Have you ever noticed the way your feet and ankles move while you are walking or running? Do they roll outward? If so, you could have the condition known as supination.

The term supination also refers to a type of rotation by the hand, but in the feet supination involves the movement of the subtalar joint.

This joint is located between the talus (the uppermost bone of the foot that connects to the ankle) and calcaneus (which sits under the talus and forms the heel bone) bones.

Supination is a normal part of the gait cycle and occurs when the foot rolls outward and places most of your weight onto the outside of your foot while raising the arch. Under normal circumstances, supination does not affect us, but when the feet are put under abnormal stress, oversupination can be the result.

Oversupination is a more severe version of this part of the gait cycle, and is one of the more common causes of a sprained ankle. Oversupination often suggests poor or limited shock absorption.

The movements of supination are broken down like this:

• Inversion: turning the sole inwards
• Plantarflexion: pointing the toes away from you
• Adduction: pointing the toes across your body

Supination is the opposite movement of pronation, which is also part of your normal gait cycle. As with supination, when pronation is excessive it is referred to as overpronation.

Pronation occurs as the foot strikes the ground and rolls in to absorb the impact. Supination occurs as the foot prepares to toe-off to provide a rigid platform for leverage.

As the foot rolls out it becomes a rigid lever. Improper supination can occur when the foot doesn’t pronate enough.

When the foot does not pronate enough, there isn’t enough shock absorption, which places an enormous amount of stress on the entire foot/ankle/leg/knee structure. This stress is what makes the structure susceptible to injury.

Do I Have Oversupination?

There is no substitute for the experience and training of a qualified doctor. If you feel you have oversupination, you should seek a diagnosis from a podiatrist.

If you are at home, there are little things you can do to determine whether you may have oversupination.

• If possible, stand in front of a mirror and position yourself so you can see the inside of your foot. Examine the foot. Can you tell if you have a high arch? High arches may be a sign of oversupination.
• Next, look at your favorite pair of shoes, particularly running shoes. Is the upper part of the shoe pushed over the outside of the sole, mainly on the forefoot area? If so, you may have oversupination.
• You can also try the “wet test.” You’ll need a flat, dry surface and a wet foot. Place your foot on the ground and remove it to view your footprint. Normal footprints have a heel, connected to the forefront by a strip that is almost half the width of the foot on the outside of the sole. If this strip is missing or barely visible, you may have oversupination. Although this does not necessarily represent the amount of movement in the subtalar joint, it can offer a clear picture of your foot type, making it easier to determine whether you have oversupination.
• Are you pigeon-toed? People with oversupination are sometimes pigeon-toed, or have feet that turn inward when they are standing, walking, or running.

What Should I do if I have Oversupination?

The first thing to understand is that supination is a normal part of our gait cycle. Our gait cycle is the way we walk and run.

If you feel you are suffering from oversupination, the first thing you should do is seek medical attention and advice from a licensed podiatrist or sports therapist in order to get an assessment of your running style.

Your doctor may recommend using particular stretching or strengthening exercises, along with custom-made orthotics, to improve the condition and alleviate symptoms.

Your doctor will be able to determine the next steps in treating the oversupination based on factors such as the severity of the condition and your activity levels, among others.

Is Oversupination Painful?

Supination is not necessarily painful, as it’s a normal part of our gait cycles, but oversupination can cause injuries to the ankles, knees, and feet, which can be painful.

Ankle sprains are the most common injury caused by oversupination, due to the fact that  repetitive sprains weaken the muscles and softens the ligaments surrounding the ankle bone.

Recurring ankle sprains are also very common among people with oversupination. Swelling, pain, bruising, and immobility can be the result of ankle injuries caused by this condition.

What Are The Complications of Oversupination?

Although oversupination is not always injurious or painful, it can lead to complications in other regions of the body, such as:

• Arch pain
• Heel pain
• Corns and calluses on feet
• Sprained ankles
• Shin splints
• Achilles tendonitis
• Knee pain
• Hip pain
• Back pain

Oversupination Treatment Options For You

If you think there is a problem with the way you supinate, the first thing you should do is see a podiatrist or sports therapist for a running analysis. Based on their findings, your doctor may recommend the following treatment options for you:

• Change in your footwear
• Orthotic inserts
• Stretching and strengthening exercises
• Physical Therapy

Additionally, it may help to warm up thoroughly before any exercise or performance. When you have finished exercising, you should perform the same stretches to cool down.

Stretching and conditioning the muscles of the lower leg will help to prevent ankle and lower leg injuries.

If you haven’t already, you should check out our Plantar Fasciitis Exercises article for step-by-step guides on several types of exercises for your toes, arches, ankles, and calves. Always talk with your doctor about beginning any type of stretching exercise.

Questions to Ask Your Doctor

Here are some questions you may want to ask your doctor about supination:

• Do I oversupinate?
• Will I still be able to wear my favorite shoes on a daily basis? If not, what do you recommend I look for in a shoe?
• How long will it be before I see changes?
• What are the chances treatment options won’t work for me?
• Will a change in my diet reduce my excessive supination?