Supination is a problematic condition that can lead to severe limitations in your athletic abilities. Before we discuss the details and treatment, however, we need to take a look at natural supination and how your body is supposed to move.
Supination And Pronation
Pronation is the natural inward roll of the foot that occurs during normal movement. When the outer edge of the heel strikes the ground and rolls inward, the foot flattens out slightly. Pronation is an integral part of the normal movement of the foot.
Supination is the opposite – when this happens, the foot rolls outward instead of inward. Supination is also a normal part of movement, and usually occurs when you’re running and lift your heel off the ground.
The real problem is excessive supination, which can put added strain on the muscles and tendons around the ankle. If things progress too far, this can lead to an ankle sprain or even a total rupture of the ligaments. This state is sometimes referred to as “oversupination” or “hyper-supination.” For this guide, all other references to supination refer specifically to oversupination.
If you suspect that you have foot supination, reduce the amount of walking and running you do until you can see a doctor. Small amounts of movement each day aren’t enough to cause significant damage to your body, but you should avoid any intensive activity that requires the use of your feet.
It’s also possible for the foot to have too much pronation, rather than too much supination. Overpronation is a different condition that’s particularly common in people with flat feet, and it’s diagnosed and treated in ways similar to oversupination.
Causes Of Supination
The primary cause of a supinated gait is genetic – some people inherit a poor foot structure that leads to supination more often than it should. Other causes of supination include:
- Shoes that don’t fit correctly
- A poorly aligned body
- Previous injuries, especially around the foot or ankle and affecting the muscles or tendons
Feet that are too supinated cannot adapt to surfaces. This rarely results in stumbling and falling all by itself. The human body is extremely good at balancing itself, and it usually finds another posture that can keep you upright.
Unfortunately, this posture is rarely good for you – many bones and muscles have to work differently, and the result is added tension in places not meant to take that kind of stress over prolonged periods. Supination itself is not especially dangerous, but if left untreated, it can lead to serious injuries.
This condition usually affects both feet when caused by genetics. If it occurs as the result of a sports injury or other form of damage, it will only affect that foot.
Symptoms Of Supination
Many different symptoms are associated with supination – some caused by it, others leading to it. The most common symptoms include:
- Achilles Tendinitis
- Arch Pain
- Ankle Sprains
- Back Pain
- Corns, calluses, and other rough areas on the feet
- Flat Feet
- Heel Pain
- Hip Pain
- Knee Pain
- Shin Splints
Most people do not develop all of these symptoms. However, supination almost always comes with several of these. If you only have one of these symptoms – say, knee pain – chances are you have a different condition.
(This is because the roll of the foot affects many different bones, tendons, and muscles. Put simply, supination can’t affect just one of them.)
Supination is easily diagnosed by podiatrists, sports therapists trained to recognize feet problems, and some other doctors. Most exams will use a gait analysis, where supination is easy to observe. The analysis will also help to rule out other problems.
If you developed supination after sustaining an injury, your doctor might order an imaging test to rule out other potential causes. Pain in the foot and ankle can come from a wide variety of different problems, and it is possible to have several conditions at the same time. Resolving other problems may or may not resolve the supination, especially if you are genetically predisposed to this condition.
Specialist shoe shops may also be able to diagnose supination. That said, you should always see a doctor before buying any products the store suggests. Supination can be caused by problems that stores aren’t able to identify, and it’s important to determine the cause of supination before deciding on a treatment plan.
Supination is easy to treat once identified. In many cases, the only thing you’ll need to do is wear the right type of shoe while walking, exercising, or participating in sports. Shoes that are designed for oversupination naturally help to correct your posture and help your body absorb the shocks of movement.
In particularly severe cases, your doctor may order custom orthotics. It is possible to buy correcting insoles in stores, but this is usually less effective than custom-made orthotics. This is especially important if your foot has another condition, such as fallen arches. Most store-bought orthotics are only designed to treat one condition, and may not be appropriate for your situation.
Outside of supination shoes, several other techniques are used to help treat this condition. The following are exercises and stretches that help loosen muscles and train the body to use its feet appropriately.
Jump ropes may be associated with children, but the rapid up-and-down motion (landing on the outside of the foot and rolling in with proper pronation) can help teach your body the correct way to contact the ground.
You can do this without a rope, but it won’t be quite as effective – the movement of the rope helps to ensure a steady pace. A good introductory routine includes:
- 20 seconds of basic jumping
- 20 seconds of off-step jumps (tapping each foot twice, much like skipping)
- 20 seconds of alternating between each foot
- 20 seconds of basic jumps (again)
- 40 seconds of rest
Start with one cycle, then work your way up to five. This serves as a solid ten-minute warmup for the rest of your exercise.
Most people with supination have tight Achilles tendons and calves. Stretching these areas can help to reduce tension and decrease the impact of supination on the rest of your body. A good stretch includes:
- Placing your hand on a solid vertical object (usually, but not always, a wall)
- Moving one leg backward while both feet are firmly on the floor
- Keeping your back leg straight as you bend your front knee
Supination can lead to conditions like plantar fasciitis, an affliction of the ligament connecting the toes to the heel. Gently stretching this ligament helps keep it the proper length.
Could Surgery Be Necessary?
Surgery is only necessary in the most unusual cases of supination – and even then, it’s usually to correct another issue that’s causing the supination. While you can never say never about the appropriate treatment – there are always outliers who don’t match the norm for any condition – it’s safe to say that surgery is extremely uncommon for this condition.
Similarly, it’s rare for people to need medication. However, if supination goes untreated for too long (for example, because you’re waiting for the delivery of orthotics), you may need to use a mild painkiller. Over-the-counter medicine is fine for this since the pain is rarely bad enough to need a prescription. If it is, you should see your doctor immediately – you may have, or be developing, another serious condition.
How Long Does Supination Last?
That depends on the source. If you’re genetically disposed to supination, chances are the condition is permanent – you’ll have to wear orthotics, special running shoes, and similar gear for the rest of your life.
If the supination is caused by inflammation or injury, it may go away as soon as the cause is treated. You may not even need to get orthotics or do any special treatments to stop its effects.
Unfortunately, there is no “cure” for this condition. It’s not like a disease or virus that can be removed from your body, and no known surgical technique can treat this condition without causing more harm.
The good news is that supination is extremely treatable. Once you have the right shoes and your postures are corrected, supination will have effectively no impact on your life. With the right treatment, you can even compete in intense events like races and marathons.
In short: It’s a problem if left alone, but it’s easy to treat once diagnosed. That said, if you so much as suspect you have supination, you should see a qualified podiatrist (or another analyst) as soon as possible. This will help to reduce the long-term effects that can come from damaging your muscles and ligaments.