Runners tend to be obsessed with pronation. The fact is, we all pronate when we walk and run – it’s only when we veer away from neutral pronation that you might need to pay attention to the way in which your feet move, argues runner Sarah Haselwood.
If you’re a runner, there’s no doubt you’ll have heard of pronation or overpronation. But do you really know what pronation is and how it could be affecting your form?
While there are different types of pronation and varying views on whether any pronation that veers off neutral can cause injury, it’s important to get acquainted with the basics before you start over-analysing your gait.
What is pronation, and why does it matter for runners?
Quite simply, everyone pronates. When you run and your feet connect with the ground, there will be an inward movement of your foot as it rolls to manage the impact of the surface. But it’s how it moves and how much it rolls that may affect your running.
Pronation is a natural process of absorbing shock. When you make contact with the ground, you’re pronating, and like so many aspects of exercise, how you pronate differs in each individual.
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Steven Connor, a podiatrist specialising in podiatric sports medicine, tells Stylist: “Pronation is the foot rotating in three different ways; it’s a naturally occurring movement, and it’s essential for us to walk and run.”
He goes on to explain that we need pronation to run, and stresses that “there are a lot of myths about pronation in the running world with quite negative connotations towards it”. You’ve probably heard people talking about it with regard to heightened injury risk and ‘wrong’ styles of running. According to Connor: “We have many bones in the foot, especially in the middle part, and we need pronation to walk and run over uneven surfaces because pronation lets us adapt to those services like a natural suspension.
“Without pronation, something like trail running would be almost impossible.”
There are three types of pronation:
Normal pronation means that your foot comes into complete or even contact with the ground when you run and rolls slightly inwards.
If you’re an overpronator, then it’s likely that your foot rolls further inwards and the outside of your heel makes the initial contact with the ground. While some overpronators may suffer from injuries, many overpronators won’t be negatively affected.
If your arch barely collapses when you run, you’re a supinator. This landing may put more pressure on your smaller toes and outside of your foot, potentially causing increased lower leg or ankle strain.
How does pronation affect running?
How your ankle and foot progress through the gait cycle will be governed by how you pronate. Rachael Bruford, a UK Athletics running coach, says: “Most of us pronate in some form or other; what matters is the degree of this pronation and if it leads to any issues such as pain/injury or overcompensation in other areas.
“For some people, pronation may influence the type of shoes they wear (eg stability shoes for extra support). Some shoes with a high stack may not be suitable for runners who pronate as they require quite a bit of ankle stability, and if you don’t have enough of this, it can lead to pain and possible injury.”
But Connor stresses that there are many ways to run well. “If you watch a marathon and look at all the different foot strikes, there will be a lot of variety.
“Sometimes you see patients with lots of pronation in their foot who may never have been injured, and then other runners, who look like they have quite a good foot function, might be riddled with injuries. So, it’s not definitive that pronation is associated with injury.”
Can pronation cause injuries for runners?
Does pronation have to be problematic for runners? Not at all. Everyone’s response to their specific pronation will differ, and just because you’re overpronating or supinating, it doesn’t mean you have to rush to seek advice from a specialist.
There have been ongoing schools of thought about pronation and its impact on running, pain and injury. However, overpronation certainly isn’t a recipe for disaster for affected runners, although there are those who believe non-neutral pronation can have negative associations.
Connor agrees: “Because of the negative associations with pronation, runners do come in and sometimes say they feel they overpronate or think pronations may be causing injuries. When I do an assessment, I often find that this isn’t normally the case.”
In fact, Connor says that while patients might think they may pronate too much, it’s not always clear if their foot placement is to blame for injuries when there are other factors to consider.
How should you manage your pronation and running?
If you’re injury and pain-free, don’t start trying to make alterations to how you run just because you’re worried about pronation. However, most runners could benefit from additional strength training, so it might be worth incorporating this into your fitness routine if you don’t already.
Bruford believes that strength training is key: “My main advice to improve your running gait would be to focus on core and glute strength. I’d recommend three short sessions a week for new runners, plus working on overall mobility.”
And Connor advises living according to a popular phrase in sports medicine: “You can’t go wrong with getting strong.”
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He adds, “We know the foot is just an extension of the hip, so strength training to the legs and core is important to reduce injuries. If the foot is pronating quite excessively, but the muscles have the strength and range of motion to cope with that movement, then that will ultimately reduce the risk of injury. If your body, foot and ankle don’t have the strength to cope with the amount of pronation in the foot, that’s when you need a little helping hand with specific strength training.”
And is there anything else runners can do to improve their running form and balance their pronation? Connors believes you can’t go wrong with supportive, comfortable running shoes and “altering your running volume or using orthotics to help redistribute the load in the foot”.
If you’re worried your gait might be why you’re getting injured, chat to your GP or seek out a specialist PT/podiatrist/physio who can assess your running technique.
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