Supination And High Arches

Your feet are the foundation of your body. Your feet have 52 bones, 66 joints, 214 ligaments and 38 muscles. You take between 8000-10000 steps every single day and healthy, pain free feet are essential to leading a happy and active life.

Your feet have two main jobs – stability and mobility. They keep us stable and upright and act as a lever to help move us forward. The help us to be mobile through shock absorption and at different paces (or ‘gaits’) from walking to sprinting. About 30% of people have a ‘normally’ functioning foot. The rest of us will probably over-pronate (95% of those remaining), or more rarely‘over-supinate’ (5%).

Supination happens in 3 stages:

(1) Inversion is where the sole of the foot is turned inwards,

(2) then plantar flexion is where the foot and toes point downwards and

(3) adduction of the ankle involves the toes pointing across the body.

Combine all three movements and you have supination.

Why do our feet pronate and supinate?

Pronation – within normal limits – is an entirely normal and in fact necessary function of the foot. Pronation allows the forefoot to make complete contact with the ground, absorb shock and stabilise.

Supination is the opposite of pronation. Supination is when your foot rolls outwards. Like pronation, some supination is also a necessary part of your natural gait. When you supinate, you lift your arch and shift your weight to the outer (lateral) edge of your foot. In a pronated position the joints within the foot can move more freely which allows the foot to adapt to the ground it is on. In a supinated position the foot is more rigid which improves its function as a lever when walking and prepares the foot to ‘propel’ your body forward.

What are the signs / symptoms?

Supination, like its more common counterpart over-pronation, can be the underlying root cause behind a range of other foot, ankle and leg problems. Supination causes the foot to be less able to deal with shock and causes your leg knee and shin to twist. Most oversupination injuries are related to your foot being unable to deal with shock forces during walking and running. If your foot oversupinates, by default it underpronates.

Common injuries you are at risk from, if you oversupinate are:

• Stressfractures (typically the tibia, calcaneal or metatarsals)
• Corns,callous as the foot tries to protect itself from abnormal pressure
• Shinsplints
• Lateral knee pain
• Hip pain
• Lowerback pain
• Achilles tendonitis
• High arches
• Clawed toes

How can a Podiatrist help?

The Podiatrists at Dubai Podiatry Centre are biomechanical experts and renowned Chief Podiatrist Michelle Champlin is a biomechanics and orthotics specialist.

Mrs Champlin advises commencing custom orthotic therapy under the supervision of a qualified and experienced biomechanics podiatrist, who will carefully examine and assess you and take a mould / cast of your foot in order to hand-make custom prescription orthotics. These should be corrective, based on your individual prescription and made by the Podiatrist, in order to actually address and correct the foot and ankle malalignment causing the supination. It is important that the Podiatrist sees you back at regular intervals to progress your prescription as required and monitor progress until end of treatment. Check that your Podiatrist is podiatry degree qualified by a recognised University and licensed by the local health authority (e.g. DHA).

Orthotic therapy has advanced greatly in recent years, with Dubai Podiatry Centre being a centre of excellence in developing innovative custom prescription orthotics to be worn discretely within most footwear, from regular sports and school shoes to work shoes. Nobody else will know that you are wearing orthotics.

Why should you correct over-supination?

Supination does not just affect your feet, but can also affect the rest of your alignment up to your knees, hips and lower back and places extra stress on your legs. This is why foot alignment should be corrected, both to address any foot pain and also to prevent any further problems later in life throughout the rest of the body. This is similar to making sure the foundations of a building are strong and sound, therefore preventing the rest of the building higher up from being out of alignment, like the Leaning Tower of Pisa.

Years of walking and running over-supinated can cause subsequent problems with the ankles, knees, hips and back. We advise checking children’s feet when they start school, so that any malalignment can be caught and treated early. If you feel any form of leg, foot or ankle pain, early intervention is key. So if you notice any tell tale signs such as a high arch, foot pain, clawed toes or forefoot pain, make an appointment with an experienced Podiatrist for a gait assessment, biomechanical assessment and possible orthotic treatment to correct the supination and return your walking and running to its dynamic, ergonomic best.