Tag Archives: running

What is the problem with overpronation in runners?

The term “overpronation” is a frequently used and misused term by runners and health professionals in the framework of running injuries as well as the use of running footwear. Pronation is really a normal motion of the rearfoot in which the ankle tilts medially and the mid-foot of the foot flatten. This is exactly what the foot is meant to do as it is how the feet adapts to unequal surfaces and absorbs impacts. It is healthy and there is absolutely nothing wrong with it. The way some runners chat about what they have read about it, you would think they have some type of illness.

Where the problem occurs is that it is widely assumed to be a risk factor for an injury when running. Because of this, there are design characteristics in running shoes that are sold to assist runners with this overpronation. These are what are known as the motion running footwear. In contrast, the neutral running shoes don’t have these types of design features directed at helping the so-called too much pronation.

The issue with the concept of overpronation is that there isn’t a consensus on what is ‘normal’ and what is ‘over’. Many runners with significant overpronation get no problems and other runners with only small amounts get lots of complaints. The actual research linking overpronation to an overuse injury is not well supported. The agreement of the systematic reviews of the data is that it is only a very small risk factor, so it is not really a major problem  due to so many additional factors that go into runners getting an injury.

So should overpronation be treated? Yes, if it is bringing about the issue. No, if it is not contributing to the issue. This is often challenging to decide. A key in determining if it is causing the issue is to decide if the loads in the foot that it is causing are high enough to damage the tissues. The supination resistance test can be helpful here in helping decide this. If that assessment is higher, then the forces are high, so the overpronation should probably be dealt with. If the forces are low, then it may not be necessary to manage it.

If  it should be managed, then the reason for the overpronation needs to be dealt with. There is not a one-size-fits-all when it comes to overpronation. If a muscle weakness could be the reason for the problem, then exercises such as the short foot exercise should help (it won’t help other reasons). When restricted calf muscles are the issue, then  stretching is what is needed (muscles strengthening or foot supports will fail in these); when a bony alignment, for example forefoot varus, problem is the reason, then only foot orthotics are going to help (strengthening muscles and calf muscle stretching will not help); and so it continues. The reason has to be resolved.

There are numerous fallacies and junk being spread about overpronation. A key red flag is that whoever is talking or writing about overpronation is, if they advocate a one-site-fits-all when it comes to this, then they probably do not know what they are blogging about.

What casues a running injury?

Running for fitness or competition might seem like a simple activity, but up to half of all runners can get some sort of injury each year. That injury might be minor and they run through it until it gets better or it may be serious enough for them to have to stop running. The most common reason for these injuries is that they simply over did it. They run too much before the body has been given a chance to adapt or get used to the distances being run. Every time that a load is applied to the body it is important to give it a rest before applying another load by going for another run. If too much load is applied before recovery from a previous training session, any damage get exacerbated and this may progress into an injury. Rest is just as important as the training runs and that is how fitness and strength is increased and is also how injury is avoided.

In addition to the too much too soon scenario, biomechanics also plays a role. This is the way that we run and different runners do it differently. Different running techniques can load different tissues in a different way and load some tissues too much, so that when running that might be enough to cause an injury. For example, conditions like medial tibial stress syndrome (shin splints) can occur when the width between the foot placement when running is too narrow. Those with  this condition may benefit from running with a wider base of gait. Another common biomechanical problem is runners is tight calf muscles. When running this causes the arch of the foot to collapse or overpronate and can result in a a range of conditions like plantar fasciitis to runners knee. These people will benefit the most from a calf muscle stretching program. The treatment of running injuries will depend on the cause and should be directed at the cause, whether its biomechanics to training load issues.