Is Pronation Bad for Running?

What do you think of when you hear the word “pronation”?

If your initial reaction is negative, you’re not alone…

Many runners only hear about pronation in frustrating contexts, like being told they run incorrectly or that they’re in pain because their feet pronate.

It’s an understandable association; if running coaches or medical professionals are blaming pronation for your pain or limitation, then it must be the villain, right?

Not quite.

Here’s what pronation actually means for your running.

What Exactly Is Pronation?

First things first, let’s clarify what we mean when we say “pronation.”

Pronation is what allows your ankle joint to roll inward, toward the midline of your body. When this happens, the arch of your foot splays and flattens out.

Though it may be uncomfortable to think of your ankles rolling inward (no one wants a sprained ankle…), pronation is such a subtle mechanic that we don’t often realize when it happens.

For instance, our feet technically pronate when we stand up! When getting up, your arches flatten to help stabilize the body as you bear weight on your legs and feet. Similarly, when we walk, the degree of pronation increases slightly to help tolerate more dynamic loading.

So, it’s clearly important for some movements. But what about running?

Is Pronation Bad for Running?

Nope! With sufficient muscle strength and mobility, your ankle is capable of keeping its pronation within a safe and healthy range.

In fact, controlled pronation positions your foot and ankle in a way that lengthens your muscles, which improves their ability to absorb shock. (When the tissues elongate, they’re able to bear higher forces without using as much energy, making it a prime opportunity to disperse your landing forces.)

This becomes especially important with running, as it’s a repetitive, high-impact sport. With your feet being the first point of impact, they’re the first major structure of the leg that has to take in the forces safely.

So, long story short: no, pronation is not inherently bad for your running, and it’s actually a necessary part of proper biomechanics!

The reason why runners often assume it’s not good is because it can easily get out of hand (or should we say, out of foot?). This issue, also known as overpronating, is brought on by insufficient muscular control that causes the ankle to roll too far inward while under load.

Overpronation isn’t based on any arbitrary feelings, either. There are 2 distinct qualities that define when your pronation passes the ideal threshold…

The more obvious indicator is when your ankle visibly rolls in too much. Sometimes this is noticeable with the naked eye, and other times it’s more nuanced and requires the assistance of technology. (Our clinic specifically utilizes high speed cameras for slow-motion video capture. If you want the nitty gritty details, we consider anything over 8 degrees of pronation to be excessive!)

Example of overpronation using high speed footage and pressure map readings

The second defining quality is a little harder to identify — it depends on how quickly you pronate.

In order for your muscles to properly mitigate impact forces, your muscles need enough time to lengthen and activate. But if your feet pronate too fast, the muscular tissue isn’t primed to absorb shock, and the forces get displaced onto the passive, tendinous tissues of your feet instead.

This brings us to another important consideration: overpronation and injury risk.

What Injuries are Associated with Overpronation?

As mentioned, the tendons of your foot and ankle are especially vulnerable to displaced forces, so tendinopathies are one of the most common injuries for runners who overpronate.

Depending on how excessive the overpronation is, it can affect anything from the Achilles or posterior tibialis tendons in the back of the calf to the peroneal tendons along the outer side of your lower leg or the plantar fascia that runs along the bottom of your foot.

Most commonly, runners experience inflammation in these tissues, resulting in tendinopathy (also referred to as tendinitis) or plantar fasciitis.

But beyond the tendinous tissues, runners are also at risk of developing joint pain. Some people develop bunions at the base of their big toe, whereas others may experience pain in their lateral ankle where the talus and heel meet.

Bunions
Lateral Ankle

Many runners also end up dealing with pains further up the kinetic chain. Because overpronation typically occurs with insufficient stability in the foot and arch, that lack of stabilization travels up the leg as well.

This can be an indirect factor behind certain kinds of knee pain, like issues in the patellar tendon or the medial knee, as well as poor positioning of the hip joint that can cause problems similar to hip impingement.

Of course, knee and hip pain can be caused by plenty of other factors beyond overpronation, but we frequently find that runners present some degree of underlying foot and arch instability alongside these symptoms. (Ultimately, you can stabilize the knee or hip joints as much as you want, but it’s also essential that you assess the foot and ankle and build that stability from the bottom up.)

How Can You Assess if You Overpronate?

If you’re trying to measure your degree of pronation by yourself as you’re running, we’ll stop you right there: that’s virtually impossible. (And strenuous, at best.)

But, you can try to self-assess your pronation with less dynamic activity.

For instance, you can start by simply observing how you stabilize your arch between sitting and standing positions. When you’re seated, keep your feet resting naturally on the ground and see what your relaxed, non-weight bearing arch looks like. 

If you stand up on both feet, you’ll see the shape of your arch change — if it changes to a large degree, you likely don’t have great arch control. (You can also observe this if you move from standing on two feet to just balancing on one.) If you have to overpronate to stay balanced, you’re using the mechanic to compensate for lack of true stability.

As you’re standing, also pay attention to how your feet are oriented in your natural position. If your feet are noticeably rotated outward, or one is more turned out than the other, that’s often a sign of arch instability. (This is your body trying to compensate to find a passive position to stabilize itself.)

You can also look at how your arch loses (or retains) stability in relation to your ankle mobility. The less mobility you have, the more you have to compensate to bring your shin forward. This can be observed in the knee-to-wall mobility test; if you don’t have true ankle mobility, you’ll see your arch collapse as you bring your knee towards the wall.

Now, with all of that being said, we know that you really only care about overpronation in the context of your running. And while measuring that mechanic isn’t doable by yourself, you CAN get that data by working with a running specialist.

With services like our running gait analysis, you can collect data points about pronation (and everything else) specific to YOUR unique running form, and all in real-time!

How to Stop Overpronating

Here’s the part you’ve been waiting for, right?

We now know that pronation is good, and overpronation is the true villain — so how do you go about fixing it so you no longer overpronate?

If you’ve ever searched for a solution before, you may be thinking: “They make footwear specifically to correct overpronation! It’s time to buy a pair!”

…But let’s dig a little deeper into how effective that really is, shall we?

Do Shoes Fix Overpronation?

Alright, here’s the deal: over the years, our clinic has worked with hundreds of runners, and we’ve had countless conversations about whether or not these corrective shoes actually work.

And the verdict is… kind of.

Wearing overpronation shoes can be helpful, but it won’t fully FIX the problem. Ultimately, with any kind of footwear, you should be using them as a supplement to your running form, not as the solution to form errors.

With overpronation, you can treat these shoes like an orthotic — you may find a pair that provides some additional arch support or ankle stability, and that’s fantastic!

But, you shouldn’t be relying on the shoes to take care of your overpronation.

Think of it this way: if you have a knee problem and it feels unstable while you walk, you may wear a brace to help support it. But your goal isn’t to depend on the brace forever; the goal is to strengthen the structures around your knee so you eventually don’t have to wear the brace again.

It’s the same logic for your running shoes. Use them as a temporary support while you focus on building strength and muscular control in the foot and ankle for more innate stability.

Address Biomechanical Deficiencies

This is the real solution you’re looking for.

At its root, overpronation is caused by improper biomechanics — this can include actual movement mechanics to particular deficiencies in muscular functionality and control.

The key is to identify what exactly is contributing to your overpronation. Once you pinpoint that root cause, you can set a game plan to address those specific needs and eliminate the problem for good.

Let’s review some of the most common deficiencies we’ve found associated with overpronation and what you can do to fix them.

#1. Limited Ankle Mobility

Just like we mentioned earlier, if you have restricted mobility in the ankle joint, your body has to compensate with overpronation to bring your shin forward while running.

Part of addressing this issue requires simple drills to improve your ankle range of motion, as well as running-specific mobility drills to practice regularly throughout your training.

Depending on the type of limitation you’re dealing with, you may need specific joint mobilization (which can either be done independently, or assisted by a physical therapist).

#2. Lack of Arch Stability

Another familiar-sounding one, right?

To clarify, when we say that the arch lacks stability, we actually mean that some of the muscles in your foot aren’t strong enough to support your arch. These muscles are specifically referred to as your “arch stabilizers”: the posterior and anterior tibialis, the peroneus longus, and the foot intrinsic muscles.

But the good news is muscle weakness has an obvious solution — strength training!

We know, not all runners are fans of strength training, but it’s essential for retaining the level of muscular strength and power needed to match the demands of the sport. Plus, when it comes to strengthening the muscles around the foot and ankle, the exercises aren’t that rigorous or time-consuming.

#3. Tightness in the Calf

This is a super common issue that runners deal with.

Some people feel a distinct tightness in the muscle, while others feel like their Achilles tendon is stiff while they run. Understandably, if either tissue is restricted, it’s unable to elongate (which is necessary for both shock absorption and controlled pronation).

To help combat this lower leg tightness, be sure to incorporate a regular calf-stretching routine into your training plan. Focus on static stretches and hold them for one to two minutes at a time to really accustom those tissues to lengthening.

#4. Poor Hip Control

Remember how we talked about overpronation impacting the rest of your kinetic chain? Well, the inverse is true, too.

Many runners who present a lack of functional control at the hip also deal with overpronation as a consequence. This is because poor alignment is associated with internal hip rotation, which affects your knee stability, and this travels all the way down to your ankle stability and ultimate degree of overpronation. (Plus, having poor control of the local foot and ankle joint will also have an inevitable effect on your stability.)

To improve this alignment control, you will naturally focus on alignment control training, like Bulgarian split squats, Romanian deadlifts, or statue of liberty drills. You’ll also likely incorporate activation training to ensure that all your major muscle groups are turned on and firing as needed to help retain proper alignment.

Pronate Away!

And there you have it, runners: pronation is NOT bad for running.

It’s sort of like the old adage, “Don’t judge a book by its cover.” If you don’t take the time to truly understand what pronation is, you’re led down a path of injury, ineffective gear, and subpar training, all due to a simple misconception.

That’s why it’s imperative for runners to learn about optimal running biomechanics. Even though running is an innate ability for humans, it’s a skill that can constantly be improved upon if you approach it deliberately.

By Dr. Torey Page DPT OCS

Dr. Page is recognized as a specialist in evaluation and rehabilitation of the lower extremity, spine, and shoulder. He has had years of experience working as a physical therapist and as a strength and conditioning coach, so he is well-versed in the analysis of human movement and biomechanics (as well as advanced training in running mechanics and return to sport training). Torey has advised a wide range of clients, from sports teams to triathletes to the Woodside Fire Department. In his spare time, he enjoys spending time with his wife Joey, their beautiful daughter Savannah, and their dog Gatsby.

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