Foot Pronation Guide: Prevention for Healthy Steps

Discover effective treatment and prevention strategies for overpronation.

What is Pronation of the Foot?

In short, pronation is the degree to which your ankle rolls inward or outward. Yet, the terms “pronation of the foot” and “over pronation” typically refer to an ankle that rolls inward more than it should.

A small degree of foot pronation is an intrinsic part of our foot’s design and allows it to function as a natural spring. In fact, a “neutral” foot will pronate slightly inward by up to 15 percent. This helps us jump, run and walk with a bounce in our step—we love this.

Problems can occur when the pronation of foot goes beyond anything more than 15 percent.

Over pronated feet occur when the ankle rolls inward (or pronates) more than it should, resulting in increased weight distribution on the inner edge of the foot. An under pronated foot happens when an ankle rolls outward (or supinates) more than it should, resulting in increased weight distribution on the outer edge of the foot.

Both over- and under-pronation can be treated with high-quality supportive footwear and simple exercises to improve the body’s natural biomechanics. Check out the video below for a demonstration of the toe extension and arch stretch.

  • Explore foot pronation's impact on health.

Most Common Causes & Risk Factors for Developing Overpronation

What is over pronation? Over pronation describes the inward rolling motion of the foot during walking or running. While a small degree of feet pronation is a natural part of the gait cycle, overpronation can lead to foot pain and other problems. Below are some of the most common causes and risk factors for pronation.

If you experience foot pain or other symptoms related to overpronation, it’s important to consult with a medical professional for proper diagnosis and treatment. They will assess your unique condition and, if needed, provide a plan of how to fix pronated ankles.

  • Naturally low arches or flat feet
    Individuals with low arches or flat feet are more likely to have over pronated feet due to the lack of support in their foot structure.
    Naturally low arches or flat feet
  • Muscle imbalance or instability in the ankle joint
    Weakness or imbalance in the muscles and ligaments around the ankle can lead to overpronation.
    Muscle imbalance or instability in the ankle joint
  • Improper footwear
    Shoes that lack proper support or cushioning can exacerbate overpronation.
    Improper footwear
  • Genetic predisposition
    Some individuals may have a genetic predisposition to overpronation, making it more likely that they will experience foot problems.
    Genetic predisposition

Symptoms

Excessive pronation can lead to various issues, affecting not just the feet but also the ankles, knees, hips, and back. Understanding the symptoms and how to diagnose pronation is key to addressing any related problems effectively.

Understanding these symptoms and diagnostic methods is crucial for anyone experiencing foot discomfort or pain. Early detection and proper management can prevent further complications and improve overall foot health.

  • Arch Flattening
    One of the primary symptoms of flat feet is the flattening or lack of arches in the feet. When standing, the entire sole of the foot makes contact with the ground instead of having a slightly lifted arch in the middle.
    Arch Flattening
  • Foot Pain
    Flat feet can cause foot pain and discomfort, particularly in the arch area or along the inner side of the foot. This pain can worsen with activities such as walking or standing for long periods.
    Foot Pain
  • Uneven Shoe Wear
    Excessive wear on the inside of the shoe, especially around the heel and ball of the foot.
    Uneven Shoe Wear
  • Ankle Pain
    Pain or instability in the ankles, often due to the inward rolling of the foot.
    Ankle Pain
  • Bunions or Hammertoes
    Deformities such as bunions or hammertoes can be exacerbated by pronation.
    Bunions or Hammertoes
  • Knee, Hip, or Back Pain
    Misalignment caused by pronation can lead to pain in the knees, hips, or lower back.
    Knee, Hip, or Back Pain
  • Heel Spurs
    Development of bony growths on the heel, often due to strain from abnormal foot mechanics.
    Heel Spurs

Diagnosis

  • Visual Gait Analysis
    Observing the way a person walks or runs can reveal signs of pronation.
    Visual Gait Analysis
  • Footprint Test
    A wet footprint test can show the arch type and indicate if pronation is present.
    Footprint Test
  • Podiatric Examination
    A foot specialist can assess foot structure, flexibility, and alignment.
    Podiatric Examination
  • X-rays or Imaging
    In some cases, imaging tests may be needed to assess the foot’s structure and alignment.
    X-rays or Imaging
  • Pressure Mapping
    Advanced techniques like pressure mapping can analyze the distribution of weight across the foot.
    Pressure Mapping

Overpronation Treatment

If you over pronate—or if your activity level means you put a lot of strain on your feet and ankles—we’re here to help with treatment options and prevention tips.

Since a foot is unlikely to both over pronate and under pronate, it’s important to distinguish which foot type you have before starting treatment. Let’s dive in!

  • Stretch and strengthen the muscles
    One of the most effective methods is to practice exercises that stretch and strengthen the muscles of the foot, ankle, and lower leg to promote better alignment and control.
    Stretch and strengthen the muscles
  • Wear proper footwear
    Overpronation tends to be associated with low arches or flat feet and could benefit from anti-pronation shoes.Underpronation—or supination—is the opposite: it tends to be associated with high arches and could benefit from underpronation shoes.
    Wear proper footwear
  • Take special care when walking
    When walking, it is crucial to ensure that your foot rolls through the middle of your foot, maintaining proper alignment and preventing excessive strain.
    Take special care when walking
  • See a physical therapist if needed
    If foot pronation persists or causes pain, seeking the guidance of a physical therapist may be necessary to develop an appropriate treatment plan.
    See a physical therapist if needed

Exercises and Stretches

Overpronation can lead to various foot and leg issues. Fortunately, specific stretches and exercises can help strengthen the foot and lower leg muscles, promoting a more balanced and efficient gait. Incorporating these exercises into your routine can help correct overpronation and alleviate associated discomfort.

  • Calf Stretch
    This stretch is essential for those with overpronation. Begin by standing facing a wall with your hands pressed against it. Extend one leg straight back, ensuring the heel remains on the ground. Bend the front knee until you feel a stretch in the calf of the back leg. Holding this position for 20-30 seconds can help elongate and relax the calf muscles.
    Calf Stretch
  • Achilles Tendon Stretch
    This is a variation of the calf stretch. The setup is similar, but the back leg should be slightly bent. This adjustment targets the Achilles tendon, providing relief and flexibility to this often-overlooked tendon.
    Achilles Tendon Stretch
  • Plantar Fascia Stretch
    To address the arch of the foot, sit down and cross one leg over the other. Gently pull the toes of the crossed leg towards the shin. Holding this position for 20-30 seconds can help stretch the plantar fascia, the band of tissue running along the bottom of the foot.
    Plantar Fascia Stretch
  • Heel Raises
    This exercise is great for strengthening the feet. Stand with your feet hip-width apart and slowly raise your heels off the ground before lowering them. Repeating this motion for 10-15 reps can help build strength in the foot and calf muscles.
    Heel Raises
  • Towel Scrunches
    For this exercise, sit with your feet flat on the ground and place a towel spread out in front of them. Using only your toes, try to scrunch the towel towards you. This movement can help improve toe strength and flexibility.
    Towel Scrunches
  • Arch Strengthening
    To strengthen the arches, stand with your feet hip-width apart. Attempt to lift the arches of your feet while ensuring the toes and heels remain grounded. Holding this lifted arch position for a few seconds and then releasing can help build arch strength over time.
    Arch Strengthening
  • Ankle Inversion and Eversion
    While seated with your legs extended, turn the soles of your feet inward (inversion) and then outward (eversion). Repeating this for 10-15 reps can help improve ankle flexibility and strength.
    Ankle Inversion and Eversion
  • Single Leg Balance
    This exercise is both simple and effective. Stand on one foot, keeping the other foot raised off the ground. Holding this position for 20-30 seconds not only improves balance but also encourages a neutral foot position, essential for those with overpronation.
    Single Leg Balance

Surgical or Other Procedures

Overpronated feet can sometimes lead to chronic issues that conservative treatments might not fully address. For individuals who experience persistent pain or structural abnormalities due to severe overpronation, surgical or other procedural interventions may be recommended. These procedures aim to correct the alignment and function of the foot, providing long-term relief and improved biomechanics.

  • HyProCure® Sinus Tarsi Implant
    A minimally invasive procedure where a titanium stent is placed in the sinus tarsi, a naturally occurring space in the ankle. This helps realign the foot and prevent excessive pronation.
    HyProCure® Sinus Tarsi Implant
  • Lateral Column Lengthening (LCL)
    A surgical procedure that involves placing a bone graft or implant in the outer edge of the foot to help realign the heel and midfoot.
    Lateral Column Lengthening (LCL)
  • Medial Arch Support Implants
    Small implants are placed in the medial arch to provide support and prevent the arch from collapsing.
    Medial Arch Support Implants
  • Tendon Transfer
    Involves rerouting tendons from their original attachment to a new one, helping to rebalance the forces acting on the foot.
    Tendon Transfer
  • Kidner Procedure
    Specifically addresses an accessory navicular bone, which can contribute to flatfoot and overpronation. The accessory bone is removed, and the posterior tibial tendon is reattached.
    Kidner Procedure
  • Calcaneal Osteotomy
    The heel bone (calcaneus) is cut and realigned, then secured using screws. This procedure corrects heel valgus, a condition often associated with overpronation.
    Calcaneal Osteotomy
  • Custom Orthotics or Bracing
    While not a surgical procedure, custom-made shoe inserts or braces can be designed to support the arch and correct foot alignment, offering relief from overpronation symptoms.
    Custom Orthotics or Bracing

Prevention

While a certain degree of pronation is a natural part of the gait cycle, it’s essential to address and manage excessive pronation to prevent potential issues. Adopting specific preventive tactics can help maintain proper foot alignment, support the arch, and ensure overall foot health.

  • Supportive Footwear
    One of the foundational steps in preventing overpronation is selecting the right footwear. Shoes that offer robust arch support and a firm heel counter can significantly aid in maintaining proper foot alignment. Additionally, it’s essential to replace shoes regularly, especially once their supportive structures start to wear out, ensuring consistent foot support.
    Supportive Footwear
  • Custom Orthotics
    For those with specific foot structures or unique needs, custom-made insoles can be invaluable. These orthotics are tailored to an individual’s foot, providing targeted support and alignment, which can help counteract the effects of overpronation and offer relief from associated discomfort.
    Custom Orthotics
  • Strengthening Exercises
    Engaging in exercises designed for foot health can be beneficial. Activities like towel scrunches, heel raises, and arch lifts can bolster the muscles in the foot, providing better support and reducing the risk of overpronation. Regularly incorporating these exercises can lead to stronger feet and improved foot mechanics.
    Strengthening Exercises
  • Weight Management
    Carrying excess weight can place additional stress on the feet, exacerbating overpronation issues. By maintaining a healthy weight, individuals can reduce the strain on their feet, promoting better foot health and alignment.
    Weight Management
  • Mindful Standing
    For those who stand for extended periods, it’s essential to be conscious of one’s posture and weight distribution. Ensuring even weight distribution and taking periodic breaks to move and stretch can help in preventing the complications associated with prolonged standing and overpronation.
    Mindful Standing
  • Gait Analysis
    Avid runners and athletes can benefit from a gait analysis. This assessment identifies any improper running techniques or biomechanical issues that might contribute to overpronation. By rectifying these issues, individuals can run more efficiently and reduce the risk of foot-related problems.
    Gait Analysis
  • Rotate Shoes
    Regularly rotating between different pairs of shoes can prevent uneven wear and tear. This practice not only extends the lifespan of shoes but also ensures that the feet receive varied support, reducing the chances of overpronation due to worn-out footwear.
    Rotate Shoes
  • Regular Podiatry Visits
    Scheduling routine visits to a foot specialist is a proactive approach to foot health. Especially for those with a history of foot issues or concerns about pronation, these check-ups can help in early detection and management of potential problems.
    Regular Podiatry Visits

FAQs

  • What is overpronation?

    Overpronation is the excessive inward rolling of the foot during walking or running, which can lead to various injuries such as plantar fasciitis, Achilles tendonitis, shin splints, bunions, and even knee, hip, and back pain due to the misalignment it causes in the lower extremities.

  • What is pronation?

    In short, pronation is the degree to which your ankle rolls inward or outward. Yet often this term is used to describe your foot inward rolling in too far, also known as over pronation.

  • What causes overpronation?

    Overpronation occurs when the ankle rolls inward (or pronates) more than it should, resulting in increased weight distribution on the inner edge of the foot.

  • Can you fix overpronation?

    While overpronated feet may not be able to be fixed completely without surgery, it is absolutely possible to improve the condition and reduce painful symptoms. This can be done through the use of high-quality supportive footwear and simple exercises to improve the body’s natural biomechanics.

  • How do you treat pronation?

    You can treat pronation with a combination of treatment options, including stretching and strengthening the foot and calf muscles, wearing high quality footwear, seeing a gait specialist to check alignment while walking, and seeing a physical therapist.

In our study on foot pain across America, 19% of 6,030 survey respondents reported having flat feet.

Explore the latest foot pain trends, common causes of pain, treatment and prevention plans for maintained foot health in our 2023 Foot Pain Trends Report!

Features to Look for in Shoes for Overpronation

Selecting the right shoes to address pronation is crucial for ensuring proper foot alignment and preventing potential complications. Here are some essential features to consider when shopping for shoes designed to counteract pronation:

  • Arch Support
    One of the primary features to look for in shoes for pronation is robust arch support. A well-defined arch supports the foot’s natural curve, preventing it from rolling inward excessively. This support can alleviate strain on the arch and provide a stable foundation for the foot during movement.
    Arch Support
  • Firm Heel Counter
    The heel counter is the back portion of the shoe that wraps around the heel. A firm heel counter is essential as it offers stability to the rearfoot, helping control and reduce pronation. This feature ensures that the heel remains securely positioned, providing a consistent base of support.
    Firm Heel Counter
  • Medial Post or Dual-Density Midsole
    This feature is especially beneficial for those with overpronation. A medial post or a dual-density midsole offers added support on the inner side of the shoe. This reinforcement helps counteract the excessive inward rolling of the foot, ensuring better alignment during walking or running.
    Medial Post or Dual-Density Midsole
  • Wide Base
    Shoes with a broader base offer enhanced stability. This design reduces the chances of the foot rolling inward too much, providing a stable platform and promoting a more balanced gait.
    Wide Base
  • Shock Absorption
    Proper cushioning in the midsole is vital for distributing impact evenly across the foot. Shoes with good shock absorption can reduce the strain on the foot, especially during activities like walking or running, making them more comfortable and supportive.
    Shock Absorption
  • Deep Heel Cup
    A shoe designed with a deep heel cup can offer added stability. This feature cradles the heel, ensuring it remains aligned and reducing the chances of excessive pronation.
    Deep Heel Cup
  • Flexible Forefoot
    While it’s essential for the shoe’s midsole to be supportive, the forefoot should retain some flexibility. This design allows for a natural toe-off during walking or running, ensuring a smooth transition and reducing strain on the foot.
    Flexible Forefoot

Caring for Your Overpronation Shoes

The longevity and continued performance of these shoes largely depend on how they’re cared for. Proper maintenance not only extends the lifespan of the shoes but also ensures they consistently provide the necessary support and comfort.

As such, understanding how to care for shoes designed to address pronation is as crucial as selecting the right pair in the first place. The following tips offer guidance on preserving the structure, function, and appearance of your footwear.

  • Regular Inspection. Check for signs of wear, especially in the midsole and outsole, to ensure they continue to offer proper support.
  • Proper Cleaning. Remove dirt and debris after each use. For deeper cleans, use a soft brush and specialized shoe cleaner, avoiding harsh chemicals.
  • Air Dry Only. If shoes become wet, let them air dry naturally. Avoid direct heat sources like radiators or hair dryers, which can warp the shoe’s shape.
  • Rotate Usage. Using multiple pairs and rotating between them can reduce wear and tear on any single pair, ensuring consistent support.
  • Store Properly. Store shoes in a cool, dry place away from direct sunlight. Consider using shoe trees to maintain their shape.
  • Avoid Machine Washing. Machine washing can break down the materials and compromise the shoe’s structure. Stick to hand cleaning for best results.

Choosing Shoes for Overpronation

Choosing the right shoes for pronation is a combination of research, expert advice, and personal preference. By taking the time to understand your needs and exploring various options, you can find the perfect pair to support your feet and reduce the effects of pronation.

  • Consult a Specialist
    Before making a purchase, it’s wise to seek a foot assessment from a professional. Whether it’s a podiatrist or a specialist at a dedicated running store, they can provide insights into the degree of your pronation and recommend suitable shoe options. This expert advice can ensure you’re making an informed choice tailored to your needs.
    Consult a Specialist
  • Prioritize Fit Over Fashion
    While it’s tempting to choose shoes based on their design and aesthetics, it’s crucial to prioritize fit and function. A shoe that looks great but doesn’t support your foot correctly can exacerbate pronation issues. Always prioritize comfort and support over style.
    Prioritize Fit Over Fashion
  • Test Walk or Run
    Before finalizing your purchase, spend some time walking or even running in the shoes within the store. This test run will give you a firsthand feel for the shoe’s comfort, support, and fit, ensuring you’re making a choice that feels right for your feet.
    Test Walk or Run
  • Check for Lacing Systems
    Some modern shoes come equipped with specialized lacing systems that allow for a more customized fit. These systems can enhance support and ensure the shoe snugly wraps around your foot, providing optimal support for pronation issues.
    Check for Lacing Systems
  • Consider Shoe Last Shape
    The “last” of a shoe refers to the shape it’s designed from. For those dealing with overpronation, shoes with a straight last often provide better support. It’s a feature that can make a significant difference in comfort and alignment, so it’s worth considering during your selection process.
    Consider Shoe Last Shape
  • Replace Shoes Regularly
    Shoes, no matter how good, will wear out over time. As they wear, they lose their supportive and protective qualities. It’s essential to monitor the condition of your shoes and replace them as needed to maintain optimal foot health.
    Replace Shoes Regularly
  • Assess Activity Level
    Your activity level and type play a significant role in the kind of shoe you’ll need. Whether you’re walking, running, or engaging in sports, each activity has specific demands. Ensure the shoe you select is designed to support your primary activities.
    Assess Activity Level
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Why Others Love KURU

Why Others Love KURU

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LOVE THESE! I bought these a few months ago after reading the great reviews. I thought with free returns,I had nothing to lose. I have over pronation on one foot due to an old injury (15 plus years),& usually wear some type of memory foam shoe (skech*rs),& even then I can only walk for a short period before my foot starts hurting. It took a short breaking in period but after a few days I have been pain free every time I wear them. They’re so comfy & stylish. As my foot pain progressed I thought I would be stuck with having to wear some chunky/funky looking orthopedic type shoes to actually get relief but thanks to KURU I don’t have to.

ARLENED81

WONDERFUL SUPPORT AND SO COMFORTABLE. My husband has Parkinson’s, flat feet, and over pronates. The stability of the shoes have been way beyond excellent for him. He is walking much better and loves them. We have tried every show imaginable, and this is the one he wants to wear. They are very easy for him to get on, too.

SWEDE

GRATEFUL FEET! These shoes are AWESOME! They are cute, fit perfectly, mine did not require any real break in period. I wore them in the house twice for maybe an hour each time before I started wearing them on my 5 mile walks. Zero issues. They have made my walking so much more enjoyable as the tingling in my toes and fatigued feet are no longer bothering me. My feet pronate so I really appreciate the arch support in these! I am women size 9 and I have bigger ankles. Often times tennis shoes are cut in such an unflattering way around my ankle that it almost would appear that my ankles have love handles hahaha. Anyway, I find these shoes are flattering fun AND reduce swelling in my legs and feet. SOOOO happy I made this purchase. I want the hiking Kuru’s next!

NIIICOLA

I LOVE THESE SLIPPERS. FIRST KURUS. I have been looking for slippers that are supportive. I have flat feet and extreme ankle pronation. These are so supportive and comfortable that I didn’t want to take them off. They aren’t nearly as hot or sweaty as fleece lined slippers. I would call them three season. I bought a pair of Kuru flip flops for Summer and those are also super comfortable. I usually wear a 10.5 or 11 (44 in EU) and the 10.5 fit perfectly. I would go up if you are in doubt. The 11 would be a bit roomier on me, but I like the 10.5. These are very cushy and I think they look really cool.

SEAN000

SOO COMFORTABLE! Love them! I was skeptical that Kuru sneakers would be better than any other sneakers, but they are. Recently, I went hiking and realized that my feet didn’t hurt at all after several hours. That is highly unusual for me because typically, my arches hurt, I get blisters on my heels, and my ankles start hurt (I pronate my ankles). I’m so happy I took the leap and got these!

RACHEL21

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