A Simple Description of Foot Supination

Foot SupinationFoot supination is the term used to describe the outward tilt of the heel. Foot supination can also be described as foot inversion, an under pronated foot or a Pes Cavus foot type.

The supinated foot is less common that the over pronated foot. Foot supination is the opposite movement to foot pronation. Foot pronation is the movement of the foot as it rolls inwards. The pronated foot will have a low arch (sometimes) and the heel will tilt inwards whereas the supinated foot will have a high arch and the heel will tilt outward.

Scientists are still trying to fully understand the movement patters of the different joints of the foot and ankle during normal walking. It is a complicated process. However, for the purpose of this article and to allow a basic understanding of the foot, we can summarise the supination movement of the foot as an outward roll of the foot onto its’ lateral (outside) aspect.

The most obvious supinated foot type is a Pes Cavus foot. A Pes Cavus foot is considered to be congenital and it presents as a high arch foot with outward tilt of the heel on standing and adduction of the metatarsal bones. The more rigid Pes Cavus Foot, i.e. reduced flexibility/range of movement of the foot and ankle joints, tends to remain high arched when walking and running. However, it is also true that the more flexible supinated foot type becomes a pronated foot type when running, and sometimes walking, due to excess flexibility/range of movement of the foot and ankle joints.

Injuries associated with the Supinated Foot

A large number of supinated feet lack sufficient pronation moments (lowering of the arch of the foot) around the subtalar joint of the foot (the rearfoot joint). This reduced pronation of the foot means that the foot does not absorb enough shock on impact as it should and the resulting impact forces are then absorbed by the shin, knee, hip, and back, hence increasing risk of injury.

The foot which remains supinated when walking, running, or playing sports can result in numerous injuries such as:

  • Lower back pain
  • Lateral knee pain
  • ITB Syndrome
  • Peroneal Tendinopathy
  • Shin Splints
  • Stress Fracture
Supinated Foot

Pes Cavus Feet: Note the high arches, outward heel tilt and the adducted metatarsals (i.e. the forefoot ‘swings’ inwards).

The supinated foot on standing which becomes more of an over pronated foot type when walking and running can result in numerous injuries, such as:

  • Lower back pain
  • Lateral knee pain
  • ITB Syndrome
  • Peroneal Tendinopathy
  • Shin Splint
  • Stress Fracture
  • Sesamoiditis
  • Metatarsalgia
  • Tibialis Posterior Tendinopathy

Treatment of symptoms associated with Foot Supination

For those with the more rigid supinated foot, i.e. the supinated foot in standing that remains a supinated foot when running and walking, foot orthotics are required to realign the foot. Foot strength alone will not reposition this foot as it is a structural deformity.

Those with a supinated foot type may benefit from cushioned footwear as this help to improve shock attenuation, which has been affected by the rigid supinated foot.