Merriam-Webster Medical Definition:   “Supination”: a corresponding movement of the foot and leg in which the foot rolls outward with an elevated arch so that in walking the foot tends to come down on its outer edge.

Pronation”: rotation of the medial bones in the midtarsal region of the foot inward and downward so that in walking the foot tends to come down on its inner margin.

By looking at your shoes can tell you a lot, if the outside of the shoe is worn from the back to the front you are supinating. If the heel is worn on the inside to the big toe you are pronating. Imagine balancing yourself on two broomsticks down the center of your feet, now rotate your weight to the outside of your foot-supination, now to the inside of your foot – pronation.  This is exaggerated but the picture is clear. Many problems can occur because of the way we walk and by added weight that is carried by our feet. If a person’s gait is pronated (over 90% of the people with foot problems over pronate) it is common for them to have claw toes, toes that are curled up, this is because only the big toe carries the weight. If the other toes carried weight they would be forced spread out. People that walk on the inside of their foot are prone to ankle, knee and back pain. The least common issue is supination, where the weight of the body is carried on the outside the foot. People that supinate, are prone to aching arches, knee and back pain, because shock absorption from the feet is reduced. “So, what is the big deal, I was born this way”?  30% of the people have normal feet and gait, out of the 70% left, probably only 30-40% are abnormal enough to cause pain. I personally played baseball, football, basketball and played outdoors from sunup to sundown when I was young- no pain. Looking back, when I reached my mid 40’s I started noticing ankle, knee and back pain. (Read the article – “Build Your Foundation”)   Being out of line didn’t matter before I was 40ish. I can remember my big toe aching sometimes after basketball practice, now I know it was carrying most of the weight. As I approach 60, I notice my ankles and knees kill me if I forget my orthotics on a day of walking or working in the yard. Advil and Aleve help but my orthotics have done wonders. They have actually changed my walking gait. As soon as I walk with my orthotics I can feel my outer toes bearing weight. It is so apparent I notice before I walk 20 ft.

Breaking them in: When I first received my orthotics years ago I was told to wear them a few hours a day and progress more hours every day. This was good advice. The Orthotics supported my high arches for the first time, so I could feel pressure in my arch then to my toes. The toes were fine but it took a couple weeks before my arches were pain free. Now it feels abnormal if I am not walking on them. At first you will notice the distribution of weight in your feet, then you will notice the knees feeling different, like the body weight is wearing on a different part of the knee, finally you’ll notice less back pain.

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