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Foot Health for Better Running: An Effective Approach to Supination

The last foot issue we are going to review is supination. This foot condition is not as common as pronation. Still, it has become misunderstood because of misinformation spread among runners.


Supination happens when the soles of the feet turn upward so that the outer part of the foot takes on much of your body's weight.















If you are supinating, your foot will roll to the outside after landing instead of staying neutral or "upright." This is also called "underpronation." (if your foot collapses to the inside you are "overpronating.")


When runners have supination, it's common to see uneven wear on the outer parts of the soles of their shoes.


The natural thing to do when you notice supination is to go to the running store and purchase shoes designed for supinating runners. These shoes can come with a hefty price tag and, unfortunately, don't treat the cause of supination. Additionally, these shoes can cause leg pain for some athletes.


Causes of Supination

In a recent blog, we discussed how pronation is caused by a flat foot. Supination is the opposite. It's caused by an excessively high arch. Some of the most common causes of extremely high arches are tight plantar fascia and stiffness in the tibial muscles. The plantar fascia is the muscle that runs through the foot and attaches to the heel.


Tibial muscle stiffness is usually the reason runners experience pain when using a new pair of running shoes designed for pronation.


A tight plantar fascia pulls upward and causes muscular and joint imbalances in the ankles, muscles of the calves, knees, hips, and lumbar spine. Why? Because your body naturally wants to compensate for that imbalance, it tries to rely on other muscles and joints.


Other complications or symptoms of supination include calluses or bunions on the outer edge of the foot, hammertoes or clawed toes, and weakness in the foot or ankle that gets worse when running, walking, or standing for long periods.


Some conditions that lead to supination include plantar fasciitis, medial tibial stress syndrome (MTSS), metatarsalgia, Achilles tendinopathy, sprained ankles, and stress fractures.


A better approach to addressing supination includes treating the tightness of the plantar fascia and the stiffness in the tibial muscles by adding the neuromuscular control process.















Put the ball of your feet against the corner of the step, block your knee and bend slightly. You will feel a light stretch in your arch, calves, and sartorius. This is a signal that these muscles are stiff.


This is an effective exercise to relax and stretch the plantar and tibial muscles. It's best to incorporate them into your daily routine. Begin with 3 reps of 50 seconds for the first week. Increasing to 4 reps the second week. If you run regularly, consider adding these stretches after each run session for better results.


Neuromuscular Control

In many runners, supination and other issues are caused by poor running technique rather than anatomical or mechanical issues.


Next time you go running,

  • Look at your feet: how are your feet landing?

  • If you see your foot "collapsing" or rolling outward (supinating), see if you can voluntarily correct this. Focus on keeping your foot "neutral" through the entire stride. Take very short and slow strides.

If you are able to correct both feet by focusing on your foot strike, try to perform the following:

  • 5 x 100 m run, keeping your foot strike "neutral" (watching your feet to ensure you are landing and not supinating). Add a 30-second active walk rest between each set.

  • Build these short runs up to 20 x 100 and lower the active rest to 5-10 seconds.

This method aims to overcome some level of supination or bad technique during running.


We must perform at least 1000-2000 correct movements to achieve this change, so we need patience, but the end result is worth it!

 

Manuel Delgado Gaona is a USAT Level II and Youth & Junior Coach, FMTri Level II Certified Coach, an ACSM Exercise Physiologist, and a Physician specializing in Anatomic Pathology. His coaching philosophy is based on exercise efficiency. Coach Manuel can be reached at manuel@teammpi.com.

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