By: Angela Ciroalo

As a runner it is very common to develop aches, pains and even injuries.

These various aches and pains may be due to a number of causes such as; repeated overuse, improper shoes, overused shoes, improper form, running surface, and many others.

When an injury occurs it is best to confront the issue by examining the gait cycle of the runner.

A gait cycle begins when the foot lifts off the ground and ends when the same foot returns. Analyzing the gait cycle will reveal any issues that may be occurring between the foot and ankle during the landing and lift off of the foot.

The gait analysis is broken up into two phases; the stance phase and the swing phase.

The phase most commonly examined is the stance phase where pronation can be distinguished.

The stance phase includes the foot strike, the mid-stance of the foot, and the propulsion of the foot.

The type of gait that the runner displays may explain the reason behind the pain or injury the runner is experiencing.

The different types of gaits include neutral pronation, under pronation and over pronation.

Neutral pronation is normal and signifies that the runner’s foot is properly landing and lifting during each step of the gait cycle.


Neutral pronation occurs at a 15-percent inward rotation of the ankle.

The small degree of inward rotation is normal for the ankle and foot because it allows the foot to properly absorb the force of the foot strike and propulsion.

During neutral pronation the propulsion of the foot occurs amongst the two largest toes. Lift-off of the foot is best observed in this position due to the strength of these two toes.

Injuries are not associated with neutral pronation because neutral pronation is the optimal gait cycle of a runner.

Under pronation and over-pronation are associated with higher rates of injury due to the improper positioning of the foot and ankle during the gait cycle.

Over pronation is the excessive pronation of the foot and ankle during the gait cycle.

During excessive pronation, the foot and ankle roll inward at an angle greater than 15-percent causing the arch of the foot to collapse upon landing.

Over pronation does not only affect the rotation of the foot and ankle, the inward rotation of the ankle further causes the lower leg, knee and hip to also internally rotate.

Due to the internal rotation of the entire leg limb, there is a much higher instance of experiencing running-related injuries.

Excessive pronation is most commonly recognized amongst runners who have little-to-no arch, or flat feet. However, it is also possible for over pronation to occur amongst those who have neutral and high arches.

Over pronation occurs due to lack of stability in the ankle and foot, which can occur regardless of arch type.

Common signs of over pronation include wear found on the lining of the inside of the shoe, wear found along the lining of the bottom of the shoe, in addition to the formation of foot calluses and foot bunions.

pronation defined

Each of the signs demonstrate the consistent force that internal portion of the foot has had with the shoe due to the excessive internal ankle rotation.

Common injuries associated with over pronation include plantar fasciitis, Achilles tendinitis, patella-femoral syndrome, shin splints, tarsal tunnel syndrome, and anterior compartment syndrome.

Fortunately, over pronation can be confronted.

Over pronation occurs due to the lack of stability in the ankle and foot, therefore a stability running shoe can aid in preventing over pronation.

In a stability show a medial post is used to provide stable ankle movement during the running process.

Another option over-pronators can try is the use of orthotic inserts or arch supports. Both options will provide ankle support in runners that will aid in preventing excessive pronation.

To prevent pain or tightness attributed to over pronation it is suggested that runners stretch the plantar fascia muscle under the foot, the Achilles tendon, as well as the soleus and gastrocnemius muscles.

To prevent over pronation from occurring runners can also try performing strength building ankle and foot exercises to create a natural stability in the ankle and foot.

Pronation supination

Under pronation is in fact the opposite of over pronation. Under pronation is the lack of inward rotation.

Under pronation occurs when the foot does not effectively roll inward upon landing causing the outside edge of the foot to absorb the landing of the foot instead.

During under pronation the foot rotates at an angle less than the 15-percent of neutral ankle pronation, creating an almost external rotation at the ankle.

During this process the smaller toes are then forced to support the propulsion of the foot as it lifts from the ground, opposed to the larger toes which were created for this purpose.

Similar to over pronation, the angle of the ankle and foot is irregular therefore the foot and ankle are not properly inline during the gait cycle.

The irregularity in the foot and ankle will then in-turn create irregularity in the entire leg limb.

Due to the outward rotation in the ankle and foot, the lower leg, knee and hip are forced to turn outward, causing a different variety of running-related injuries.

Common signs of under pronation include wear found on the external lining on the bottom of the shoe, tight Achilles tendons, heavy-footed running and high arches.

foot soleArches

Common injuries associated with under pronation includes iliotibial band syndrome, shin splints, ankle sprains, lower back pain, plantar fasciitis, Achilles tendinitis, hip and heel stress fractures, knee, hip or ankle pain, and metatarsal stress fractures.

Fortunately, under pronation can also be confronted.

Due to the lack of flexibility in the foot and ankle it is suggested that an under-pronator run in a neutral shoe that does not offer stability.

An under-pronator requires a shoe that offers flexibility and promotes movement in the ankle creating neutral pronation and proper foot landing and propulsion.

Under pronators can also use orthotic inserts and arch supports to stabilize proper movement of the ankle during the gait cycle.

To address tightness caused by under pronation stretch is another important component.

Lower leg muscles, such as the soleus, gastrocnemius, the plantar fascia under the foot,  and the Achilles tendon should all be stretched.

To prevent under pronation from occurring runners can also try performing strength building ankle and foot exercises to create a natural stability in the ankle and foot.

Keep running

Though injury can be a hassle, it is important for runners to never lose sight of their goals. Do not allow a small speed bump ruin the entire ride.

Injuries can be healed. Imbalances can be strengthened. Improper form can be straightened.

Never lose sight of your goal. Stay committed to healing the injury and focus on improving your overall strength and health – and you will run your best.

Find motivation to run this month from the words of author Joyce Carol Oates, “Running! If there’s any activity happier, more exhilarating, more nourishing to the imagination, I can’t think of what it might be. In running the mind flees with the body, the mysterious efflorescence of language seems to pulse in the brain, in rhythm with our feet and the swinging of our arms.”

This article was previously published in Night & Day Magazine. 

Now I would love to hear from you!

  • Has this article been helpful to you?
  • Have you experienced any recent running-related injuries?
  • Do you feel that over or under pronation has impacted you and your running ability?
  • What is you experience with pronation?
  • I look forward to hearing from you!

❤ Blessings, joy & love,

Angela Joy