Under-pronation and treatment by podiatry

Under-pronation is one of many abnormalities of the foot which can disrupt the healthy biomechanics of our everyday movements. While the extent of under-pronation can vary extensively depending on its cause, the condition invariably causes discomfort and pain over time, and in this article we look at what causes under-pronation, and how podiatrists, specialists in foot care, can work to alleviate the condition.

What is under-pronation?

Under-pronation is a sister condition to the more common over-pronation, but while the latter involves a distinctive inwards movement of the foot during a walk or run, under-pronation involves an outward movement. Under-pronation involves a disruption of the normal mechanism of weight distribution when we walk or run. A healthy gait involves a smooth transition of weight from the heel, across the arch of the foot and towards the big toe. This movement does not stress any part of the foot, ankle, knee, or hip, unnecessarily, thereby preventing injury and pain.


During under-pronation the distribution of weight is not along this normal path, instead, weight is placed on the outside of the foot, with virtually no use of the arch or big toe at all. This is usually caused by an abnormality in the structure of ankle, knee, or hip joints that causes a certain degree of rotation which drives weight outwards. This abnormal placement of body weight stresses the foot, ankle, hip, and knee, causing distinctive pain and discomfort during walking and running moments.

An under-pronating foot will typically cause shoes to wear down on the outside first, and in many cases an effective method of checking wither or not a person is under-pronating is to check their shoe for signs of this pattern of wear.

A common misconception is that people with flat feet (collapsed arches) will over-pronate, in truth under-pronation can also be caused by flat footedness, it all depends on the mechanics of an individual case. Ultimately the foot and its movements are unique to you, and if you start under-pronating the best thing to do is to seek professional advice from a doctor or podiatrist to address the issue.

Under-pronation and podiatric care

Your podiatrist can determine whether or not you are under-pronating, and if you are, what the specific causes of your condition might be. It is important that you see either a podiatrist or doctor to determine the exact nature of your under-pronation as the condition and its causes can vary immensely.

The main method of managing under-pronation through podiatry is through the production of an individualised orthotic sole insert. These are supporting devices that can be placed into a shoe to remedy gait and adjust how weight is carried across the foot when you move. Orthotics are extremely effective and convenient, although they can take a few weeks to have a noticeable effect. You may need follow up appointments with your podiatrist to fine tune your orthotics to the needs of your foot.

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