the extent of flat feet..

Foot pathologies: causes and main diagnoses

The first symptom from which all serious foot pathologies arise is fatigue of the feet when walking.

Feet fatigue when walking

Feet fatigue is due to a degenerative process that occurs with age. Weakening of the foot muscles causes flat feet – a foot deformity. Foot and vault. As a result, the width of the toe area of the foot (breadfoot) increases.

The flattening of the arch of the foot disrupts the biomechanical axis and the biomechanics of foot movement. The biomechanics of the foothis pronation i his supination.

pronation of the foot

pronation of the foot – The inclination (inversion) of the inner arch of the foot in relation to the supporting surface during movement. In other words, pronation is the ability of the foot to turn inward when walking or running.

supination of the foot

supination – The reversal of pronation.

Shortening of the leg (limb).

It is a compensation – shortening of the foot. If the foot cannot handle the load, the knees, pelvis and spine ultimately become the shock absorbers and are not suitable for this. Poor posture of the injured leg leads to muscle hypertension and ultimately scoliosis.

Diseases of joints, spine and internal organs

Poor posture leads to over time Pains, restriction of freedom of movement, different Deformationsand joints, the spine and internal organsOsteochondrosis, herniated discs, radiculitis.

Heel spurs (plantar fasciitis)

Plantar fasciitis is also caused by flat feet in 90% of cases and results in heel pain that worsens and intensifies with exertion.

Valgus deformity of the foot (valgus)

Valgus (from Latin hallus valgus) is a common cause of flat feet and other injuries: uncomfortable shoes, prolonged standing and…

The foot: innovations in correction

The uniqueness of each pair of feet lies in its creation. Just as no two fingerprints are the same in nature, no two footprints are the same either. This is due to each person's unique life experiences, training of different muscle groups, body asymmetries, etc. We often go to tailors to adjust a dress or suit to our figure. But how many of us do this with our shoes? Shoes manufactured to an average industry standard that are supposed to protect the foot cause irreparable damage.

In the grip of the shoes, the foot gradually loses its natural mobility, which can be compared to the roots of a tree: support and nourishment.

Modern man cannot afford not to wear shoes. So we came up with a solution: let your foot work in the shoes you wear every day. You can personalize your footwear by making Orthopedic Compensators® so that your foot functions properly in any footwear you are used to wearing, be it boots, slippers or even high heels! The foot-supporting surface of the foot with Inventa's biomechanical correctors at specific, strictly individual points compensates for the damage to the footwear and triggers a chain reaction of repair processes. That is why our innovative method for rehabilitation of the musculoskeletal system by correcting the biomechanics of the foot can be described as a true revolutionary breakthrough in rehabilitation.

Rehabilitation center Inventa Ortho – orthopedic insoles, diagnostics and correction of the musculoskeletal system

Criteria for selection

First, you need to understand a number of terms. Maybe you don't know what pronation, droop or torsional stiffness are at the moment. All of this needs to be researched at least superficially. After all, these are some of the criteria you will use when looking for the perfect pair of running shoes.

Size

One of the most difficult criteria. You come to the store with your size 42 and there are mostly foreign models and each manufacturer has its size table with national measurements such as US, UK, Euro, CM, etc. Sometimes even salespeople and consultants cannot cope with all these numbers. So what should be done? There is only one solution: you have to measure until you find the best option.

If you run more than 10 km every day or train in the mountains, you should choose a model that offers plenty of space. If you exercise under normal conditions, you should still leave some space: If your feet swell, you need insoles or have to wear wool socks in winter - there are many reasons to leave some space. Never wear shoes that are too tight or you will injure your toes, heels and nails.

Walk around the gym when trying on: the sneakers should be slightly larger than your size, but you should feel comfortable in them.

damping

When running, make sure you choose running shoes with good cushioning. This minimizes the shock load during training, which affects not only the foot but the entire body. Nowadays almost every manufacturer has its own unique cushioning system technology: Adidas has Boost, Mizuno has Wave, Asics has Gel, etc.

Differences from conventional ones

Almost all previous posts aim to answer the question of how running shoes differ from regular running shoes. This is one of the most common mistakes you can make: walking in them is like running in them. Don't make this mistake - you'll definitely end up with training discomfort and injury.

By now you should have figured out which shoes are suitable for morning jogging as part of your workout and which are suitable for evening walks, so to speak. These are two completely different things that should not be mixed.

Which shoe models do you need an insole for?

First of all, orthopedic therapeutic shoes must have a cushion with a certain level of stiffness and height. However, these options are usually selected in consultation with the doctor, so we do not want to delve into this question any further. It is much more interesting to know for which models of everyday children's shoes a podiatrist is desirable and when it is unnecessary.

As already mentioned, the insole is important for active children. Therefore, it is mandatory for sports shoes. For other options, it depends on the wishes of the parents. Nevertheless, for a product in which a boy or girl spends several hours a day, it is better to have soft, low supination. This relieves strain on the musculoskeletal system.

Tips for healthy children's feet

The golden rule when choosing children's shoes with cushioning: the product must be perfectly tailored to the size of the child. If the shoe is too big or even too small for the child, the arch of the foot shifts and forms an anatomically incorrect curve. The result: Instead of cushioning and creating a correct movement habit, it increases stress on the feet and causes foot deformity.

Now to the design of the insole itself. If it is almost flat and presses slightly under the pressure of the toes, it will not fulfill its function in the shoe. In other words: a model with such a supine is no different from a version without it. Buying a shoe with an insole that is too hard and too high (more than 5 mm) is also not a good idea. Such support weakens the foot muscles over time. The right insole should not be more than 4 mm high; it is sufficiently soft and springs back well under pressure.

When choosing shoes that are good for children's feet, you should not only pay attention to the presence of an insole. The sole is of great importance for the correct development of the feet. It should be light, flexible under the big toe, have a wide and stable heel counter and should not slip. Equally important are a firm grip on the ankle, which holds the ankle joint in place, and a wide toe box without squashing the toes. Only if all these rules are followed are the shoes good for children's feet.

What is pronation and supination?

Running shoes for flat feet: the 13 best models

Running shoes for flat feet: the main differences.