Supination severity diagram
Diagram showing difference between supination vs pronation.
Illustration: © 2014 Dennis Homack, DC, MS, CCSP

It is extremely rare for someone’s feet and their stride to be perfectly balanced and equally weighted. Some people have feet that visibly turn inward or outward, while others have a subtler inner or outer weight distribution.

It’s hard to see, unless you look at the bottom of your shoes or have your feet scanned with the Foot Levelers Kiosk or other Foot Levelers scanning technology. (Click here to find a provider near you.)

Pronation vs Supination

When bodyweight is placed on the outside of the foot while walking or running, it is known as supination. When the weight is placed more on the inside of the foot, it’s referred to as pronation. An easy way to differentiate and remember the difference is that supination has “up” in the word. In a proper stride, the foot should move from heel to toe with a person’s bodyweight evenly distributed on their feet, giving them neutral pronation.

When there is supination, there is uneven wear on the outer part of the shoe, reflecting the stress of a person’s stride. People with supination typically have ankle pain and soreness, shin splints, discomfort on the heels and balls of the feet, and can experience calluses and bunions on the outside of the foot. People who have supination tend to experience more ankle twists and injuries because it is easier for their ankles to roll outward while walking or running.

Conversely, pronation is much more common. Pronation is natural and happens because your feet naturally roll inward when walking. It becomes a problem when you overpronate, meaning your feet roll in excessively. This causes the arches of your feet to flatten out over time. Overpronation is shown by uneven wear on the inside part of a shoe’s sole. People with overpronation are more likely to experience plantar fasciitis, knee, hip, and/or back pain.


While identifying supination or pronation is easy, it can be difficult to pinpoint the exact cause. First, many people are born with their feet doing one or the other due to high or low arches or legs that are seemingly uneven (which could be due to hip alignment rather than actual length).

However, injuries can also cause supination or pronation issues, particularly when discomfort is ignored. When the body is experiencing pain, it is a waving red flag that attention is necessary. Ignoring things like soreness, twists, sprains, leg, hip, knee or back pain, can only exacerbate an injury. Typically, rest is just one remedy to an issue, but not the only remedy. If someone is already experiencing knee or back pain, for instance, they will likely adjust their gait to accommodate their pain, which can lead to overpronation.

A third possible cause can be lifestyle. People who are on their feet for excessive amounts of time might experience supination or pronation to try and find comfort and relief. Running may similarly cause issues, particularly when someone trains at a pace that can lead to injury. It is also possible that a person’s weight can lead to an uneven gait, especially if someone has recently gained or lost a significant amount of weight and their body is adjusting to the change.


The good news is that treatment of supination or pronation is easily achieved, which can help reduce long-term discomfort and susceptibility to injury. The most effective treatment for supination or pronation is a customized orthotic insole in shoes. But, note the need for this to be customized. Over-the-counter solutions will not provide the relief necessary to correct the issue.

The first step to treatment is getting a quick foot scan. Chiropractors and physical therapists throughout the country have Foot Levelers scanning technology in their office and can scan a patient’s feet in less than two minutes, and get the results immediately. A foot scan will determine how someone is distributing their weight on their feet, which informs the design of their customized orthotic insoles. After a scan, an order can be placed for personalized insoles that fit right into to your shoes, to provide immediate relief and improved mobility.

By wearing Foot Levelers custom orthotics, the entire body achieves balance, starting with the feet. After a few months of wearing orthotics, the wear on shoes should become more equal. Not to mention, any discomfort caused by supination or pronation will subside as the body regains balance and alignment. Lower back pain, knee pain, and an increased risk of ankle injuries can be greatly reduced, if not totally eliminated, through Foot Levelers custom orthotics.

To find a Foot Levelers Healthcare Provider in your area, click here.


Download the Infographic “Degrees of Pronation”: