Diagram photo of different areas of the legs that you can feel pain

Could I supinate?

To start finding out, take a closer look at where you feel pain.

What areas of my body hurt?

A Outer thigh

B Knees

C Ankle

D Outside of foot

E Achilles tendon

F Heel

G Toes

What is supination?

Drawn diagram of foot showing supination and the pain it can cause

As part of a normal stride, your rear-foot should roll inward a bit after your heel hits the ground, cushioning the impact and helping you adapt to uneven surfaces. That's called pronatio

But if your rear-foot doesn't roll in far enough, or seems to roll outward, that's supination. When that happens, your foot no longer properly absorbs the shock of each step.

Supination, or under-pronation, is common among people with high arches or tight Achilles tendons (the stretchy bands of tissue that connect your calf muscles to your heels).

Supination is considered natural for some people, but it places extra stress on your foot and leg that can cause problems elsewhere. That's because the shockwave from your heel strike isn’t absorbed properly and the outside of your foot bears the full force of your step's impact.

Underpronating can cause:

Think you might supinate? TAKE THIS SELF-ASSESSMENT
Self- Assessment
Do I suffer frequent:
  • Ankle sprains or pain?
  • Pain or swelling in my knee?
  • Muscle tightness or inflammation in the outer thigh or knee?

If you answered yes to any of these questions, you show symptoms that may be caused by supination. Take the next quick quiz to find out if you are at high risk for supination.

Self- Assessment
Do I have:
  • High arches?
  • Tight Achilles tendons?
  • Toes that turn inward (pigeon toes)?

If you answered yes to any of these questions, it's possible your symptoms stem from supinating.

Now, pull out a well-worn pair of your running or walking shoes.
Self- Assessment
Do they:
  • Show uneven, heavier wear on the outside edge of the sole?
  • Tilt outward when placed on a flat surface?

If you answered yes to either of these questions, you likely supinate. Make an appointment with a podiatrist to confirm your condition. Keep reading for recommendations on treatment and relief from the experts at FootSmart.


Repetitive injuries are the biggest concerns with supination. If you supinate, you may end up with recurrent Achilles tendonitis, swollen painful knees, or outer thigh pain. If left unchecked, those injuries will worsen over time and may lead to stress fractures.

Supinators also have a tendency to roll and sprain their ankles, since they are placing so much weight and pressure on the outside and rear of the foot. It is a vicious cycle, since sprains weaken the ankle, leading to more sprains. A moderate to serious sprain could keep you off your feet for weeks.

How do I treat supination?

Supination may just be part of your natural gait. But you can correct it—and avoid the many associated effects—with some simple measures. Your podiatrist will help you determine the best next steps for you. Here are the recommendations from the experts at FootSmart.

Photo of a comfortable athletic shoe that is recommended to treat supination that has extra cushioning
Wear shoes with:
  1. Extra cushioning, to help absorb the force of impact.
  2. A straighter instep shape—called a last—to control inward motion and counter supination.
  3. Flexibility and lightweight materials, to allow for more foot motion.

Also consider the following remedies to help correct your supination, stabilize your feet, and reduce pain.

  • Use deep heel cups.
  • Use orthotics and insoles.
  • Replace worn shoes diligently.
  • Use lateral heel wedges—inserts that stabilize your heel to keep your foot from rolling in or out.
  • Do extra stretching of calves, hamstrings, quads, and outer thighs, including your iliotibial band, which runs from your hip to just under your knee and helps stabilize the knee while running.

If you suffer frequent ankle sprains or pain, you should also:

  • Wear ankle supports.
  • Wear high-topped shoes that extend up over your ankle for athletic activities.