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Runners on a paved road, pronation vs. supination

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Do You Overpronate or Underpronate While Running? Here's How to Tell—and What to Do

The experts break down what these movements mean for your training.

By Jen Ator February 27, 2024

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As runners, we each have our own unique stride, but one thing is the same: With each step, our feet “roll” from side to side. This is known as pronation.

While it’s a normal and natural movement, there’s such a thing as too much of it. Since your feet are the foundation of your body, overpronation and underpronation (more commonly referred to as supination) can affect your running—often without you even realizing it. “Our body is a very clever machine, and it works around imbalances in order to continue to function,” says Peloton instructor Becs Gentry

Here, we break down what you need to know about these important stride movements. 

Pronation vs. Supination: Key Differences

Pronation and supination are normal joint actions that occur in your feet. Pronation refers to the natural inward movement of the foot, while supination is the natural outward movement.

What Is Overpronation?

When you walk or run, pronation is your foot’s natural tendency to roll inward as it connects with the ground. However, when this inward roll (or pronation) becomes excessive, it’s called overpronation. On a step, your ankle and foot continue to roll inward when your toes should be pushing off of the ground. This movement places more pressure on the inner side of your foot and also puts greater strain on your big toe and second toe. 

Overpronation can have a number of causes, but it’s often related to the shape of your foot’s arch. For example, if you have flat feet (i.e. little to no arch) you’re much more likely to overpronate than those with normal or higher arches. 

How can you tell if you overpronate? “A simple way is to look at the wear pattern on the heel of your shoe,” says Nicholas Anastasio, MD, a board-certified physician at Orthopedics and Joint Replacement at Mercy Medical Center in Baltimore, Maryland. “If the medial (inside) part of the heel wears down more, you overpronate.” 

What Is Supination (Underpronation)? 

While pronation is the natural inward roll of your foot, supination is the outward rolling of your foot. The balance between your foot’s inward rolling (pronation) and outward rolling (supination) is what helps stabilize your gait, Anastasio says.

But when that outward roll is excessive, it’s referred to as oversupination, or more commonly, underpronation. Runners with high arches are more likely to underpronate. To see if you underpronate, check the wear pattern of your shoes. If you notice that the lateral (or outside) part of the heel wears down more than the inside, that’s a sign of excessive roll, Anastasio says. 

Woman puts on running shoes, pronation vs. supination

Emilija Manevska/Moment via Getty Images

The Risks of Overpronation and Underpronation

Pronation and supination are natural—and essential—movement patterns that help your body shoulder the load of running. It’s when they become “excessive” that you want to pay particular attention to them. 

“Overpronation or oversupination can be relatively benign,” Anastasio says. “But they can also lead to excess stress on the forefoot and shin, leading to injuries such as stress fractures, joint pain, or tendonitis.” 

For example, overpronation puts the foot in a far less stable position, which can impact the biomechanics of your lower leg. According to the Cleveland Clinic, overpronation can be correlated with a number of injuries and conditions including: 

  • IT band syndrome 

  • Heel pain

  • Achilles tendonitis

  • Bunions

  • Back pain

And while overpronation is more common than underpronation, it’s still important to pay attention to the signs of too much outward rotation, Anastasio says. That’s because excessive supination can lead to injuries and pain in your ankles, knees, back, and hips.

How to Avoid Overpronation and Underpronation

Generally speaking, your degree of pronation or supination shouldn’t be cause for too much concern. “If you are not experiencing any significant pain or limitations, you do not need to worry about adjusting your foot or running mechanics,” Anastasio says. “However, if you have recurrent injury while running, this may be a factor.”

Some aspects of overpronation and underpronation cannot be fixed. For example, runners with flat or low arches are more prone to overpronation, while runners with high arches are more likely to underpronate. But as Becs says: “If there is a way of working with your body to correct imbalances and get stronger, why not? This can lower injury risk and increase the joy of running.” 

Here are a few tips for avoiding (or at least mitigating the impact of) overpronation and underpronation:

  • Get an assessment. “Heading to a running store where a professional can evaluate your running form can help hugely as it may impact what shoes you wear and what exercises you do outside of running,” Becs says. The key is having them see you in motion. Anastasio agrees. “Some running shoe stores have a device that looks at your weight distribution when standing on a plate,” he adds. “This is only a static measurement, whereas shoe wear pattern [or gait analysis] can give a better estimate of your actual dynamic mechanics.” Call your local store ahead of time to ensure that they offer this type of assessment. 

  • Choose the right shoes. It’s crucial to find running shoes that provide the most comfort for your specific arch and pronation tendencies. “Just because a running shoe is worn by someone you know doesn't mean it is suitable for you,” Becs says. Same goes for a shoe’s aesthetic appeal. “It may look cute but does it serve your needs?”

  • Shore up your weaknesses. Make sure to keep strength training and mobility work in your exercise routine. “Maintaining good strength in the ankle tendons on both sides of the ankle will help support the foot in a neutral position,” Anastasio says. Working with a physical therapist can help you to identify the best exercises to help you to avoid injuries related to overpronation or underpronation. 

  • Don’t just opt for orthotics. Before you splurge on pricey custom insoles, it’s worth getting a professional perspective. Sometimes there are “mechanical issues” that prevent the correction of your gait, Anastasio says. For example, you may have a uniquely shaped arch. In those instances, “there are orthotic inserts and shoe adjustments that can be made to accommodate most foot mechanics,” he says.

What to Consider with Pronation and Supination

Many runners take their feet for granted, not realizing the significant impact they play in the health and proper function of their entire kinetic chain. You may even be one of them. And while you may be able to compensate for excessive pronation or supination without experiencing any negative symptoms, you may develop knee, hip, and back issues perpetuated by your poor foot function—without realizing the root cause. 

That’s why the most important thing you can do is tune into your body. “Every body is different,” Becs says. “The demands and expectations we each have for our running journeys are different, too. It is super important that as we begin and progress in anything we do in life, we stay in tune to our body and any signals it's giving us.”

Developing that sense of awareness will help you identify new issues that emerge over the course of your running journey. “Your mechanics can change over time,” Anastasio says. “This can be due to things such as wear and tear of the supporting tendons of the ankle, development of stiffness in the joints or tendons, or joint arthritis.”

When in doubt, it’s a good idea to see a doctor if you have any persistent pain. This can be your regular doctor or a podiatrist. A thorough foot and ankle evaluation can make a profound impact on your overall health and happiness—and keep you running for miles to come.

This content is for informational and educational purposes only and does not constitute individualized advice. It is not intended to replace professional medical evaluation, diagnosis, or treatment. Seek the advice of your physician for questions you may have regarding your health or a medical condition. If you are having a medical emergency, call your physician or 911 immediately.

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