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Does Underpronation Increase the Risk of Injury?

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Underpronation, otherwise known as supination, occurs when your weight shifts to put excess pressure toward the outer edge of your foot. One way to tell if you suffer from supination is to look at the soles of your shoes.

If you notice that you have excessive wear where your pinky toes are, you may have supination. Patients with this condition have an abnormal gait, and this causes them to lose their balance easier than most.

Underpronation can be extremely painful, and if not treated, can cause other issues later in life, such as arthritis. While this is not true for everyone, underpronation can also increase your risk of injury, not only while playing high-impact sports but also while doing everyday activities. If caution is exercised, you can avoid most injuries that could occur from underpronation.

Does Underpronation Increase Risk of Injury?

This question can be a slippery slope when investigating. You will find several opposing answers, some stating that injury with supination is inevitable, some saying that under pronation has does not affect the risk of injury.

Statistically, under pronation does not increase the risk of injury when the proper precautions are practiced. While this is true, few will know how to take precautions to prevent falls, muscle and tendon tears, and other future injuries when it comes to the condition.

If under pronation is left untreated, injuries can occur. To protect your feet from more injuries, or from developing additional conditions, there are many options you can choose to combat under pronation.

What Causes Underpronation or Supination?

Underpronation occurs when weight is displaced so that it puts pressure on the outer sides of your feet. Underpronation is often caused by an excess in weight with the mixture of ill-fitting shoes, or those which offer little support. Another typical cause of underpronation is a misalignment of the body.

Many times, if you have a major injury to one of your knees or your back, you may eventually develop underpronation. Unfortunately, another factor that can cause your feet to underpronate is simply genetics.

If your underpronation is caused by a genetic predisposition, seeing a doctor is likely the best option for you, as they may suggest any number of treatments, including but not limited to specialized physical therapy, stretches, exercises, and sometimes even surgery if there is some other underlying condition involved.

Stretches and Exercises for Underpronation

Instead of jumping straight to weight-loss solutions, starting with some stretches will be a better place to start to reach your goal. With pronation, your calf muscles can be stressed when contracting as a reaction to the extra weight placed on the outside of your foot.

The Achilles tendon will also be uncomfortable and tight. This can even lead to Achilles Tendonitis or plantar fasciitis, so it is important to nip the problem in the bud. Some stretches to try to help loosen the tightness in your legs and feet are:

Hamstring Stretches

  • Your hamstrings are made up of five different tendons that run along the back of your knee. A simple stretch to start with to help your hamstrings starts with you sitting on the floor. This stretch does tend to put some pressure on your back muscles, so be cautious and don’t push your body past what it is prepared to handle. Straighten your legs in front of you, keep your knees straight and bend at your waist as far as you can.

  • This stretch is similar to toe touches, without putting as much pressure on your legs, and you will not need to balance so much. It is recommended to hold this position for at least 30 seconds and repeat it 3 to 5 times.

Towel Calf Stretch

  • Needless to say, this stretch requires the use of a towel. A smaller towel or hand towel will work best for this one. You start this stretch by sitting, again with your feet straight out in front of you. Place the towel in the middle of your foot, straighten your back with your shoulders remaining down, and pull the towel toward you.

  • It is suggested to hold the towel pulling toward you for approximately 20-30 seconds, and to repeat this stretch 3 to 5 times on each alternating leg for the best results.

Prone Quadricep Stretch

  • This stretch is particularly nice because you start by laying on your stomach. Laying on your stomach helps stabilize your pelvis, making it easier to focus on stretching your quadriceps. Once you are laying down, bend your leg back, and grab your ankle. The goal is to have your foot touch your butt, or at least pull your foot as close as possible to it.

  • Even if you can not reach to pull your ankle back, a towel can be used to wrap around your foot and pull it back that way. Either way you choose to do this stretch, it will be useful to stretch your quads. It is best to maintain the position for 30 seconds, and repeat it 3 to 5 times with each alternating leg.
Stretches for underpronation

Visit a Massage Therapist, or Give Yourself a Massage

Another good choice to gain some of your flexibility back is to massage the areas causing you pain. You will have difficulty attempting to work out while your muscles are contracted and you are already in pain. There are several different methods massage therapists use, but we will break them down into the 5 basic types of massage strokes.

  • Effleurage– Effleurage is the use of long, gliding strokes. This method of massaging uses the least amount of pressure and it is typically the first and last type of method used on each body part.

  • Petrissage– Petrissage pertains to the kneading, squeezing, and lifting of the muscles. As a massage goes on, the pressure will increase, so naturally, this type of stroke uses more pressure.

  • Friction– As friction does, this method is used to heat a particular body part that may need extra attention.

  • Tapotement– Tapotement is intended to stimulate circulation. There are several types of tapotement, but they all consist of rhythmic percussion movements. This is a harsher method of massage, with increased pressure, and uses the striking of the area in pain to achieve. This method is best for knotted muscles.

  • Vibration– This type of stroke is intended to stimulate the nerves and the soft tissues of the body. For vibration, sometimes additional instruments are needed to get the desired effect to relieve muscular tension.

Opt for Foot Support

For those who supinate, a lot of pain can be caused by minimalist shoes. For running, soft or semi-rigid orthotics have been documented to work more effectively, but the benefits of these supports were mainly reported from those who were lighter in weight. Custom orthotics are often specifically mentioned or prescribed by podiatrists when underpronation is involved.

Custom orthotics are going to be one of the most beneficial treatment options you can choose for your foot health. Not only do supportive shoes or the use of custom orthotics help correct current problems and reduce pain and inflammation, but they can also help prevent other injuries and conditions of the foot from developing.

Low-Impact Options to Work Out

Now that we have gone over the easiest ways to help combat the tightness in your legs, and add some extra layers of protection to your feet, it is time to analyze what forms of working out will be best for under pronation pain and to prevent future injuries. It is always better to opt for low-impact sports when you suffer from a gait issue or a condition of the foot.

The most important area of your body to work out when you suffer from underpronation is the hips. Strengthening your hips and glute muscles will help combat your balance issues caused by under-pronation.

A few low-impact hip and glute exercises to try are:

Use a stationary bike

  • If you set the resistance on your stationary bike to be fairly low, this will help you gain some muscle in your hips and glutes, without causing too much pain to your legs and feet. This may cause some discomfort in your legs for the first few days, so it is important to remember to stretch plenty before working out.

Walking on a treadmill

  • A treadmill will allow you to have something to hold on to while you walk to help improve your balance and strengthen your hips and glutes. Treadmills also reduce the shock to your feet, rather than going outside on any number of terrains, including hard concrete, treadmill belts usually have some give and will not be so harsh for your foot and leg pain. This is especially beneficial when combined with custom orthotics, or other supportive shoes.

One option you have is swimming

  • Swimming gives little resistance, and you are required to put forth minimal effort with your feet, as most movements in the water are based mainly on your arms pushing you forward and your hips moving from side to side. Swimming will also help work out your core muscles and the muscles in the middle of your back. Swimming is by far one of the best sports to lose weight and keep you in good health.

  • Once you have had time to work on strengthening your hip and glute muscles, the leg muscles will be easier to move on to and will not be so painful when exercising.

Visit a Physical Therapist

  • While most symptoms of underpronation can be managed at home with the correct information, some cases are more severe than others. In the instance of an extreme case of underpronation that cannot be helped with at home remedies or stretches, it is recommended to see a physical therapist.

  • A physical therapist may suggest additional stretches, or alter your stretch routine completely. They may also help you learn how to tape your feet and legs to reduce the amount of pressure you feel when you walk, prescribe you customized exercises, and more.

Bilt Labs Custom Orthotics

Underpronation, also known as supination, occurs when your feet roll outwards excessively during walking or running. This can lead to a cascade of problems, including pain in your feet, ankles, knees, and even hips. Here's where Bilt Labs custom orthotics come in as powerful allies in your fight against underpronation.

Precise Biomechanical Correction:

Unlike generic insoles that offer a one-size-fits-all approach, Bilt Labs orthotics are meticulously crafted based on the unique contours of your feet. This personalized design allows them to address your specific underpronation pattern. Through a pressure analysis and gait evaluation, Bilt Labs creates orthotics that incorporate targeted features like:

  • Medial Arch Support: A strategically placed arch support helps control the inward rolling motion of your foot, promoting proper alignment and reducing stress on various joints.

  • Varus Wedging: This wedged design tilts your heel slightly inwards, further guiding your foot towards a neutral position during gait.

Enhanced Stability and Balance:

Underpronation can lead to instability and a feeling of rolling outwards with each step. Bilt Labs orthotics provide the necessary support to counteract this issue:

  • Custom Fit for Stability: The personalized design ensures a snug and secure fit within your shoes, preventing excessive foot movement and enhancing overall stability.

  • Improved Balance: By addressing underpronation and promoting proper alignment, Bilt Labs orthotics can significantly improve your balance, leading to a more confident gait.

Reduced Pain and Increased Comfort:

The abnormal mechanics of underpronation can put a strain on your entire lower body, leading to pain in your feet, ankles, and even beyond. Bilt Labs orthotics offer significant pain relief by:

  • Distributing Pressure Evenly: The custom design helps distribute pressure more evenly across your foot, reducing the excessive stress placed on specific areas during underpronation.

  • Shock Absorption: Bilt Labs orthotics often incorporate high-quality shock-absorbing materials, which can further reduce impact and minimize pain with each step.

By incorporating Bilt Labs custom orthotics into your underpronation management plan, you can experience a range of benefits, including improved stability, reduced pain, and a more comfortable walking experience. Remember, consulting a healthcare professional for a proper diagnosis and treatment plan is essential. Bilt Labs orthotics can be a valuable tool in your journey towards correcting underpronation and getting back on your feet with confidence.

Bilt Labs Custom Orthotics


In conclusion, the relationship between underpronation and injury risk remains a topic of debate. While some studies suggest minimal correlation, others highlight a potential link to specific injuries. Regardless, underpronation can cause pain and discomfort. If you suspect you have underpronation and experience any pain, consulting a healthcare professional is vital. They can assess your individual situation and recommend appropriate treatment options, which may include strengthening exercises, footwear modifications, or even custom orthotics like those offered by Bilt Labs. By addressing underpronation, you can promote proper foot mechanics, improve comfort, and potentially reduce your risk of future injuries. Take our free quiz today to find out which orthotic type is best for your feet.

Disclaimer: The information provided in this article is intended for general informational purposes only and should not be construed as medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare professional before making any decisions about your health. If you have any questions about your health or are experiencing any medical problems, please contact your doctor or other healthcare provider immediately. Do not delay seeking medical attention based on the information provided in this article.