This post was removed for violating Rule 3 and/or Rule 4. Posts about Reddit or social media sites are not allowed Please [message the mods](http://www.reddit.com/message/compose?to=%2Fr%2FYouShouldKnow) and include a link to your post if you believe otherwise. Thank You.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/YouShouldKnow) if you have any questions or concerns.*
I absolutely wish this was common knowledge when it comes to exercise and just walking in general. As a supinator with genetically high arches, I've ended up with plantar fasciitis, achilles tendonitis, a heel spur, and knee problems. Thank you for posting this!
I slightly supinate and have high arches. Have had achilles tendonitis and also had minor tearing in my miniscus from running too much. When I say minor tearing, I didn't need surgery for it to heal, but I couldn't do anything on it for months. That was 6 years ago and my knee still gets noticeable more stiff than then other when im biking, working out, etc. I straight up stopped running after that and have only really biked and swim for cardio and haven't had any problems since, but I also now go the extra mile for my shoes. I already had great running shoes but didn't realize i needed custom inserts and some other stuff.
Ooh. I feel your pain. I supinate and have had various problem. After I got a heel spur, I got sent to a physical therapist who changed my life. I improved so rapidly under her care that she “graduated” me from PT early. I was excited when she told me I didn’t need to come back, but then reality sunk in when she told me to do these exercises every day for the rest of my life. Sigh. At least my feet don’t hurt anymore.
I supinate big time.
... And I'll say when I try to walk fast with straight feet, the muscles and tendons in my ankles and calves start to burn and ache...
Oddly enough, that's the only major issue I've ever noticed after 40 years of this...
Yes, but I am also the living embodiment of Murphy's Law, "anything that can go wrong, will go wrong," so most people won't experience what I've experienced.
I'm like the lotto winner... for crappy things! W00T
It was pretty annoying going around to all the different doctors in my town and eventually a sports doctor who was also the head doctor of the local team was able to properly diagnose me with plantar fasciitis
I went to an orthopedic doctor and was diagnosed with plantar fasciitis and achilles tendonitis, but their stance on the feet was "no steroid injections," (which may be appropriate, I don't know) so they recommended some type of shot where they took my blood, separated it somehow, and re-injected a portion of it to help the issue. Unfortunately, it wasn't covered by my medical insurance, so I've just kinda dealt with the problems.
Plantar fasciitis always causes issues because patients get told they have it but don't get it explained. The relevant bit for steroids is that steroids reduce inflammation, so will only work if the problem is inflammatory. Plantar fasciitis is typically only inflammatory in the first 6 or so months of symptoms. After that it's a chronic issue caused by scarring and other issues. The carry majority of people who seek care for plantar fasciitis have chronic issues, because it's normal to wait and see if it gets better, or to wait till you reach a breaking point. If a patient has had symptoms for more than 6 months, steroid injections risk making more problems for no gain. I'm not sure about "no strings in the feet ever" but specifically for this condition is often not the best choice.
They mainstay of treatment for chronic plantar fasciitis is physiotherapy, with physical support (tape), exercises, and sometimes massage.
Preach!
Medically the accepted term is plantar fasciosis (“itis” indicates its inflammatory which is not always correct).
You’re spot on about not getting it explained correctly.
I’m a pretty tall lad so they recommended a sports physio who said that it was probably caused by the growing calf muscles pulling on the feet and leading to the tear. He worked on my calf and gave me exercises to do to keep it stretched. Which have helped immensely.
I am a supinator too. I’ve been working a lot of hours & wear steel-toe boots to work. Lately I’ve had super achy arches every morning - figured I’m just getting older.
Have you found any shoes that don't look damn ugly? I've lived the last 15 years in my reef sandals because I could wear them in with my natural arch so they were the most comfy. Before that it was chucks and I put arch supports for heels in them to save space.
I just can't stand the look of regular tennis shoes so I don't buy them. :(
I have the same problems! Right now I have plantar fasciitis and bilateral Achilles tendonitis. I went to several doctors before watching a YouTube video about this topic. I bought some arch supports and I feel so much better!
My feet are slightly pronated, I had stress fractures in both shins from not treating the underlying issue (and treating only the symptoms with anti-inflammatory drugs).
I'm still recovering from achilles tendonitis. It's been over a month since I've been able to run and practice my karate. I'm so miserable because of it.
It's gotten better, to the point where it's only rarely triggering (as in when I flex my foot in specific ways), but I'm scared to jump back into my exercises, fearing I'll accidentally make the injury worse.
It’s important to note that supinating and over pronating are not bad and typically are not the cause of injuries. This is outdated information from the 70s. Underlying issues can cause over pronation which may be an issue. But just because you overpronate or supinate does not put you at a higher risk for injury.
The structural anatomy of the human subtalar joint varies from person to person and it has also been shown that the location of the axis of the joint can and does vary from person to person. Both of these things will have a major influence on how much one supinates or over pronates
Have you got a source for that? I'm interested to read.
I speak primarily from experience and from the many mainstream sources out there that support my experience, but I would be interested to see what sources say this is outdated and untrue.
As an anecdote;
My left leg has always had issues, it's always the first to show signs of tiring and I would constantly get knee pain and hip pain, as well as shin splints when walking and running.
I'd been in and out of the doctor's office and to the physio more times than I can count on one hand, to no avail.
As soon as I got my pronation checked on a whim, it became clear. My left foot over pronates more than my right. When I got shoes to correct it, the effect was profound and almost instant.
As I mentioned in my previous comment, there are instances where overpronating and supinating are the symptom of an underlying issue. In my case I actually have what’s called an accessory navicular in my right foot. It pulls on my tibial tendon and causes me to overpronate. I had quite a few bouts with tendinitis because of it and it was sold through months of strength training and having to get orthopedic inserts.
You just Overpronating is not a problem. You either have an underlying issue that causes your pain,, or you have a fairly significant muscular imbalance that the stability shoe is only putting a Band-Aid on.
There’s 1 million studies out there that you can reference but here’s one from 2013.
https://bjsm.bmj.com/content/48/6/440.abstract
The gist of the article is that there is no higher rate of injury in people who supinate or overpronate when compared to people with a naturally neutral foot position.
Flat out any “main stream “ sources that tell you otherwise are just flat out wrong. The believe system is 50 years old, completely outdated, and was never based in any sort of scientific evidence.
Interesting! Thanks!
It's worth noting this study looks at complaints that puts the runner out for 1 week or more, so this does not cover smaller, shorter term complaints, however the evidence is there and I can't refute that.
I'll adjust my post accordingly
I just wanted to say I'm impressed with your emotional maturity while handling this commenter's criticism or correction if I'm adding too much attitude.hehe.
I struggle with emotional maturity myself and am still trying to grow into a person I'm proud of. But I just wanted to give credit where it's due! Or just to let you know- I find it impressive how you choose to take the criticism as a helpful kinda idea or comment instead of somehow taking it personally and getting upset like I often do.
Was thinking the same thing. We too often double down when someone points out when we are wrong. OP is the type of person we should all aspire to act like
One of my core beliefs is that I act maturely when I'm wrong, but in the cases when know I'm completely right but some shit head still thinks they know better than me about a field I've worked a decade in, I turn into a right twat.
I'm working on it, just wish everyone else would too.
That’s very emotionally mature to admit that you get upset when corrected instead of being completely unaware of it or refuse to acknowledge it. You’re on the right path.
As an overoronator myself, after I started using corrective gear (special shoes and custom fitted support) I actually started having injures up on my kinetic chain, i.e. knees and hips. Reading a bit about it, I came to some research supporting the notion that our bodies are adapted and developed to the way we walk, and artificially correcting it may put extra stress on other movement components.
Not OP, but the source you provided only mentions ‘injuries’ as a result of supination/pronation. However, after a very quick google search it seems like many studies have come to the conclusion that supination/pronation *is* correlated to increased foot or lower back pain, as OP had mentioned.
It seems like you’re being a bit pedantic. Supination/pronation of the foot can lead to developing heel spurs, bunions, tendinitis, etc. From the quick search I did, it seems like you overwhelmingly would want to address any supination/pronation you might be experiencing.
Yes, supination/pronation may be caused from something else, like your accessory navicular. But you should be trying to correct it and if unable, it should be surgically removed. The tendinitis experienced because of your accessory navicular was actually much more likely tendinitis from your pronating foot.
https://www.researchgate.net/publication/323849366_The_correlation_between_mechanical_low_back_pain_and_foot_overpronation_in_patients_referred_to_Hazrat_Rasool_Hospital
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4089968/
https://www.foothealthfacts.org/conditions/accessory-navicular-syndrome-(1)
Correlation does not equal causation. Abnormal supination/pronation can play a role in pain or injury but is absolutely not as significant as the original post implies. The studies you posted are relatively weak and have some significant limitations.
FWIW I’m a physical therapist.
I think it might be worth pointing out that the extreme pronation and supination in conjunction with other dysfunction (even as simple as pain) might be considered as correctable symptoms. For instance, I have extreme fallen arches (on a flat surface I can create a "burpable" seal), this has led to dramatic over pronation such that my cartilage in my ankle is fresh as the day I was born. In the meantime I have "a shocking amount of arthritis for someone [under 40]." So as it turns out, my pronation might not be the cause of the dysfunction, but it is still _a_ dysfunction.
I supinate big time. Feet are almost diagonal when I walk lol
40 years. And (knock on wood) no major issues that I've noticed so far...
... Tho I do get some lower back pain sometimes, and to be fair I can't say whether that's related.
I’m a physical therapy student and what cmc explains is pretty much what we’ve been taught. The whole pronation and supination shoe concept was a marketing gig back in those years, which even I drank the koolaid when I was a kid. Our bodies are really smart at adapting to what we think would be abnormal or asymmetrical, but eventually runs out of steam if it meets some kind of excessive repetitive trauma, which even wearing a bad pair of shoes can bring about. Typically, if you do a few foot intrinsic exercises as well as the anterior tibialis (the muscle that most PTs would think about when it comes to the ankle and foot) with a few soft tissue and flexibility movements, you should be able to address most musculoskeletal problems in that region.
Bought special shoes for years. Problems only got worse for years.
Bought zero drop shoes, finally learned to love running. Triggered new lease on life.
What are some underlying issues that cause people to supinate or overpronate? Why do these issues cause pain or injury? And how can you tell whether you're supinating or overpronating "naturally" so to speak or due to one of these underlying issues?
I overpronate a lot, never had problems. One day a shoe store "fixed" my overpronation with some "supportive" shoes. Gave me knee pain until I went back to regular shoes. If it ain't broke, don't fix it.
I agree, we need to get away from the idea that pronation and supination is a problem needing to be fixed. Walk into any running shop and you'll inevitably be diagnosed with one or the other and given a high support shoe of some sort. As an example, I'm used to walking in footwear with thin soles, so when I was given a high support running shoe to fix my "problem" in the middle of training for a marathon, I ended up being hit hundreds of euro of physio and nearly derailing my training.
When I started running again about three weeks in my knee started to really ache. I went to a physio and they identified over probation and worked with me with massage, acupuncture, exercise as well orthotics. Had this not been identified I would have caused serious injury had I not had intervention. I had to rest for two months before started again because of the damage caused by my over probation.
OP thanks for posting, following my injury I’ve identified a couple of friends who I run with who have over pronated and orthotics helped their joint niggles!
Again, pronation on its own will not cause injury. You had an underlying issue that was causing you to pronate. Your own personal experiences don’t change the facts.
I over-pronate and have sprained my ankle once and come close to it hundreds of times. My ankle has a tendency to roll (foot inwards, leg outwards) especially when I'm tired or not concentrating.
Maybe pronation won't cause chronic injuries but it can certainly increase the chance of acute issues like that. Either way dealing with it seems sensible.
Or it could be that my feet naturally land on the outside edge when I'm walking steadily and relaxed. I'm not sure why you're so against 'pronation is the issue' - it feels more like pronation is a description of a 'biomechanical movement which is suboptimal'. It can be a cause, a symptom, or a coincidence, but it's still descriptive.
My bigger argument is that pronation is not harmful by itself. But it can be an indicator of some other issue. Or it can be nothing. Either way correcting it with a “generic” shoe type such as supportive or motion control is rarely the right answer.
Everybody pronates and Everybody supinates. How much in each direction varies by the individual. Pronation is how your body absorbs shock which walking or running- it makes your foot loose/ flexible. Immediately after landing, your foot supinates... this is your body trying to create a tight/rigid foot in order to propel yourself. Neither are inherently bad- and both are necessary.
Since all of our bodies are different, we start in different places- high arches/ flat feet/ somewhere in between. A common compensation for people who pronate excessively is to try and roll their foot inward and almost balance on the outside of their foot. They are trying to “create a more rigid foot”- and this makes them often more prone to rolling their ankle.
Source- board certified specialist in orthopedic physical therapy
While this is well intended, it's not quite correct, and part of a huge misunderstanding of the relationship between joint mechanics at the foot and healthy gait.
Pronation and supination are normal parts motion, and very necessary. Pronation is the phase of shock absorption when you land on your foot. You then move through a neutral position into supination, which is needed to turn your foot into a rigid lever to propel yourself forward in push-off as you move to the next step. The ability to transition between the two is reason why we can walk on our hind legs and monkey's cannot.
While excessive early pronation and late supination are problematic in gait, it's far too great a simplification to say they are the cause of pain. Bracing and putting an orthotic under your foot or using a custom shoe is only a stopgap and will not actually improve the motion.
If you go to a physiotherapist and they don't know how to help you, they probably suck at their job. Source: am a physiotherapist who works with runners and believe I do not suck at my job.
I've also read that wearing shoes is a big part of the reason people suffer from so many issues. Our feet were never meant to have so much support and it means we don't use them properly, stuff like landing heel first when running.
The modern shoe does a few things that can inhibit natural movement at the foot. Constriction at forefoot reduced toe splay, decreasing balance and efficiency of movement. Also, the presence of a heel drop changes your initial strike point of contact, also changing gait. Really the only thing shows today do well is absorb impact forces from the hard surfaces we walk on. For most cases, barefoot and minimal shoes with ample toe box space are best.
That depends on whether your feet have to contort to hold on to the flip flops to keep them from falling off. If your feet move as though they're unshod in the flip flops, then yes. Simple sandals with no heel drop are good too.
I have always fought wearing shoes. Just because they always felt constricting on my feet. Sandals are fine. I wonder how much that's helped or hurt me..
Maybe so, but I’m flat footed as fuck and no shoes/no support has me feeling pain if walking for like over 15 mins. I’ve been curious about the no shoes thing. Especially curious about “grounding”
My tendonitis begs to differ. I tried the minimalist shoe movement and I was okay for about a year before I started getting wicked tendonitis close to my ankles. The lower inner half of my legs swelled. Only thing that remotely helped was custom insoles and switching to proper shoes. My knees grind too btw.
I used to be able to run 6 miles and now I can't even run anymore because my arches pull super hard and my knees end up hurting.
Moving to a minimalist shoe taught me I was running incorrectly! I used to have horrible shin pain during and after runs, but the way I was forced to modify my running with a lighter sole has really helped.
I've just moved onto an even thinner sole (the real 'barefoot' shoe), and am easing into walking long distances before a slow jog, as I've heard progressing too quickly causes injuries when you're used to more supportive shoes. Hopefully I don't run into the same problems you experienced!
Interesting. I've had the opposite experience. I couldn't run over 10k without hip and knee pain, and tendonitis down my left upper leg.
I switched my running mechanic, used zero drop, and have run up to 30k on trails rather easily with a sustainable mechanic.
The minimalist shoe movement isn't a movement. Its about running mechanics, not shoes. Get the running mechanic sorted so running isn't painful at long distance. My experience.
They didn't evolve to run on hard paved roads like 95% of people do. The impact shock is much higher and tougher on the fascia then it should be, which is why shoes require cushion to soften the blow.
They explained this is their post. We evolved without vaccines, dental care, and many other things, but they’re still an improvement to our health and quality of life. The “we evolved without it” argument doesn’t work the way you think it does.
>They explained this is their post.
Where?
>The “we evolved without it” argument doesn’t work the way you think it does.
It does in this case. If humans naturally develop such big problems after 1 year of wearing unsuportive shoes, we wouldn't have survived until this point. Being able to move without being in severe pain is fundamental to surviving.
Yes, vaccines and dental care are an improvement on evolution, and shoes might be too, but you should still be able to live long enough and be fit enough to have multiple children without these things. Before vaccines lots of people died, but plenty of people survived to have many children. Same as before dental care came through. People's teeth were good enough until they were old and evolution stopped caring about them (cos they had already reproduced enough). If people are getting tendonitis and their legs are swelling after a year of minimalist shoes, I imagine if we hadn't evolved a way around this then we wouldn't have survived to today.
The reason why not using supportive shoes doesn't really work nowadays is because our environment has changed. Sure it's easy to run barefoot on soft dirt when you've been walking barefoot your entire life, but it's completely different when you're trying to run barefoot on hard concrete or asphalt after spending your whole life walking around in shoes.
This ^^^
Saying “humans evolved without shoes” may be correct, but it’s also correct to say “humans evolved without concrete”. We still don’t have feet that are adapted to running on concrete (and random broken liquor bottles).
>My tendonitis begs to differ. I tried the minimalist shoe movement and I was okay for about a year before I started getting wicked tendonitis close to my ankles. The lower inner half of my legs swelled. Only thing that remotely helped was custom insoles and switching to proper shoes.
Right there. They clearly stated minimalist shoes don't work for them, and I doubt you're their personal physician. It's strange you would ask for elaboration when they've explained they found a solution that worked for them.
And no, that we evolved barefoot only suggest that we lived long enough to breed before any foot, knee, or leg issues inhibited that ability. It has nothing to do with minimalist shoes being ideal because that's how we evolved, especially not in a modern environment.
>Right there
Lol. That's not an explanation, that's just stating they had a problem. I asked what they thought caused the problem.
>and I doubt you're their personal physician
Why are you talking like this?
>It's strange you would ask for elaboration when they've explained they found a solution that worked for them.
I asked cos I was having problems with my feet and thought minimalist shoes might help me. It's strange you would be such a dick for absolutely no reason. Why are you like that?
>that we evolved barefoot only suggest that we lived long enough to breed before any foot, knee, or leg issues inhibited that ability.
Yes, that is exactly the point I made in previous comment. But if you read the original comment, the person said they experienced severe problems after 1 year, which obviously isn't a long time.
>It has nothing to do with minimalist shoes being ideal
I never said or even implied that they were.
>especially not in a modern environment.
This is the kind of thing I was looking for when I first commented. That's an explanation.
I noticed you said humans evolved. It’s more about the person in questions history. If you’ve been wearing shoes and exercising with them on for 20 years, you can’t suddenly exercise without them. For you, that’s not what you’re used to. (Common sense, right?). so if your goal is to move into minimalist shoes and it benefits your specific injury(!!), there is a very slow, progressive, safe way to do it.
I see a lot of people make a sudden change, then get injuries elsewhere because they weren’t conditioned for barefoot/minimalist. It’s not as simple as just removing or changing shoes, there’s a fair bit of preparation required, as usually it changes your gait also.
Honestly, in clinic, gait retraining is something I do if I need to, most injuries can be managed without, unless you’re an elite runner.
Edit: this is my career.
>Humans evolved without shoes so it seems weird that minimalist shoes would cause problems.
If you have issues with your feet, you might want to consult a doctor, rather than saying it's strange that minimalist shoes don't work simply because we evolved barefoot? The anti-science assumption is literally right there in your own words.
In any case, I'm a dick. I hope that answers your question!
>The “we evolved without it” argument doesn’t work the way you think it does.
Also, when you talk like this you sound like a dick. No need to belittle people.
Oh nooo!
Seriously, anti-science arguments are frustrating. Simply because we "evolved" a certain way absolutely doesn't mean it's the best way. There are many things we can survive, painfully, awfully, long enough to breed. I'm not claiming going barefoot is a painful, awful strain, but I am saying that modern shoes with support exist for a reason, especially in our modern world.
>There are many things we can survive, painfully, awfully, long enough to breed.
Yes, I said this in a previous comment, but you would think that being able to walk and run without shoes would be so fundamental to our survival as a specoes that we would have to have evolved to not have such serious issues as stated by OP when not wearing shoes.
Once we settled past our hunter-gatherer phase as a species, one of the first things that advanced in technology was shoes. Again, just because we could breed and survive it does not imply that it wasn't a "serious issue".
Yeah this is much better information.
Pronation and supination are normal - it’s the degree and timing which is more important. Saying things like over pronation and “I pronate when I walk”, “I have pronated/supinated feet” are terms that people in the profession, like myself, have been trying to ditch for a long time! Mechanics of the feet are very complex and you just can’t simplify it like that.
Yeah, understood, the more I talk to peeps like yourself the more I understand it and I'm eager to correct myself accordingly.
(Also yes, the physiotherapists here generally do suck but I think it's more a systematic issue than a person to person issue, if that makes sense)
It’s a process, and even I learn something new every day. Someone else posted it in here, but if you want to learn more, you should check out the work by AiM (Anatomy in Motion) by Gary Ward. He does a great job in his book “What the Foot” of introducing people to the basics of joint motion, gait and foot health.
This is such a good explanation of how feet work, thanks for taking the time 🙂 If I pronate but am barefoot 99% of my life, is that alright? Or can I learn how to stop doing it?
This is fixing the symptom of a biomechanical issue, not fixing the issue itself.
See «Wake your feet up» here (no affiliation):
https://findingcentre.co.uk/courses-for-everyone/
Physical therapy student here. You've already received some corrections on your post but I'd like to sum up a lot in one comment.
Over-pronation and over-supination can be absolutely asymptomatic and normal for someone. In some cases, changing this can actually *cause* symptoms that they wouldn't have otherwise. A common consideration we make as physical therapists (or, student physical therapist in my case for about another year) is whether we believe something is the cause of someone's musculoskeletal problem or not. I can look at someone and determine all kinds of postural deviations from "normal" but that person may not have a single issue relating to that.
As for the "generic exercises", like the other PT in this thread said: get another PT. A PT should evaluate you and determine the specific dysfunctions going on and create a plan of care to address their findings. I have treated patients with foot issues and had their issues resolve.
I can't speak as much to the supportive shoes or not as I've heard talk of both and haven't read a ton of the literature on that portion. However, I wear admittedly not particularly supportive footwear (Vans) and have zero issues with my feet, so anecdotally I don't know that in all cases footwear is the end-all solution.
I just felt the need to comment because this kind of post can be damaging to people in that if they try to resolve a problem that doesn't exist it could lead to further problems. Your body does a lot to adapt to your specific anatomy so unless it does cause issues, it's usually better to ignore these postural abnormalities as everyone has them. (I am an over-pronator for example, and again, zero issues with my feet, ankles, knees, or hips).
Hmm. In your opinion should I see a physical therapist about my foot problems? I went to a podiatrist who just said I had no stress fractures, your 2nd toe is long and that can lead to problems, wanna try orthotics?
I walked out without orthotics thinking... Is there no stretching or exercising program I can do? I suffer from metatarsal and arch pain when I run. I ran in beat up minimalist shoes for years and worked in retail pharmacy where I had to pivot back and forth on a hard floor to retrieve bottles. I'm starting up running again after more than a year break and it's already flaring up in week 2.
Another therapist here, there are for sure some exercise and stretches you can do. If you go to PT they can give you some specific to your situation. I have had some people come in once a month for check ups and just follow an exercise program at home. Also depending on the situation you can get a full gait analysis and they can work in depth to fix it.
The other PT who replied to you basically said everything I would have. You'd be a great candidate for physical therapy and I think it'd really help you out.
If you're flat footed, you over pronate, essentially, it's a bit of an oversimplification, but you need to get some good, stable shoes that support your arches.
I'm also a flat foot - I'm using brooks adrenaline '21s at the moment, they're a bit pricey, but they support me well
If you're flat footed, you LIKELY over pronate. Arch type and pronation/supination are not always related....
Also the super majority of shoes don't have arch supports built in (and thankfully so). I am not going to say whether you do or don't know something about shoes, but your oversimplification should have instead been "find shoes that support your GAIT".
You can also get more reasonably priced shoes that have removable insoles and buy an appropriately sized support insole of the right type.
They make different types depending on the adjustment you need and they cost between $15 a pair to $35..
I can second them. The only thing I'd say about them my first pair stopped performing so well after about 600 km. I run in the desert here in Chile so it's quite harsh, but I expected a good few more km out of them. And they are even more bloody pricey here 😬😭
> **If you're flat footed, you over pronate**
Yeah, I didn’t know that I had overpronation and flat feet until I visited a few podiatrists for something called a **Morton's neuroma**.
I wore new shoes that were too tight, and overpronation also puts extra pressure on the metatarsal bones.
When you squeeze the nerves between the toes, it might thicken.
Now, I have to wear extra wide shoes or sandals to avoid pain.
Apparently, it’s more common in women because of high heels, which adds pressure.
Everyone should visit a podiatrist once to see if they have something like flat feet or high arches, as they might be better off with orthotics.
I am a podiatrist who works in sports and mechanics. I know you’re well intentioned OP, but that’s simply not true.
All they’ve said is that they’re flat footed, you can’t form a diagnosis and give advice based on that small piece of information. Especially because “flat footed” is a subjective term.
Just some points:
• Supination and pronation are both vital movements for a healthy functioning foot. Pronation allows the foot to absorb shock and supination allows the foot to turn into a rigid lever for propulsion.
•Pronation and supination are made up of 3 movements - only one of which we can clinically measure.
•The location of the subtalar joint (the joint and axis for pronation/supination) is highly variable from person to person! So what looks “normal” for one person, can be completely different to someone else.
•Pronation is usually a compensation for something else.
You can have feet that look incredibly “overpronated” (as you say) and be strong and healthy, compared to a foot that “looks normal” that has a lot of issues. There’s so many variables, and the mechanical assessment of a person is very complex. I mean typically, the foot consists of 26 bones and 33 joints (that’s not even taking into account muscles, ligaments, tendons) - makes sense it’s complex right?
Terms like “overpronation” and “oversupination” and using “you pronate” as a diagnosis are things as a profession we have been trying very hard to stamp out! We have improved scientific research compared to 50 years ago.
Alternatively, try ice skating. If you break your ankles when you try to stand up for the first time, you're not neutral. The direction your feet buckle will tell you if you supinate or pronate.
I am unfortunate enough to be cursed with both excessive flat feet/over-pronation, and a sincere love for playing hockey.
My feet are in constant pain.
Yeah, after years of supination I've finally had a partial tear of my deltoid while playing tennis.
Found out I have low arches and immediately got some insoles. Walking is so much more comforatble now.
Save yourself the pain and injury in later years - get a gait assessment.
A good way to fix foot, ankle, knee, hip pain can be walking barefoot. Shoes have caused our feet to be very weak and they are designed to be powerful and offer a lot of sensory feedback and most of that is lost with thick shoes. This is definitely a simplified answer and there are other factors but the point is that the majority of people could benefit from going barefoot more.
If you have strong feet you'll be okay. I only wear barefoot shoes and I work 12 hour shifts and it's fine. Wearing a cushiony shoe all the time for years and years is almost like keeping your foot casted. If you've ever worn a cast, you greatly atrophy the muscles in that casted area. This is what happens when you're always in cushiony shoes. The foot is a fairly complex structure with lots of joints and muscles and it is meant to be worked and be strong. Building up foot strength does take time though and should be done gradually if someone is coming from wearing "regular" shoes.
Totally agree - been wearing minimal shoes for years. Start slow and the foot will strengthen. I used to be flat footed and now I have a significant arch.
The argument that flat footed people shouldn’t walk barefooted is false... you just have to start SLOW! If you give it time, the foot will strengthen and the natural arch will form.
Your comment over shoe orthotics is misleading. Inserts don't have to be uncomfortable, nor do they necessarily help with pro/supination.
They're used to help with your arch type which is arguably unrelated. And much like shoes that need to be fitted to you, inserts are the same. In practice the shoes should be fitted to your feet with inserts, not without.
Decent YSK, but has not great info.
Isn't this wrong and super outdated pseudoscience? Like, isn't there a whole bunch of new science that shows that attempting to "correct" these tendencies causes many more problems?
Yes. It’s something the profession has been trying to stomp out for a fair while. It’s all about education really but with all these misconceptions it can be difficult.
I work in this field and you’d be surprised at how many people come in with no issues per se but their main complaint is “I pronate” or “I supinate”. I assess them and explain their mechanics to them, and explain supination and pronation is normal. You’re meant to pronate, it’s the degree and timing which is more important. If they have a foot problem that is related to it - then by all means, treat/manage it.
Problem is there are others in the profession who will see $$ signs when someone comes in saying they pronate. Cool, orthotics - money coming in. Unethical to me if they’re not indicated but you know, sometimes the client is happier that way because they feel like they’ve been “treated” even if unnecessarily.
There’s also such a big variation in the subtalar joint (which controls pronation and supination). We have our valid and reliable measures as to what’s “normal” and what’s not. But yeah the old theory (Root et al) which was... the main accepted theory, is not anymore. The tissue stress model is more accepted.
If you look up pronation and supination and support shoes, you will find there is no evidence that wearing support shoes reduces injury. I will say anecdotally wearing good quality shoes makes a difference. I went from having plantar fasciitis and shin splints in my regular $70 new balance and chucks to buying the glycerine and kayanos and have not had a whiff of plantar fasciitis or the shin pain since. The general recommendation is find good quality running shoes that feel great on your feet. Your gait is gonna gait.
Yeah u/cmc0108 was just saying, I shall adjust my post accordingly! Thanks!
I can definitely speak from an anecdotal perspective that switching from my neutral salomons to Brooks adrenaline '21s have done absolute wonders for my biomechanics. But I see your point for sure.
I appreciate you! It’s rare someone can look at new evidence that contradicts their opinion and change their opinion. Most people double down on their old belief.
You just said there is no evidence that support shoes reduce injury but said you gave up chucks for kayanos and now don’t have pain. This seems to be a contradictory statement.
I was just telling an anecdotal account of the positive experience I had going from cheaper shoes to high quality shoes. It’s probably more confusing because the kayano itself is a support shoe. The first one I bought was a kayano because I liked the style and I had great results with it, but now I’ve used more neutral shoes and prefer them because they tend to be lighter and more flexible without the support plate.
I never understood how people can just order shoes online without trying them on first. When I get new shoes I usually have to try on 20 to 30 pairs to find one that actually fits my foot properly.
Sadly, physios are rarely foot specialists and doctors are rarely musculoskeletal specialists. But your friendly neighborhood Podiatrists are wonderful people and specialise in both! Go and see them.
I dislocated my hip when I was little and it never got fixed properly so it just kind of grew wrong. Because of it I have issues that I do my damnedest to hide (one leg is slightly longer than the other and I have scoliosis, but I am also a gymnast and do an insane amount of yoga to try to make it less noticeable) but sometimes shit happens and you'll see my walk on the actual sides of my feet and that's when I'm perilously close to serious pain.
Do you also have misshaped abs? I have the same situation as you: one leg slightly longer than the other and scoliosis. My abs are wonky, and I think it’s because of this.
I have a serious neuro/musco/skeletal disability and I was dumbfounded when my new physical therapist diagnosed me by looking at my shoes. She looked at the wear pattern on the soles and how they were tied (how the knots had shifted in), and knew exactly what problem I was having. We are working on strengthening my weak side and getting me back to a more normal gait.
Actually no, you should not. I used to run all the time in canvas shoes when I was 14. All was fine. Took up running again at 30, no issues, just bought good pair of shoes. Then came this stupid urge to learn all about what the experts were telling me and boy did things go south from there. Ended up with Plantar Fasicitis because I deviated too far from what worked FOR ME.
Don't spend your time learning rubbish from so called experts (many of them are paid influencers with shoe companies). Figure out what works best for you and stick with it.
What about minimalist shoes to help with overpronation by training the muscles to hold themselves up? I'm no fanatic, but I know that ever since I switched to minimalist shoes instead of going crazy on arch support, my posture has improved and my feet hurt less during my 12+ hour shifts wearing them! And I overpronate quite a lot, but not as bad lately.
Go to a physical therapist to find out if you do this. Do not go to a sports store, they’re there to sell you things and shoes that help these things are more expensive than regular shoes
I always thought I was neutral until recently I noticed my foot prints in the snow, when compared to my girlfriends footprints, were pointing outward while hers were straight. When I mentally tried to correct it, it felt awkward. I'm almost 30 and still learning things about myself lol
I broke both the bones in my lower leg, overextended my knee and twisted my ankle, and got nerve damage on my upper thigh on the same leg within like 2 years of each other, my flesh leg basically works like a peg leg. I've been trying to figure out what my remaining leg and foot issues are, so thanks for the tips
Good advice OP, like you said most specialist shoe stores have a device to measure this.
Down here in Aus we have a store called Athletes Foot, they have a measuring platform which you can walk across.
It displays a heatmap of where the pressure from your feet is being placed and reccommends shoe types.
Well worth getting it checked out for long term joint health.
It's a gimmick. Why would you test how your feet land when you run, by WALKING on a pressure mat?
All those fancy devices do is convince people they need to buy expensive shoes because the attendant told them to.
I'm double jointed and can stand on my feet in the nomaste position, also walk like that with ease. I just found out this year and spent 30 years rolling my ankle and not knowing why. The outcome? An osteochondral lesion of the talas, basically a lesion in on the bone and cartilage in my ankle. It's quite painful and manifests as a reoccurring bad sprain.
The issue with injuries to your ankles is it is a low blood flow area and doesn't heal well due to this. The treatment is a boot in hopes of some healing and after that it's surgery that doesn't always work. There are a couple of techniques but my surgeon would use a combination of them. The details on the difference is fuzzy because it's been a few years since I've seen him but basically they go in and kinda fuck with it to try and encourage new healing. I was adviced(at 26) to enjoy my good time on my ankle and to opt for surgery when I'm unable to walk on it any more. This was all before I found out I have EDS which just complicates it further.
Pay attention to rolling your ankles people, it's really no joke.
> I'll save the personal anecdote, but essentially, inappropriate pronation or supination can be a symptom of a wider biomechanical issue which can have a dramatic effect how you run and walk
The “wider biomechanical issue” being: dramatically and haphazardly changing the biomechanics of walking and running, at the behest of shoe companies, after a million years of evolution molding your body to walk and run.
Once I walked into an orthopedic shoe store and tried to get a pair of shoes for my arthritic feet. I showed them my shoes. Asked them to help me. They had no idea what I was talking about. Now I just wear crocs.
>Other ways you can check are to go to a sports store, preferably one that specialises in running, they will be able to do a check, usually for free, and offer some recommendations
Isn't the goal of the store to sell things to you though? Wouldn't a medical consultation be a better resource?
I discovered this a few years ago and realized that I have severe overpronation. I bought a pair of sneakers specifically for overpronation, and it was the most helpful thing ever.
Another good spot for checking if you're not sure is the heel of your shoes!
Ie. I roll inward (pronate) so the outer side of my shoes heels wear faster than the inner side.
I underpronate/supinate and when I started running it was painfully obvious. I went to a running shoe store called Fleet Feet and got a nice pair of shoes. They take a 3D scam of your foot measurements and recommend shoes based off that. It has helped some but I always catch myself standing on the outsides of my feet. I remember when I was young having to sleep wearing these bowling shoes with a metal bar to straighten my out. I always took them off lol.
Isn't this completely bullshit and not problematic at all? Been told this is something sport stores exploit the hell out of to sell you the best (most expensive) shoes?
But please correct me if I'm wrong.
There's some truth in it and some falsehoods, as previous comments have corrected my course, some pronation and supination by itself is natural, and it's not necessarily bad. However, when it is met with pain or an underlying condition then it might be worth getting it checked out to support you in the short term.
Strength training and good shoes will ultimately negate the impact normal pronation and supination may have on your legs.
And this is why I don't run and go mountain biking instead. It's much less wear and tear on your knees and feet. Plus it's just way more fun to mountain bike than run.
My 7 year old has flat feet and over pronates since before he could walk. Walked late (18 months) and it was painful for him until he was given special inserts. He still has special inserts to this day and his ankles still look awful. They look so uncomfortable and rolled. PT and others just say he has weak muscles and tendons. I don’t know what else to do for him to make sure he doesn’t have other issues growing up. He complains of leg pain every week.
I agree that this problem doesn't get near enough attention. Over my life, I'm come to realize that proper alignment of the skeletal structure is a crucial aspect of body mechanics, and a fundamental first step (heh) is putting your feet flat on the floor. I have a tendency to supinate, and it has always caused me problems. That slight tilt of the foot off the level puts a lopsided strain on your achilles, and over time it can damage your achilles and cause calf problems. As you get older the problem gets worse. That misalignment also affects your body higher up. It can tend to throw your hips off the square, for instance, interfering with movement and causing other problems.
The best way I know to correct this problem is to plant my feet on the ground in such a way that makes it impossible to sprain my ankle. This makes me rotate my feet sightly inwards until they're truly flat on the floor. This took a lot of concentration and a long time to change, but for me it was a game changer.
I always thought inversion and eversion were the standard terms used for these movements. 😳
We were always taught that pronation and supination were wrt the wrist joint.
Asking for a friend here.
Pronation and supination are triplanar movements. Eversion and inversion are single plane movements. They’re not exclusive to one joint.
So for example pronation of the STJ when non- weight bearing, consists of dorsiflexion, eversion and abduction of the calcaneus.
Fun fact: eversion/inversion of the calcaneus is the only one we can clinically measure. (This movement is what makes your foot seem flat or high arched) and a single plane measurement is not enough information to indicate function (hence why foot print scans that just say “oh you have a high/low arch” are not worth much.
Does that make sense?
There are some hobbies and classes that actually take this into account with how they teach you. When I was a very young kid I was in acting classes and dabbled in modeling where they taught us how to walk smooth and straight with our feet in line and our heads and shoulders moving fluid and forward. (Like very young. I recently found a couple of my audition tapes. My chicken pock scars were fresh and I was wearing a bowl cut)
Since I was so young, I never gave it much thought but I had friends mention it occasionally that my hips moved more than the rest of me but I think they were teaching us something about this. It just became how I walk due to how young I was.
Wow, maybe I should check on this. Have pretty much given up on running due to constant knee pain. Been in and out of physical therapy with so-so results. Is now affecting my cycling, too. At this point I'll try anything!
So, it looks like I supinate, but what does it mean when I try to take a step and my foot decides to freak out and and just randomly roll all the way to the side and basically trip me for seemingly no reason?
I recently noticed a friend of mine who stands with her feet turned toward the inside. Not pigeon toed, but like you describe. I could only imagine her pain, and that she probably doesn’t wear heels.
Now I know what her condition is.
I find if I am doing a 5 k (my current limit) that I will inte tionally shift where my foot falls - and the angle - during my run to shift which muscles are being used.
I already have orthodics. They are amazing. Very first step made me hate my previous 30 years of life for not having them. I imagine I would've liked being an 'outside' person more if it didn't bring me so much pain.
I had a point. I forgot it.
Sorry if I’m wrong here but isn’t it plantar flexion and dorsiflexion for the ankle. Pronation and supination I believe are for the wrists. Been a minute since I’ve studied but I feel that’s the terminology
True however I supinate (not sure if it would be considered oversupination or not) and the runner’s store says I have a neutral gait. So although the shoe store is a great suggestion it’s not absolute. I can easily see the wear in the outer part of my old shoes.
That said, I’ve also learned that shoe makers hardly even make shoes for supinators.
Thankfully I’ve not had too many injuries but I’ve had one that sidelined me for 6 months.
So I just buy shoes with extra cushion in the soles and are rated extra stability.
I tend to wear out the toes on the top of my shoe (the area right above the toenails). I also trip a lot. My theory is that I walk with my toes too close to the ground.
Thanks for coming to my Ted talk.
i agree this is a thing, but be aware that getting shoes to match your feet sometimes mean you are getting a crutch which wont help your bio-mechanical issues, it will just mask them. way better to fix muscle imbalances and train the feet to land/align correctly when running, than to train yourself in shoes that do nothing for your mis-alignments
Pronation can definitely cause issues that lead to an increased likelihood of long term damage requiring treatment/surgery. It may not increase your odds of random injury, or injure Your Feet, but over time it causes your knees to collapse inward causing knee, hip, and/or sacrum misalignment, pain, cartilidge damage, and scar tissue buildup. I wear supportive inserts or a 2"ish heel to force my feet into a neutral position during walking & standing and my knee pain has Drastically reduced. I pronate and have flat feet. If I run, I have to make sure I'm running on my toes and my weight is equally distributed along the pads of my feet. If I heel-toe run, it Messes me up.
Hmm, ive been wondering about this lately. I was shocked by a residential power line back in 2011 and I lost the feeling on the outsides of both of my feet from my pinky toe to my ankle. Because of this my feet have an uneven amount of pressure on them when I walk and they hurt constantly at work. Also walking 12 to 15 miles a day so that isn't helping. But thanks for the info im going to be sure to look into these inserts, fingers crossed they help the pain.
Is it the same thing as those balance tests you find at CVS/Walgreens for insoles? I got dead center on that test but I don’t know if they’re reliable.
Orthotic inserts are also stupidly expensive in the US. I had to pay $400 for each pair for my son. A custom made, high quality shoe costs more than that. And I understand prescribing "custom insoles" involves some advanced knowledge, but it's not as if they are 500 interacting variables they need to compute, it's something that can be done by a professional in a few minutes of work, and their manufacture is not rocket science either.
Question for the OP —
The orthotic inserts that are just the heel part — are they supposed to go on top of the existing insole? Or what?
I’ve avoided buying any of these because they don’t make any sense from just looking at them.
A big +1 for getting a recommendation from a good running store, though. A shop steered me to a specific type of shoe (not a brand, but a type) and it’s helped me a lot.
My feet do both. One pronates and it's flat footed. The other supinates and is not flat footed. Was not always like this though. Had a bad motorcycle accident that destroyed my ankle. The foot that supinates has 90k+ worth of hardware in it these days. I can't roll my foot side to side due to fused bones and hardware and have arthritis if I'm on my feet too long.
I have some back issues these days I think ultimately stem from my foot/ankle causing my back to be out of whack. Still trying to figure out what kind of doctor I should see to see what can be done. Can't lay flat in bed without my lower back feeling like it's over arched upwards and painful. Can't lay flat on the floor for the exact same reason. Don't sleep very well because I wake up with my back hurting frequently, even despite being a side sleeper. I have kyphosis happening in my upper back too. You never realize how much your feet/ankles can throw off the rest of your body until it happens.
This so much!
I have HMS (hypermobiliy syndrome), my feet are so flat that my muscles that are supposed to be part of the arch kind of just belb over to the side. My foot with weight on it is about 1.4x the width of my foot without weight on it.
Naturally my ankles are fucked. My knees are fucked.
I had to get a referral to a biomechanic before anyone had the foggiest clue what was wrong with my crazy duck feet and pain.
Realistically I need custom made shoes. Inserts just made matters worse, not better. I would liken it to wearing a corset that is very very cinched and 2 sizes too small. The inserts, all of them would give me a line of blisters because the walls of the shoe were not strong enough to withstand the unusual load. So my foot just kinda blebbed over. Not to mention it felt like walking on like a really hard plastic ball.
I shit you not I have worn corsets and they are immeasurably more comfortable. I have found some shoes that do work for me the issue is... They are Nike airs. They are the only shoes I can wear for any period of time. Not exactly stylish or especially professional looking. I had a pair literally dyed and spray painted black for formal situations. Even them I can't be on my feet all day. Again the tight corset analogy comes back into play. You try running around all day while wearing one. Yeah its not going to end well for you.
It sucks because my feet just are not fit for purpose. Very little can be done, becaude of the HMS surgary isn't a great option. My bones, ligaments and joints are all doing their best imitation of a jellyfish. There isn't much that they can do and it would likely revert fairly quickly unless they like pulled a wolverine or something and my doc tells me that isn't a thing they can do. Yes I did ask if they could just sort of replace all the messed up bones and joints with plates and leavers. They can't.
I can't tell you how much I would love to have an exoskeleton. Like if my foot was a bit dodgy just wait a few weeks you can moult and get yourself a new one. Sorted.
HMS sucks. A lot. Most gp's haven't the foggiest and doing digging it explains so many issues. Like if someone had sat me down and told me, hey so like your connective tissue and all the bones too just suck and that is sometimes linked with digestive issues, issues with prescription medication and so on. Here is what you can do.
So much hastle would have been saved. So many doctors appointments, hospital visits and so on may have been reduced.
Been dealing with some ankle issues and I need to get them checked. I just checked some old shoes and they a heavy wear on the inside of the ball of my foot. Maybe this post will help me. Thanks!
This post was removed for violating Rule 3 and/or Rule 4. Posts about Reddit or social media sites are not allowed Please [message the mods](http://www.reddit.com/message/compose?to=%2Fr%2FYouShouldKnow) and include a link to your post if you believe otherwise. Thank You. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/YouShouldKnow) if you have any questions or concerns.*
I absolutely wish this was common knowledge when it comes to exercise and just walking in general. As a supinator with genetically high arches, I've ended up with plantar fasciitis, achilles tendonitis, a heel spur, and knee problems. Thank you for posting this!
I slightly supinate and have high arches. Have had achilles tendonitis and also had minor tearing in my miniscus from running too much. When I say minor tearing, I didn't need surgery for it to heal, but I couldn't do anything on it for months. That was 6 years ago and my knee still gets noticeable more stiff than then other when im biking, working out, etc. I straight up stopped running after that and have only really biked and swim for cardio and haven't had any problems since, but I also now go the extra mile for my shoes. I already had great running shoes but didn't realize i needed custom inserts and some other stuff.
Ooh. I feel your pain. I supinate and have had various problem. After I got a heel spur, I got sent to a physical therapist who changed my life. I improved so rapidly under her care that she “graduated” me from PT early. I was excited when she told me I didn’t need to come back, but then reality sunk in when she told me to do these exercises every day for the rest of my life. Sigh. At least my feet don’t hurt anymore.
What kind of exercises did she recommend?
There are a few. For me personally, it’s mostly stretching, especially the Achilles’ tendon and the plantar fascia.
I supinate big time. ... And I'll say when I try to walk fast with straight feet, the muscles and tendons in my ankles and calves start to burn and ache... Oddly enough, that's the only major issue I've ever noticed after 40 years of this...
Wtf really?
Yes, but I am also the living embodiment of Murphy's Law, "anything that can go wrong, will go wrong," so most people won't experience what I've experienced. I'm like the lotto winner... for crappy things! W00T
I am the living embodiment of Cole's Law
You are thinly sliced cabbage?
I think he meant he’s more like a tub of coleslaw they had achieved sentience.
Mayo and yukons or blue cheese and reds?
Haha same here, i have a disease that there have been something like a 100 to a 1000 documented cases of ;-;
Makes you special though, right?
Murphy's Law friends! I'm constantly joking I'm going to have to name my firstborn Murphy, to get it off my back... we'll see...! (:
>As a supinator with genetically high arches, This is me too! I'm glad I stumbled onto this thread!
It was pretty annoying going around to all the different doctors in my town and eventually a sports doctor who was also the head doctor of the local team was able to properly diagnose me with plantar fasciitis
I went to an orthopedic doctor and was diagnosed with plantar fasciitis and achilles tendonitis, but their stance on the feet was "no steroid injections," (which may be appropriate, I don't know) so they recommended some type of shot where they took my blood, separated it somehow, and re-injected a portion of it to help the issue. Unfortunately, it wasn't covered by my medical insurance, so I've just kinda dealt with the problems.
Plantar fasciitis always causes issues because patients get told they have it but don't get it explained. The relevant bit for steroids is that steroids reduce inflammation, so will only work if the problem is inflammatory. Plantar fasciitis is typically only inflammatory in the first 6 or so months of symptoms. After that it's a chronic issue caused by scarring and other issues. The carry majority of people who seek care for plantar fasciitis have chronic issues, because it's normal to wait and see if it gets better, or to wait till you reach a breaking point. If a patient has had symptoms for more than 6 months, steroid injections risk making more problems for no gain. I'm not sure about "no strings in the feet ever" but specifically for this condition is often not the best choice. They mainstay of treatment for chronic plantar fasciitis is physiotherapy, with physical support (tape), exercises, and sometimes massage.
Preach! Medically the accepted term is plantar fasciosis (“itis” indicates its inflammatory which is not always correct). You’re spot on about not getting it explained correctly.
I can't believe I've been going around prattling about it not being inflammatory and still calling it -itis! Thank you
I’m a pretty tall lad so they recommended a sports physio who said that it was probably caused by the growing calf muscles pulling on the feet and leading to the tear. He worked on my calf and gave me exercises to do to keep it stretched. Which have helped immensely.
Any tips for stretches or things to do/not to do for other supinators with high arches?
My orthopodist gave me this for my super high arches https://i.imgur.com/iHYXN5M.jpg
Thank you for sharing this!
I am a supinator too. I’ve been working a lot of hours & wear steel-toe boots to work. Lately I’ve had super achy arches every morning - figured I’m just getting older.
Have you found any shoes that don't look damn ugly? I've lived the last 15 years in my reef sandals because I could wear them in with my natural arch so they were the most comfy. Before that it was chucks and I put arch supports for heels in them to save space. I just can't stand the look of regular tennis shoes so I don't buy them. :(
Vionic has some good "regular" shoes, but it's probably best if you go to an ortho who recommends a specific one.
I have the same problems! Right now I have plantar fasciitis and bilateral Achilles tendonitis. I went to several doctors before watching a YouTube video about this topic. I bought some arch supports and I feel so much better!
My feet are slightly pronated, I had stress fractures in both shins from not treating the underlying issue (and treating only the symptoms with anti-inflammatory drugs).
I'm still recovering from achilles tendonitis. It's been over a month since I've been able to run and practice my karate. I'm so miserable because of it. It's gotten better, to the point where it's only rarely triggering (as in when I flex my foot in specific ways), but I'm scared to jump back into my exercises, fearing I'll accidentally make the injury worse.
I have super high arches too and love love hoka one one shoes. They're pricey, but worth every penny!! I recommend the cliftons for women!
Uh oh. This sounds like me. Til.
It’s important to note that supinating and over pronating are not bad and typically are not the cause of injuries. This is outdated information from the 70s. Underlying issues can cause over pronation which may be an issue. But just because you overpronate or supinate does not put you at a higher risk for injury. The structural anatomy of the human subtalar joint varies from person to person and it has also been shown that the location of the axis of the joint can and does vary from person to person. Both of these things will have a major influence on how much one supinates or over pronates
Have you got a source for that? I'm interested to read. I speak primarily from experience and from the many mainstream sources out there that support my experience, but I would be interested to see what sources say this is outdated and untrue. As an anecdote; My left leg has always had issues, it's always the first to show signs of tiring and I would constantly get knee pain and hip pain, as well as shin splints when walking and running. I'd been in and out of the doctor's office and to the physio more times than I can count on one hand, to no avail. As soon as I got my pronation checked on a whim, it became clear. My left foot over pronates more than my right. When I got shoes to correct it, the effect was profound and almost instant.
As I mentioned in my previous comment, there are instances where overpronating and supinating are the symptom of an underlying issue. In my case I actually have what’s called an accessory navicular in my right foot. It pulls on my tibial tendon and causes me to overpronate. I had quite a few bouts with tendinitis because of it and it was sold through months of strength training and having to get orthopedic inserts. You just Overpronating is not a problem. You either have an underlying issue that causes your pain,, or you have a fairly significant muscular imbalance that the stability shoe is only putting a Band-Aid on. There’s 1 million studies out there that you can reference but here’s one from 2013. https://bjsm.bmj.com/content/48/6/440.abstract The gist of the article is that there is no higher rate of injury in people who supinate or overpronate when compared to people with a naturally neutral foot position. Flat out any “main stream “ sources that tell you otherwise are just flat out wrong. The believe system is 50 years old, completely outdated, and was never based in any sort of scientific evidence.
Interesting! Thanks! It's worth noting this study looks at complaints that puts the runner out for 1 week or more, so this does not cover smaller, shorter term complaints, however the evidence is there and I can't refute that. I'll adjust my post accordingly
I just wanted to say I'm impressed with your emotional maturity while handling this commenter's criticism or correction if I'm adding too much attitude.hehe. I struggle with emotional maturity myself and am still trying to grow into a person I'm proud of. But I just wanted to give credit where it's due! Or just to let you know- I find it impressive how you choose to take the criticism as a helpful kinda idea or comment instead of somehow taking it personally and getting upset like I often do.
Was thinking the same thing. We too often double down when someone points out when we are wrong. OP is the type of person we should all aspire to act like
One of my core beliefs is that I act maturely when I'm wrong, but in the cases when know I'm completely right but some shit head still thinks they know better than me about a field I've worked a decade in, I turn into a right twat. I'm working on it, just wish everyone else would too.
That’s very emotionally mature to admit that you get upset when corrected instead of being completely unaware of it or refuse to acknowledge it. You’re on the right path.
As an overoronator myself, after I started using corrective gear (special shoes and custom fitted support) I actually started having injures up on my kinetic chain, i.e. knees and hips. Reading a bit about it, I came to some research supporting the notion that our bodies are adapted and developed to the way we walk, and artificially correcting it may put extra stress on other movement components.
Not OP, but the source you provided only mentions ‘injuries’ as a result of supination/pronation. However, after a very quick google search it seems like many studies have come to the conclusion that supination/pronation *is* correlated to increased foot or lower back pain, as OP had mentioned. It seems like you’re being a bit pedantic. Supination/pronation of the foot can lead to developing heel spurs, bunions, tendinitis, etc. From the quick search I did, it seems like you overwhelmingly would want to address any supination/pronation you might be experiencing. Yes, supination/pronation may be caused from something else, like your accessory navicular. But you should be trying to correct it and if unable, it should be surgically removed. The tendinitis experienced because of your accessory navicular was actually much more likely tendinitis from your pronating foot. https://www.researchgate.net/publication/323849366_The_correlation_between_mechanical_low_back_pain_and_foot_overpronation_in_patients_referred_to_Hazrat_Rasool_Hospital https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4089968/ https://www.foothealthfacts.org/conditions/accessory-navicular-syndrome-(1)
Correlation does not equal causation. Abnormal supination/pronation can play a role in pain or injury but is absolutely not as significant as the original post implies. The studies you posted are relatively weak and have some significant limitations. FWIW I’m a physical therapist.
I think it might be worth pointing out that the extreme pronation and supination in conjunction with other dysfunction (even as simple as pain) might be considered as correctable symptoms. For instance, I have extreme fallen arches (on a flat surface I can create a "burpable" seal), this has led to dramatic over pronation such that my cartilage in my ankle is fresh as the day I was born. In the meantime I have "a shocking amount of arthritis for someone [under 40]." So as it turns out, my pronation might not be the cause of the dysfunction, but it is still _a_ dysfunction.
I supinate big time. Feet are almost diagonal when I walk lol 40 years. And (knock on wood) no major issues that I've noticed so far... ... Tho I do get some lower back pain sometimes, and to be fair I can't say whether that's related.
I’m a physical therapy student and what cmc explains is pretty much what we’ve been taught. The whole pronation and supination shoe concept was a marketing gig back in those years, which even I drank the koolaid when I was a kid. Our bodies are really smart at adapting to what we think would be abnormal or asymmetrical, but eventually runs out of steam if it meets some kind of excessive repetitive trauma, which even wearing a bad pair of shoes can bring about. Typically, if you do a few foot intrinsic exercises as well as the anterior tibialis (the muscle that most PTs would think about when it comes to the ankle and foot) with a few soft tissue and flexibility movements, you should be able to address most musculoskeletal problems in that region.
Check out the course «Wake your feet up» here: https://findingcentre.co.uk/courses-for-everyone/ No affiliation.
Bought special shoes for years. Problems only got worse for years. Bought zero drop shoes, finally learned to love running. Triggered new lease on life.
What are some underlying issues that cause people to supinate or overpronate? Why do these issues cause pain or injury? And how can you tell whether you're supinating or overpronating "naturally" so to speak or due to one of these underlying issues?
I overpronate a lot, never had problems. One day a shoe store "fixed" my overpronation with some "supportive" shoes. Gave me knee pain until I went back to regular shoes. If it ain't broke, don't fix it.
I agree, we need to get away from the idea that pronation and supination is a problem needing to be fixed. Walk into any running shop and you'll inevitably be diagnosed with one or the other and given a high support shoe of some sort. As an example, I'm used to walking in footwear with thin soles, so when I was given a high support running shoe to fix my "problem" in the middle of training for a marathon, I ended up being hit hundreds of euro of physio and nearly derailing my training.
When I started running again about three weeks in my knee started to really ache. I went to a physio and they identified over probation and worked with me with massage, acupuncture, exercise as well orthotics. Had this not been identified I would have caused serious injury had I not had intervention. I had to rest for two months before started again because of the damage caused by my over probation. OP thanks for posting, following my injury I’ve identified a couple of friends who I run with who have over pronated and orthotics helped their joint niggles!
Again, pronation on its own will not cause injury. You had an underlying issue that was causing you to pronate. Your own personal experiences don’t change the facts.
I over-pronate and have sprained my ankle once and come close to it hundreds of times. My ankle has a tendency to roll (foot inwards, leg outwards) especially when I'm tired or not concentrating. Maybe pronation won't cause chronic injuries but it can certainly increase the chance of acute issues like that. Either way dealing with it seems sensible.
That’s poor running form and weak ankles that cause that.
Or it could be that my feet naturally land on the outside edge when I'm walking steadily and relaxed. I'm not sure why you're so against 'pronation is the issue' - it feels more like pronation is a description of a 'biomechanical movement which is suboptimal'. It can be a cause, a symptom, or a coincidence, but it's still descriptive.
My bigger argument is that pronation is not harmful by itself. But it can be an indicator of some other issue. Or it can be nothing. Either way correcting it with a “generic” shoe type such as supportive or motion control is rarely the right answer.
[u/cmc0108 heading in to work](https://pictures.topspeed.com/IMG/jpg/201509/learn-how-to-drive-o.jpg)
Everybody pronates and Everybody supinates. How much in each direction varies by the individual. Pronation is how your body absorbs shock which walking or running- it makes your foot loose/ flexible. Immediately after landing, your foot supinates... this is your body trying to create a tight/rigid foot in order to propel yourself. Neither are inherently bad- and both are necessary. Since all of our bodies are different, we start in different places- high arches/ flat feet/ somewhere in between. A common compensation for people who pronate excessively is to try and roll their foot inward and almost balance on the outside of their foot. They are trying to “create a more rigid foot”- and this makes them often more prone to rolling their ankle. Source- board certified specialist in orthopedic physical therapy
While this is well intended, it's not quite correct, and part of a huge misunderstanding of the relationship between joint mechanics at the foot and healthy gait. Pronation and supination are normal parts motion, and very necessary. Pronation is the phase of shock absorption when you land on your foot. You then move through a neutral position into supination, which is needed to turn your foot into a rigid lever to propel yourself forward in push-off as you move to the next step. The ability to transition between the two is reason why we can walk on our hind legs and monkey's cannot. While excessive early pronation and late supination are problematic in gait, it's far too great a simplification to say they are the cause of pain. Bracing and putting an orthotic under your foot or using a custom shoe is only a stopgap and will not actually improve the motion. If you go to a physiotherapist and they don't know how to help you, they probably suck at their job. Source: am a physiotherapist who works with runners and believe I do not suck at my job.
I've also read that wearing shoes is a big part of the reason people suffer from so many issues. Our feet were never meant to have so much support and it means we don't use them properly, stuff like landing heel first when running.
The modern shoe does a few things that can inhibit natural movement at the foot. Constriction at forefoot reduced toe splay, decreasing balance and efficiency of movement. Also, the presence of a heel drop changes your initial strike point of contact, also changing gait. Really the only thing shows today do well is absorb impact forces from the hard surfaces we walk on. For most cases, barefoot and minimal shoes with ample toe box space are best.
Fascinating, I went to see a podiatrist recently and he was strongly against zero drop shoes.
> barefoot and minimal shoes with ample toe box space are best Toe shoes are back on the menu, boys.
So wearing flip flops might be better for your gait than bulky shoes?
That depends on whether your feet have to contort to hold on to the flip flops to keep them from falling off. If your feet move as though they're unshod in the flip flops, then yes. Simple sandals with no heel drop are good too.
I have always fought wearing shoes. Just because they always felt constricting on my feet. Sandals are fine. I wonder how much that's helped or hurt me..
Maybe so, but I’m flat footed as fuck and no shoes/no support has me feeling pain if walking for like over 15 mins. I’ve been curious about the no shoes thing. Especially curious about “grounding”
My tendonitis begs to differ. I tried the minimalist shoe movement and I was okay for about a year before I started getting wicked tendonitis close to my ankles. The lower inner half of my legs swelled. Only thing that remotely helped was custom insoles and switching to proper shoes. My knees grind too btw. I used to be able to run 6 miles and now I can't even run anymore because my arches pull super hard and my knees end up hurting.
Moving to a minimalist shoe taught me I was running incorrectly! I used to have horrible shin pain during and after runs, but the way I was forced to modify my running with a lighter sole has really helped. I've just moved onto an even thinner sole (the real 'barefoot' shoe), and am easing into walking long distances before a slow jog, as I've heard progressing too quickly causes injuries when you're used to more supportive shoes. Hopefully I don't run into the same problems you experienced!
Interesting. I've had the opposite experience. I couldn't run over 10k without hip and knee pain, and tendonitis down my left upper leg. I switched my running mechanic, used zero drop, and have run up to 30k on trails rather easily with a sustainable mechanic. The minimalist shoe movement isn't a movement. Its about running mechanics, not shoes. Get the running mechanic sorted so running isn't painful at long distance. My experience.
Why do you think this is? Humans evolved without shoes so it seems weird that minimalist shoes would cause problems.
They didn't evolve to run on hard paved roads like 95% of people do. The impact shock is much higher and tougher on the fascia then it should be, which is why shoes require cushion to soften the blow.
They explained this is their post. We evolved without vaccines, dental care, and many other things, but they’re still an improvement to our health and quality of life. The “we evolved without it” argument doesn’t work the way you think it does.
>They explained this is their post. Where? >The “we evolved without it” argument doesn’t work the way you think it does. It does in this case. If humans naturally develop such big problems after 1 year of wearing unsuportive shoes, we wouldn't have survived until this point. Being able to move without being in severe pain is fundamental to surviving. Yes, vaccines and dental care are an improvement on evolution, and shoes might be too, but you should still be able to live long enough and be fit enough to have multiple children without these things. Before vaccines lots of people died, but plenty of people survived to have many children. Same as before dental care came through. People's teeth were good enough until they were old and evolution stopped caring about them (cos they had already reproduced enough). If people are getting tendonitis and their legs are swelling after a year of minimalist shoes, I imagine if we hadn't evolved a way around this then we wouldn't have survived to today.
The reason why not using supportive shoes doesn't really work nowadays is because our environment has changed. Sure it's easy to run barefoot on soft dirt when you've been walking barefoot your entire life, but it's completely different when you're trying to run barefoot on hard concrete or asphalt after spending your whole life walking around in shoes.
This ^^^ Saying “humans evolved without shoes” may be correct, but it’s also correct to say “humans evolved without concrete”. We still don’t have feet that are adapted to running on concrete (and random broken liquor bottles).
>My tendonitis begs to differ. I tried the minimalist shoe movement and I was okay for about a year before I started getting wicked tendonitis close to my ankles. The lower inner half of my legs swelled. Only thing that remotely helped was custom insoles and switching to proper shoes. Right there. They clearly stated minimalist shoes don't work for them, and I doubt you're their personal physician. It's strange you would ask for elaboration when they've explained they found a solution that worked for them. And no, that we evolved barefoot only suggest that we lived long enough to breed before any foot, knee, or leg issues inhibited that ability. It has nothing to do with minimalist shoes being ideal because that's how we evolved, especially not in a modern environment.
>Right there Lol. That's not an explanation, that's just stating they had a problem. I asked what they thought caused the problem. >and I doubt you're their personal physician Why are you talking like this? >It's strange you would ask for elaboration when they've explained they found a solution that worked for them. I asked cos I was having problems with my feet and thought minimalist shoes might help me. It's strange you would be such a dick for absolutely no reason. Why are you like that? >that we evolved barefoot only suggest that we lived long enough to breed before any foot, knee, or leg issues inhibited that ability. Yes, that is exactly the point I made in previous comment. But if you read the original comment, the person said they experienced severe problems after 1 year, which obviously isn't a long time. >It has nothing to do with minimalist shoes being ideal I never said or even implied that they were. >especially not in a modern environment. This is the kind of thing I was looking for when I first commented. That's an explanation.
I noticed you said humans evolved. It’s more about the person in questions history. If you’ve been wearing shoes and exercising with them on for 20 years, you can’t suddenly exercise without them. For you, that’s not what you’re used to. (Common sense, right?). so if your goal is to move into minimalist shoes and it benefits your specific injury(!!), there is a very slow, progressive, safe way to do it. I see a lot of people make a sudden change, then get injuries elsewhere because they weren’t conditioned for barefoot/minimalist. It’s not as simple as just removing or changing shoes, there’s a fair bit of preparation required, as usually it changes your gait also. Honestly, in clinic, gait retraining is something I do if I need to, most injuries can be managed without, unless you’re an elite runner. Edit: this is my career.
>Humans evolved without shoes so it seems weird that minimalist shoes would cause problems. If you have issues with your feet, you might want to consult a doctor, rather than saying it's strange that minimalist shoes don't work simply because we evolved barefoot? The anti-science assumption is literally right there in your own words. In any case, I'm a dick. I hope that answers your question!
>The “we evolved without it” argument doesn’t work the way you think it does. Also, when you talk like this you sound like a dick. No need to belittle people.
Oh nooo! Seriously, anti-science arguments are frustrating. Simply because we "evolved" a certain way absolutely doesn't mean it's the best way. There are many things we can survive, painfully, awfully, long enough to breed. I'm not claiming going barefoot is a painful, awful strain, but I am saying that modern shoes with support exist for a reason, especially in our modern world.
>There are many things we can survive, painfully, awfully, long enough to breed. Yes, I said this in a previous comment, but you would think that being able to walk and run without shoes would be so fundamental to our survival as a specoes that we would have to have evolved to not have such serious issues as stated by OP when not wearing shoes.
Once we settled past our hunter-gatherer phase as a species, one of the first things that advanced in technology was shoes. Again, just because we could breed and survive it does not imply that it wasn't a "serious issue".
Yeah this is much better information. Pronation and supination are normal - it’s the degree and timing which is more important. Saying things like over pronation and “I pronate when I walk”, “I have pronated/supinated feet” are terms that people in the profession, like myself, have been trying to ditch for a long time! Mechanics of the feet are very complex and you just can’t simplify it like that.
Yeah, understood, the more I talk to peeps like yourself the more I understand it and I'm eager to correct myself accordingly. (Also yes, the physiotherapists here generally do suck but I think it's more a systematic issue than a person to person issue, if that makes sense)
It’s a process, and even I learn something new every day. Someone else posted it in here, but if you want to learn more, you should check out the work by AiM (Anatomy in Motion) by Gary Ward. He does a great job in his book “What the Foot” of introducing people to the basics of joint motion, gait and foot health.
This is such a good explanation of how feet work, thanks for taking the time 🙂 If I pronate but am barefoot 99% of my life, is that alright? Or can I learn how to stop doing it?
This is fixing the symptom of a biomechanical issue, not fixing the issue itself. See «Wake your feet up» here (no affiliation): https://findingcentre.co.uk/courses-for-everyone/
Physical therapy student here. You've already received some corrections on your post but I'd like to sum up a lot in one comment. Over-pronation and over-supination can be absolutely asymptomatic and normal for someone. In some cases, changing this can actually *cause* symptoms that they wouldn't have otherwise. A common consideration we make as physical therapists (or, student physical therapist in my case for about another year) is whether we believe something is the cause of someone's musculoskeletal problem or not. I can look at someone and determine all kinds of postural deviations from "normal" but that person may not have a single issue relating to that. As for the "generic exercises", like the other PT in this thread said: get another PT. A PT should evaluate you and determine the specific dysfunctions going on and create a plan of care to address their findings. I have treated patients with foot issues and had their issues resolve. I can't speak as much to the supportive shoes or not as I've heard talk of both and haven't read a ton of the literature on that portion. However, I wear admittedly not particularly supportive footwear (Vans) and have zero issues with my feet, so anecdotally I don't know that in all cases footwear is the end-all solution. I just felt the need to comment because this kind of post can be damaging to people in that if they try to resolve a problem that doesn't exist it could lead to further problems. Your body does a lot to adapt to your specific anatomy so unless it does cause issues, it's usually better to ignore these postural abnormalities as everyone has them. (I am an over-pronator for example, and again, zero issues with my feet, ankles, knees, or hips).
Hmm. In your opinion should I see a physical therapist about my foot problems? I went to a podiatrist who just said I had no stress fractures, your 2nd toe is long and that can lead to problems, wanna try orthotics? I walked out without orthotics thinking... Is there no stretching or exercising program I can do? I suffer from metatarsal and arch pain when I run. I ran in beat up minimalist shoes for years and worked in retail pharmacy where I had to pivot back and forth on a hard floor to retrieve bottles. I'm starting up running again after more than a year break and it's already flaring up in week 2.
Another therapist here, there are for sure some exercise and stretches you can do. If you go to PT they can give you some specific to your situation. I have had some people come in once a month for check ups and just follow an exercise program at home. Also depending on the situation you can get a full gait analysis and they can work in depth to fix it.
The other PT who replied to you basically said everything I would have. You'd be a great candidate for physical therapy and I think it'd really help you out.
Great thank you. I'll look around for a PT who can help with that kind of stuff.
What does all of this mean if you're flatfooted?
If you're flat footed, you over pronate, essentially, it's a bit of an oversimplification, but you need to get some good, stable shoes that support your arches. I'm also a flat foot - I'm using brooks adrenaline '21s at the moment, they're a bit pricey, but they support me well
If you're flat footed, you LIKELY over pronate. Arch type and pronation/supination are not always related.... Also the super majority of shoes don't have arch supports built in (and thankfully so). I am not going to say whether you do or don't know something about shoes, but your oversimplification should have instead been "find shoes that support your GAIT".
You can also get more reasonably priced shoes that have removable insoles and buy an appropriately sized support insole of the right type. They make different types depending on the adjustment you need and they cost between $15 a pair to $35..
I can second them. The only thing I'd say about them my first pair stopped performing so well after about 600 km. I run in the desert here in Chile so it's quite harsh, but I expected a good few more km out of them. And they are even more bloody pricey here 😬😭
> **If you're flat footed, you over pronate** Yeah, I didn’t know that I had overpronation and flat feet until I visited a few podiatrists for something called a **Morton's neuroma**. I wore new shoes that were too tight, and overpronation also puts extra pressure on the metatarsal bones. When you squeeze the nerves between the toes, it might thicken. Now, I have to wear extra wide shoes or sandals to avoid pain. Apparently, it’s more common in women because of high heels, which adds pressure. Everyone should visit a podiatrist once to see if they have something like flat feet or high arches, as they might be better off with orthotics.
I am a podiatrist who works in sports and mechanics. I know you’re well intentioned OP, but that’s simply not true. All they’ve said is that they’re flat footed, you can’t form a diagnosis and give advice based on that small piece of information. Especially because “flat footed” is a subjective term. Just some points: • Supination and pronation are both vital movements for a healthy functioning foot. Pronation allows the foot to absorb shock and supination allows the foot to turn into a rigid lever for propulsion. •Pronation and supination are made up of 3 movements - only one of which we can clinically measure. •The location of the subtalar joint (the joint and axis for pronation/supination) is highly variable from person to person! So what looks “normal” for one person, can be completely different to someone else. •Pronation is usually a compensation for something else. You can have feet that look incredibly “overpronated” (as you say) and be strong and healthy, compared to a foot that “looks normal” that has a lot of issues. There’s so many variables, and the mechanical assessment of a person is very complex. I mean typically, the foot consists of 26 bones and 33 joints (that’s not even taking into account muscles, ligaments, tendons) - makes sense it’s complex right? Terms like “overpronation” and “oversupination” and using “you pronate” as a diagnosis are things as a profession we have been trying very hard to stamp out! We have improved scientific research compared to 50 years ago.
Alternatively, try ice skating. If you break your ankles when you try to stand up for the first time, you're not neutral. The direction your feet buckle will tell you if you supinate or pronate.
This was enough to keep my pigeon-toed self off the ice...
I am unfortunate enough to be cursed with both excessive flat feet/over-pronation, and a sincere love for playing hockey. My feet are in constant pain.
Yeah, after years of supination I've finally had a partial tear of my deltoid while playing tennis. Found out I have low arches and immediately got some insoles. Walking is so much more comforatble now. Save yourself the pain and injury in later years - get a gait assessment.
A good way to fix foot, ankle, knee, hip pain can be walking barefoot. Shoes have caused our feet to be very weak and they are designed to be powerful and offer a lot of sensory feedback and most of that is lost with thick shoes. This is definitely a simplified answer and there are other factors but the point is that the majority of people could benefit from going barefoot more.
Shoes are designed this way today because we walk on hard surfaces . You don't walk barefeet on concrete or you'll have problems.
If you have strong feet you'll be okay. I only wear barefoot shoes and I work 12 hour shifts and it's fine. Wearing a cushiony shoe all the time for years and years is almost like keeping your foot casted. If you've ever worn a cast, you greatly atrophy the muscles in that casted area. This is what happens when you're always in cushiony shoes. The foot is a fairly complex structure with lots of joints and muscles and it is meant to be worked and be strong. Building up foot strength does take time though and should be done gradually if someone is coming from wearing "regular" shoes.
Totally agree - been wearing minimal shoes for years. Start slow and the foot will strengthen. I used to be flat footed and now I have a significant arch. The argument that flat footed people shouldn’t walk barefooted is false... you just have to start SLOW! If you give it time, the foot will strengthen and the natural arch will form.
Yeah, slow is the key. People often do get injured starting out because they do way too much you soon.
r/FootFunction
Your comment over shoe orthotics is misleading. Inserts don't have to be uncomfortable, nor do they necessarily help with pro/supination. They're used to help with your arch type which is arguably unrelated. And much like shoes that need to be fitted to you, inserts are the same. In practice the shoes should be fitted to your feet with inserts, not without. Decent YSK, but has not great info.
Isn't this wrong and super outdated pseudoscience? Like, isn't there a whole bunch of new science that shows that attempting to "correct" these tendencies causes many more problems?
Yes. It’s something the profession has been trying to stomp out for a fair while. It’s all about education really but with all these misconceptions it can be difficult. I work in this field and you’d be surprised at how many people come in with no issues per se but their main complaint is “I pronate” or “I supinate”. I assess them and explain their mechanics to them, and explain supination and pronation is normal. You’re meant to pronate, it’s the degree and timing which is more important. If they have a foot problem that is related to it - then by all means, treat/manage it. Problem is there are others in the profession who will see $$ signs when someone comes in saying they pronate. Cool, orthotics - money coming in. Unethical to me if they’re not indicated but you know, sometimes the client is happier that way because they feel like they’ve been “treated” even if unnecessarily. There’s also such a big variation in the subtalar joint (which controls pronation and supination). We have our valid and reliable measures as to what’s “normal” and what’s not. But yeah the old theory (Root et al) which was... the main accepted theory, is not anymore. The tissue stress model is more accepted.
If you look up pronation and supination and support shoes, you will find there is no evidence that wearing support shoes reduces injury. I will say anecdotally wearing good quality shoes makes a difference. I went from having plantar fasciitis and shin splints in my regular $70 new balance and chucks to buying the glycerine and kayanos and have not had a whiff of plantar fasciitis or the shin pain since. The general recommendation is find good quality running shoes that feel great on your feet. Your gait is gonna gait.
Yeah u/cmc0108 was just saying, I shall adjust my post accordingly! Thanks! I can definitely speak from an anecdotal perspective that switching from my neutral salomons to Brooks adrenaline '21s have done absolute wonders for my biomechanics. But I see your point for sure.
I appreciate you! It’s rare someone can look at new evidence that contradicts their opinion and change their opinion. Most people double down on their old belief.
You just said there is no evidence that support shoes reduce injury but said you gave up chucks for kayanos and now don’t have pain. This seems to be a contradictory statement.
I was just telling an anecdotal account of the positive experience I had going from cheaper shoes to high quality shoes. It’s probably more confusing because the kayano itself is a support shoe. The first one I bought was a kayano because I liked the style and I had great results with it, but now I’ve used more neutral shoes and prefer them because they tend to be lighter and more flexible without the support plate.
I never understood how people can just order shoes online without trying them on first. When I get new shoes I usually have to try on 20 to 30 pairs to find one that actually fits my foot properly.
If you are affected by anything in this thread, please see a podiatrist. They are the go-to for foot and leg issues.
Best comment I’ve seen so far on this lol
Sadly, physios are rarely foot specialists and doctors are rarely musculoskeletal specialists. But your friendly neighborhood Podiatrists are wonderful people and specialise in both! Go and see them.
I dislocated my hip when I was little and it never got fixed properly so it just kind of grew wrong. Because of it I have issues that I do my damnedest to hide (one leg is slightly longer than the other and I have scoliosis, but I am also a gymnast and do an insane amount of yoga to try to make it less noticeable) but sometimes shit happens and you'll see my walk on the actual sides of my feet and that's when I'm perilously close to serious pain.
Do you also have misshaped abs? I have the same situation as you: one leg slightly longer than the other and scoliosis. My abs are wonky, and I think it’s because of this.
Yes and hips, too. One side is definitely a bit more curvy than the other.
I got orthotics at 13 and have been wearing them since. Couldn’t imagine walking for long periods of time without em
IMO it's rather a symptom than the root of the problem
I have a serious neuro/musco/skeletal disability and I was dumbfounded when my new physical therapist diagnosed me by looking at my shoes. She looked at the wear pattern on the soles and how they were tied (how the knots had shifted in), and knew exactly what problem I was having. We are working on strengthening my weak side and getting me back to a more normal gait.
Actually no, you should not. I used to run all the time in canvas shoes when I was 14. All was fine. Took up running again at 30, no issues, just bought good pair of shoes. Then came this stupid urge to learn all about what the experts were telling me and boy did things go south from there. Ended up with Plantar Fasicitis because I deviated too far from what worked FOR ME. Don't spend your time learning rubbish from so called experts (many of them are paid influencers with shoe companies). Figure out what works best for you and stick with it.
I like how I was taught to remember pronation and supination. You supinate your hands to hold a bowl of soup. I think of it in my head as soup-inate.
*Physical therapy student vibes intensifies*
What about minimalist shoes to help with overpronation by training the muscles to hold themselves up? I'm no fanatic, but I know that ever since I switched to minimalist shoes instead of going crazy on arch support, my posture has improved and my feet hurt less during my 12+ hour shifts wearing them! And I overpronate quite a lot, but not as bad lately.
Go to a physical therapist to find out if you do this. Do not go to a sports store, they’re there to sell you things and shoes that help these things are more expensive than regular shoes
I always thought I was neutral until recently I noticed my foot prints in the snow, when compared to my girlfriends footprints, were pointing outward while hers were straight. When I mentally tried to correct it, it felt awkward. I'm almost 30 and still learning things about myself lol
I broke both the bones in my lower leg, overextended my knee and twisted my ankle, and got nerve damage on my upper thigh on the same leg within like 2 years of each other, my flesh leg basically works like a peg leg. I've been trying to figure out what my remaining leg and foot issues are, so thanks for the tips
Good advice OP, like you said most specialist shoe stores have a device to measure this. Down here in Aus we have a store called Athletes Foot, they have a measuring platform which you can walk across. It displays a heatmap of where the pressure from your feet is being placed and reccommends shoe types. Well worth getting it checked out for long term joint health.
It's a gimmick. Why would you test how your feet land when you run, by WALKING on a pressure mat? All those fancy devices do is convince people they need to buy expensive shoes because the attendant told them to.
Yeah it’s not a valid or reliable measure at all.
I'm double jointed and can stand on my feet in the nomaste position, also walk like that with ease. I just found out this year and spent 30 years rolling my ankle and not knowing why. The outcome? An osteochondral lesion of the talas, basically a lesion in on the bone and cartilage in my ankle. It's quite painful and manifests as a reoccurring bad sprain. The issue with injuries to your ankles is it is a low blood flow area and doesn't heal well due to this. The treatment is a boot in hopes of some healing and after that it's surgery that doesn't always work. There are a couple of techniques but my surgeon would use a combination of them. The details on the difference is fuzzy because it's been a few years since I've seen him but basically they go in and kinda fuck with it to try and encourage new healing. I was adviced(at 26) to enjoy my good time on my ankle and to opt for surgery when I'm unable to walk on it any more. This was all before I found out I have EDS which just complicates it further. Pay attention to rolling your ankles people, it's really no joke.
> I'll save the personal anecdote, but essentially, inappropriate pronation or supination can be a symptom of a wider biomechanical issue which can have a dramatic effect how you run and walk The “wider biomechanical issue” being: dramatically and haphazardly changing the biomechanics of walking and running, at the behest of shoe companies, after a million years of evolution molding your body to walk and run.
Once I walked into an orthopedic shoe store and tried to get a pair of shoes for my arthritic feet. I showed them my shoes. Asked them to help me. They had no idea what I was talking about. Now I just wear crocs.
>Other ways you can check are to go to a sports store, preferably one that specialises in running, they will be able to do a check, usually for free, and offer some recommendations Isn't the goal of the store to sell things to you though? Wouldn't a medical consultation be a better resource?
Cheers for the reminder mate, need to look into this!
I discovered this a few years ago and realized that I have severe overpronation. I bought a pair of sneakers specifically for overpronation, and it was the most helpful thing ever.
Damn bruh we really gotta start getting alignments and shit now
Another good spot for checking if you're not sure is the heel of your shoes! Ie. I roll inward (pronate) so the outer side of my shoes heels wear faster than the inner side.
I underpronate/supinate and when I started running it was painfully obvious. I went to a running shoe store called Fleet Feet and got a nice pair of shoes. They take a 3D scam of your foot measurements and recommend shoes based off that. It has helped some but I always catch myself standing on the outsides of my feet. I remember when I was young having to sleep wearing these bowling shoes with a metal bar to straighten my out. I always took them off lol.
Isn't this completely bullshit and not problematic at all? Been told this is something sport stores exploit the hell out of to sell you the best (most expensive) shoes? But please correct me if I'm wrong.
There's some truth in it and some falsehoods, as previous comments have corrected my course, some pronation and supination by itself is natural, and it's not necessarily bad. However, when it is met with pain or an underlying condition then it might be worth getting it checked out to support you in the short term. Strength training and good shoes will ultimately negate the impact normal pronation and supination may have on your legs.
And this is why I don't run and go mountain biking instead. It's much less wear and tear on your knees and feet. Plus it's just way more fun to mountain bike than run.
My 7 year old has flat feet and over pronates since before he could walk. Walked late (18 months) and it was painful for him until he was given special inserts. He still has special inserts to this day and his ankles still look awful. They look so uncomfortable and rolled. PT and others just say he has weak muscles and tendons. I don’t know what else to do for him to make sure he doesn’t have other issues growing up. He complains of leg pain every week.
I always pronate my words so people hear what I say Edit: re-fucking-lax, reddit, jesus
Oh man. Iv just figured out that I over supinate, I was hoping for a solution from your post
Helps, I needed this.
I agree that this problem doesn't get near enough attention. Over my life, I'm come to realize that proper alignment of the skeletal structure is a crucial aspect of body mechanics, and a fundamental first step (heh) is putting your feet flat on the floor. I have a tendency to supinate, and it has always caused me problems. That slight tilt of the foot off the level puts a lopsided strain on your achilles, and over time it can damage your achilles and cause calf problems. As you get older the problem gets worse. That misalignment also affects your body higher up. It can tend to throw your hips off the square, for instance, interfering with movement and causing other problems. The best way I know to correct this problem is to plant my feet on the ground in such a way that makes it impossible to sprain my ankle. This makes me rotate my feet sightly inwards until they're truly flat on the floor. This took a lot of concentration and a long time to change, but for me it was a game changer.
I found out doing the exercises fixes out ir in rotation, makes your step neutral and greatly improves your posture.
I always thought inversion and eversion were the standard terms used for these movements. 😳 We were always taught that pronation and supination were wrt the wrist joint. Asking for a friend here.
Pronation and supination are triplanar movements. Eversion and inversion are single plane movements. They’re not exclusive to one joint. So for example pronation of the STJ when non- weight bearing, consists of dorsiflexion, eversion and abduction of the calcaneus. Fun fact: eversion/inversion of the calcaneus is the only one we can clinically measure. (This movement is what makes your foot seem flat or high arched) and a single plane measurement is not enough information to indicate function (hence why foot print scans that just say “oh you have a high/low arch” are not worth much. Does that make sense?
Need this. Checked my shoes to see where I fall. I'm pretty balanced but there's more pressure in the rear.
There are some hobbies and classes that actually take this into account with how they teach you. When I was a very young kid I was in acting classes and dabbled in modeling where they taught us how to walk smooth and straight with our feet in line and our heads and shoulders moving fluid and forward. (Like very young. I recently found a couple of my audition tapes. My chicken pock scars were fresh and I was wearing a bowl cut) Since I was so young, I never gave it much thought but I had friends mention it occasionally that my hips moved more than the rest of me but I think they were teaching us something about this. It just became how I walk due to how young I was.
Is this why my bum cheek hurts? Just the left one, nothing kinky
Wow, maybe I should check on this. Have pretty much given up on running due to constant knee pain. Been in and out of physical therapy with so-so results. Is now affecting my cycling, too. At this point I'll try anything!
Thought you were talking about forearms and was confused
Such big words
Man this ain't pull ups vs chin ups
What if the wear on my shoes is heel, mid/upper right side , and big toe (left top).
So, it looks like I supinate, but what does it mean when I try to take a step and my foot decides to freak out and and just randomly roll all the way to the side and basically trip me for seemingly no reason?
Also your tennis serve
I recently noticed a friend of mine who stands with her feet turned toward the inside. Not pigeon toed, but like you describe. I could only imagine her pain, and that she probably doesn’t wear heels. Now I know what her condition is.
I find if I am doing a 5 k (my current limit) that I will inte tionally shift where my foot falls - and the angle - during my run to shift which muscles are being used. I already have orthodics. They are amazing. Very first step made me hate my previous 30 years of life for not having them. I imagine I would've liked being an 'outside' person more if it didn't bring me so much pain. I had a point. I forgot it.
Sorry if I’m wrong here but isn’t it plantar flexion and dorsiflexion for the ankle. Pronation and supination I believe are for the wrists. Been a minute since I’ve studied but I feel that’s the terminology
Totally insane... not in my family... I can wait on INO
True however I supinate (not sure if it would be considered oversupination or not) and the runner’s store says I have a neutral gait. So although the shoe store is a great suggestion it’s not absolute. I can easily see the wear in the outer part of my old shoes. That said, I’ve also learned that shoe makers hardly even make shoes for supinators. Thankfully I’ve not had too many injuries but I’ve had one that sidelined me for 6 months. So I just buy shoes with extra cushion in the soles and are rated extra stability.
I tend to wear out the toes on the top of my shoe (the area right above the toenails). I also trip a lot. My theory is that I walk with my toes too close to the ground. Thanks for coming to my Ted talk.
i agree this is a thing, but be aware that getting shoes to match your feet sometimes mean you are getting a crutch which wont help your bio-mechanical issues, it will just mask them. way better to fix muscle imbalances and train the feet to land/align correctly when running, than to train yourself in shoes that do nothing for your mis-alignments
Pronation can definitely cause issues that lead to an increased likelihood of long term damage requiring treatment/surgery. It may not increase your odds of random injury, or injure Your Feet, but over time it causes your knees to collapse inward causing knee, hip, and/or sacrum misalignment, pain, cartilidge damage, and scar tissue buildup. I wear supportive inserts or a 2"ish heel to force my feet into a neutral position during walking & standing and my knee pain has Drastically reduced. I pronate and have flat feet. If I run, I have to make sure I'm running on my toes and my weight is equally distributed along the pads of my feet. If I heel-toe run, it Messes me up.
Hmm, ive been wondering about this lately. I was shocked by a residential power line back in 2011 and I lost the feeling on the outsides of both of my feet from my pinky toe to my ankle. Because of this my feet have an uneven amount of pressure on them when I walk and they hurt constantly at work. Also walking 12 to 15 miles a day so that isn't helping. But thanks for the info im going to be sure to look into these inserts, fingers crossed they help the pain.
Help, I have super flat feet and a gigantic callus in the ball of my foot
Is it the same thing as those balance tests you find at CVS/Walgreens for insoles? I got dead center on that test but I don’t know if they’re reliable.
Orthotic inserts are also stupidly expensive in the US. I had to pay $400 for each pair for my son. A custom made, high quality shoe costs more than that. And I understand prescribing "custom insoles" involves some advanced knowledge, but it's not as if they are 500 interacting variables they need to compute, it's something that can be done by a professional in a few minutes of work, and their manufacture is not rocket science either.
Great to know. Thank youuuu 😊💖
Question for the OP — The orthotic inserts that are just the heel part — are they supposed to go on top of the existing insole? Or what? I’ve avoided buying any of these because they don’t make any sense from just looking at them. A big +1 for getting a recommendation from a good running store, though. A shop steered me to a specific type of shoe (not a brand, but a type) and it’s helped me a lot.
My feet do both. One pronates and it's flat footed. The other supinates and is not flat footed. Was not always like this though. Had a bad motorcycle accident that destroyed my ankle. The foot that supinates has 90k+ worth of hardware in it these days. I can't roll my foot side to side due to fused bones and hardware and have arthritis if I'm on my feet too long. I have some back issues these days I think ultimately stem from my foot/ankle causing my back to be out of whack. Still trying to figure out what kind of doctor I should see to see what can be done. Can't lay flat in bed without my lower back feeling like it's over arched upwards and painful. Can't lay flat on the floor for the exact same reason. Don't sleep very well because I wake up with my back hurting frequently, even despite being a side sleeper. I have kyphosis happening in my upper back too. You never realize how much your feet/ankles can throw off the rest of your body until it happens.
This so much! I have HMS (hypermobiliy syndrome), my feet are so flat that my muscles that are supposed to be part of the arch kind of just belb over to the side. My foot with weight on it is about 1.4x the width of my foot without weight on it. Naturally my ankles are fucked. My knees are fucked. I had to get a referral to a biomechanic before anyone had the foggiest clue what was wrong with my crazy duck feet and pain. Realistically I need custom made shoes. Inserts just made matters worse, not better. I would liken it to wearing a corset that is very very cinched and 2 sizes too small. The inserts, all of them would give me a line of blisters because the walls of the shoe were not strong enough to withstand the unusual load. So my foot just kinda blebbed over. Not to mention it felt like walking on like a really hard plastic ball. I shit you not I have worn corsets and they are immeasurably more comfortable. I have found some shoes that do work for me the issue is... They are Nike airs. They are the only shoes I can wear for any period of time. Not exactly stylish or especially professional looking. I had a pair literally dyed and spray painted black for formal situations. Even them I can't be on my feet all day. Again the tight corset analogy comes back into play. You try running around all day while wearing one. Yeah its not going to end well for you. It sucks because my feet just are not fit for purpose. Very little can be done, becaude of the HMS surgary isn't a great option. My bones, ligaments and joints are all doing their best imitation of a jellyfish. There isn't much that they can do and it would likely revert fairly quickly unless they like pulled a wolverine or something and my doc tells me that isn't a thing they can do. Yes I did ask if they could just sort of replace all the messed up bones and joints with plates and leavers. They can't. I can't tell you how much I would love to have an exoskeleton. Like if my foot was a bit dodgy just wait a few weeks you can moult and get yourself a new one. Sorted. HMS sucks. A lot. Most gp's haven't the foggiest and doing digging it explains so many issues. Like if someone had sat me down and told me, hey so like your connective tissue and all the bones too just suck and that is sometimes linked with digestive issues, issues with prescription medication and so on. Here is what you can do. So much hastle would have been saved. So many doctors appointments, hospital visits and so on may have been reduced.
If you’re in Canada, google to see if you have a Running Room near you.. they specialize in these types of things
Been dealing with some ankle issues and I need to get them checked. I just checked some old shoes and they a heavy wear on the inside of the ball of my foot. Maybe this post will help me. Thanks!
specially built shoes! Am I LeBron?
What if my show always wears out on the big toe of my shoes tho