There’s a weird and extremely common form of body shaming that goes on in running shoe stores and health offices all over the world. They make you walk in a straight line while an observer watches your ankles and feet. If your ankles and feet roll inward more than “average,” they might call you an “overpronator.” Some runners worry that they’re more likely to get injured because of this. Then, they tell you you need more expensive shoes to “control” or “support” this ankle motion. Is any of this scientific or helpful? Today on the recover blog, we’ll offer science’s answer to the question, “does pronation cause running injuries?”
What is pronation?
To simplify it, pronation is the natural and normal rolling motion of the foot during the running or walking stride. If you watch it in slow motion, it’s pretty darn impressive how the foot and ankle work together to keep you upright and moving forward. This motion enables the smooth transfer of energy from the body to the ground and back again. Like anything with the human body, it presents itself in many forms. Some folks’ feet roll a lot, some just roll a little.
Does pronation increase running injury risk?
Not really. This 2014 review looked at 6000 athletes across 21 studies selected for their research quality and found no relationship between a “pronated foot posture” and foot or ankle injuries, bone stress injuries, or other nonspecific lower limb overuse injuries.
They found that pronated foot posture might put an athlete at a slightly elevated risk to develop patellofemoral pain syndrome or medial tibial stress syndrome. But, they emphasized that these effects are small. They should be seen as a one in a long list of potential risks rather than your destiny. This study put 900 runners in the same shoes for a year and found the “pronators” were less likely to get injured. That’s just one study, but the key takeaway here is “don’t worry about pronation!” We’d add “don’t let anyone offer an opinion about your feet unless they’re up to date on their research.”
Do any good runners “overpronate”?
You betcha. The photo on the left is a closeup of Joshua Cheptegei’s ankle taken less than a lap from the finish of one of his recent races. He broke the 5k world record. Yes, his ankles roll more than some, but they do their job pretty well.
That’s Rob De Castella on the right. His right ankle rolls inward dramatically and asymmetrically compared to his left, but didn’t stop him from becoming marathon World Champion and running a 2:08:18, which still stands as the Oceania record!
And what about shoes?
The relationship between foot movement, footwear, and running injuries has proven incredibly challenging to clearly isolate in scientific studies. This is probably because the relationship is small and insignificant relative to other factors like training load. Running shoes designed for “overpronators” and designated as “stability” or “motion control” cost more on average than “neutral” running shoes built for those with “normal” pronation. Research says these bits of shoe design are probably nonsense. If you’d like to learn more about the science of running shoes, you can check out our summary of the shoe science here.
How do we use this information to run healthily in the long term?
Your natural level pronation might have an extremely small effect on your injury risk profile, but there is no reason to invest much thought into it. Neither body shaming nor overpriced shoes will prevent running injuries. Run a lot, stay strong, and reject negative, simplistic ideas about how the body is supposed to be. Cheptegei will whoop us no matter how our ankles look! Power to the pronators.
If you deal with aches and pains from running, we use an entirely science based approach to strengthen your body so you can better handle training load. Get stronger, run more, hurt less, and recover better with the Recover Athletics App. Your first prehab routine is on the house!
