Excessive Supination of the Ankle Joint – How to Overcome the Problem?

In one of our previous articles, we discussed what foot pronation is and when this natural movement of the foot can turn into a problem.

Now, we will focus on the opposite movement, which is foot supination. We will answer questions such as:

What are the types of supination?
When do foot supination disorders occur?
Is excessive foot supination dangerous?

Supination and Pronation – The Natural Movement of the Foot

Foot supination is a movement that involves turning the foot outward and raising its inner edge. During supination, the foot’s longitudinal arch is elevated, causing the foot to twist outward and reducing its contact with the ground. This movement is often performed during running or jumping, as it helps stabilize the foot and reduces the risk of injury. Unfortunately, excessive use of foot supination can increase the risk of injury.

Pronation, also known as internal rotation, is a term often used in the context of running, especially regarding foot pronation. However, it's important to note that the term "pronation" applies not only to the foot but also to other parts of the body, such as the forearm.

Pronation is a completely natural process inherent to our body. The problem arises when foot supination becomes excessively pronounced.

Types of Supination

Depending on the joint in which the movement occurs, several types of supination can be distinguished. Examples include foot supination (also known as heel supination), forearm supination (i.e., supination in the elbow joint), and wrist supination (though the term “supination” is used informally here, as it doesn’t occur at the wrist joint itself).

The term "supination" is most commonly used and discussed in the context of the feet. It refers to the way the foot interacts with the ground. This can be described as tilting the ankle outward while rolling the foot from heel to toe. Supination and pronation of the foot occur during the transfer of body weight from heel to toe. Muscles such as the posterior tibial, anterior tibial, gastrocnemius, soleus, flexor hallucis longus, long toe flexor, plantar muscle, and extensor hallucis longus influence foot supination.

The phenomena of pronation and supination can also apply to the upper limbs, particularly the elbow and forearm. In this part of the body, supination means outward rotation, or changing the forearm bones from a twisted position to a parallel one. Pronation, on the other hand, is the opposite movement, inward rotation along the forearm’s long axis. These movements are controlled by the lateral forearm muscles, such as the brachioradialis, radial wrist extensors, and the supinator muscle.

Can Bad Shoes Cause Corns on the Feet?

We’ve discussed that corns on the feet form due to prolonged and persistent pressure. And what can apply more pressure to our feet than improperly chosen footwear?

Unfortunately, all kinds of fancy, winter, or other "heavier" shoes tend to be very stiff. In such cases, it’s very easy to create pressure in various places on the foot, leading to corns. If we react quickly, we can prevent them, but corns tend to start forming painlessly, only to quickly become a more serious problem. Especially if we are constantly taught the philosophy of "just walk it off," "a little discomfort is normal," "we need to look good," and similar ideas. Later, it comes to a point where corns need to be surgically removed, and it’s no longer a simple matter.

Properly chosen, flexible, and most importantly, NON-COMPRESSING shoes are the guarantee that calluses, corns, and even blisters won’t bother our feet.

When Does Excessive Foot Supination Occur?

Supination within the normal range of motion is a natural process and does not indicate any pathology. Problems arise when supination becomes excessive, meaning the deviation of the foot greatly exceeds the norm. A persistent supinated position of certain body parts can lead to musculoskeletal disorders. For example, excessive supination of the foot can result in overloading the joints, surrounding tissues, and tendons, as well as reducing muscle flexibility.

People with high arches are more prone to supination, and this movement is controlled by muscles such as the gastrocnemius, soleus, posterior tibial, anterior tibial, flexor hallucis longus, long toe flexor, plantar muscle, and long extensor hallucis. Excessive supination may have a genetic basis or result from wearing overly tight and stiff shoes.

In extreme cases of supination, especially among those who walk a lot, run recreationally or professionally, frequent foot pain, quick fatigue, ankle injuries, Achilles tendonitis, increased risk of ankle sprains, and possible strains of the muscles or plantar fascia inflammation may occur. Excessive supination can often be identified by the wear pattern on shoes, where the outer edge of the sole shows visible signs of wear.

Treatment of Excessive Foot Supination

Proper exercises and the selection of appropriate footwear or orthotic insoles can help correct improper foot positioning. Before purchasing shoes, it’s advisable to consult a professional, such as a podiatrist, orthopedist, or physiotherapist, to conduct a professional evaluation of the feet. Using modern tools, specialists can assess the biomechanics of a patient's gait. It will also be helpful to bring in the most frequently worn shoes, especially those used for training. The condition of these shoes can provide insights into the way steps are taken and any potential supination problems.

After the assessment and medical history, the specialist may recommend a set of exercises to help strengthen the appropriate muscle groups responsible for improving gait mechanics. Additionally, custom orthotic insoles may be fitted. Pronating orthotic insoles are recommended for patients who tend to have a varus foot position. These insoles can reduce pressure on specific areas of the foot where excessive strain occurs, while also improving support in areas where foot movement is insufficient. Individually tailored orthotic insoles help maintain proper foot positioning while walking, reducing the risk of pain, inflammation, and increasing safety during physical activity. People with excessive supination can also benefit from walking or running on soft surfaces, such as grass or sand, to reduce foot pressure.

Excessive Supination and Shoe Selection

In the case of pronation, as discussed in our earlier article, specialists recommend shoes with insoles that support the inner part of the foot. But what happens when you have excessive supination? In such cases, neutral shoes are usually recommended, which have no special insoles.

Some believe that shoes with good cushioning and uppers are the best choice for a supinating foot. However, one must be cautious not to adjust shoes to the problem, but rather address the issue itself. It’s important to ensure that the ankle is securely supported to prevent spraining the ankle.

Minimalist Shoes – Can They Help Fight Excessive Supination and Pronation?

Well-chosen minimalist shoes can be a great solution for someone dealing with excessive supination. Why?

Zero drop, meaning no raised heel, promotes the natural movement of the foot, which helps keep the foot strengthened and "exercising" continuously. For more significant foot problems, it’s recommended to consult a specialist first.
They are wide in the toe box, providing better foot stability (with toes spread wider apart). As a result, the foot is less prone to sprains in either direction.
They simulate barefoot walking, which, as mentioned earlier, is an excellent way to “naturally” treat excessive supination.

In our store, you will find women’s, men’s, and children’s minimalist shoes that will protect your feet while giving them full freedom.