You can’t talk about foot pronation without mentioning supination. Both pronation and supination are normal foot motions that occur during walking. In excess, foot pronation can be a major contributing cause of lower extremity injury, occurring  from the toes all the way to the low back.

A pronated foot position visualized as a “low arch” allows the foot to adapt to irregular walking surfaces like rough ground. The supinated foot position visualized as a “high arch” allows the foot to be very structurally stiff allowing a transfer of pressure to the ball of the foot during heel lift while walking.

A majority of people who seek the care of foot and ankle specialists have injuries or deformities of the foot that can be contributed to excessive amounts of pronation. A bunion is one such deformity that can be attributed to excessive pronation.  The “bump” that occurs in a bunion deformity is the prominent first metatarsal bone which has shifted out of its normal position. The shift in the first metatarsal position is the result of the abnormal pressure placed on the joint in the pronated foot.

Shoes can have a tremendous influence on the amount of foot pronation. Shoes that have too much cushioning can increase the amount of foot pronation already occurring. For example, if your foot is already pronating too much than standing on a bag full of marshmallows will only increase the amount of pronation. A firm shoe and orthotic however can reduce excessive foot pronation and is often times used as a conservative approach in treating many of the foot challenges  associated with excessive foot pronation. The shoe and orthotic improve foot position during walking and assist the foot in regaining a “high arch” position as the next step is taken.