Do you have foot pain? Your pronation type may be to blame.

by Kaiser Permanente |
Person in athletic shoes walking by someone sitting

Physical activity is good for your body and mind. Even a brisk daily walk can improve heart health, boost mood, and reduce stress.1 But it’s important to take steps to prevent injury, like wearing a bike helmet, using gardening gloves, or as it turns out, choosing the right shoes.

When you’re walking or running, your feet roll inward, or pronate. Everyone’s feet pronate differently, so that natural motion doesn’t always mean you’ll have problems. Sumer Patel, DPM, chair of the Foot & Ankle Surgery group for the Permanente Medical Group of Northern California, says that pronation allows you to absorb shock, flex, and adapt as you walk on uneven ground.

But for some people, pronation can lead to pain in the heel, arch, or Achilles (the tendon that connects your ankle to your calf). If you’re experiencing foot pain or have had an injury related to pronation, you may want to change your footwear.

Types of foot pronation

Pronation is when your heel joint strikes the ground, turns inward, and absorbs impact. Then your foot flattens and pushes forward to the next step. Your foot arch — normal, low, or high — influences your pronation type. Low arches are also called flat feet.

There are 3 types of pronation:

  • Neutral (normal pronation) — When the foot rolls inward about 15%. Your whole foot meets the ground and can support your body weight, and you push off the ground evenly from the ball of your foot.
  • Pronated (overpronation) — When the foot rolls inward more than 15%. Overpronation is more common in people with flat feet. Your foot and ankle may have problems stabilizing your body. As you push off to the next step, your big toe and second toe do most of the work.
  • Supinated (underpronation) — When the foot rolls in less than 15%. Supination is more common in people with higher arches. The outside of your foot absorbs most of the shock, and then your smaller toes push off.

None of these pronation types is better than the other. Problems occur when your foot turns more than your body can adapt.

How to check your pronation

One way to check your foot type is the wet foot test. Place a paper grocery bag or a piece of cardboard on your bathroom floor a couple of feet away from the shower. After showering, step on and off the paper with one foot. Then check out your wet footprint:

  • Half-filled sole — You have a normal arch and may pronate normally.
  • Complete foot — You have a flat arch and may overpronate.
  • Almost empty in the middle — You have a high arch and may supinate.

You can also have your gait checked at a specialty shoe store. Or look at the tread on a pair of flat, broken-in shoes. Wear on the inside of the forefoot is a sign that you overpronate and may have flat feet. Wear on the outside edge may mean you supinate or have a high arch.

How should I treat my foot type?

You don’t need to address overpronation or supination if you’re not in pain. People used to think that overpronation and flat feet always needed to be corrected, but this isn’t true, Dr. Patel says.2

If you have pain in your heel, arch, or Achilles tendon, there are things you can do.

Stretch or exercise

No stretch or exercise will change your arch or pronation type, Dr. Patel says. But some may help relieve pain, like:

Change your shoes or insoles

Shoes or insoles (shoe inserts) designed for your pronation or arch type should help relieve arch fatigue or foot pain, Dr. Patel says. Wearing supportive shoes or slippers around your home can also help.

People who are at higher risk for injury may feel safer in specialty footwear, Dr. Patel says. That includes people who:

  • Have very flat feet or high arches
  • Stand or walk on hard surfaces for several hours a day
  • Are overweight or have a high body mass index (your weight in relation to your height)
  • Are older adults

Tips for buying shoes and insoles

Your shoes should be comfortable and supportive, Dr. Patel says. This is true whether you’re buying fashionable everyday shoes or sneakers.

If you overpronate, try shoes with a thick sole, rigid heel, and a good supportive arch, Dr. Patel says. There isn’t one perfect shoe for any pronation type, so try on several pairs to see what feels best for you.

What’s most important is your shoes be right for your activity, Dr. Patel says. You wouldn’t wear flip-flops to run a marathon. When you play a sport, run, walk, or stand all day, wear shoes designed for that activity.

Running shoes for overpronation are called stability or motion-control shoes. They’ll balance your foot’s natural rolling motion with added support, shock absorption, and cushion. People with normal pronation and those who supinate should look for neutral running shoes.

You can also add a supportive insole to most footwear. This can be especially helpful when you can’t choose comfortable shoes — for example, if you wear dress shoes to work — or will be standing for long periods of time. Like with shoes, there are many insole options. You’ll want to look for one that has a rigid shell that keeps the insole from losing its shape, such as Superfeet or Spenco.3 Over-the-counter insoles work well for most people, Dr. Patel says. Custom insoles are rarely needed.

If wearing comfortable shoes or insoles doesn’t relieve pain in your arch, heel, or Achilles tendon, talk to your doctor. They can refer you to a physical therapist or podiatrist.

1 "Benefits of Physical Activity,", accessed October 4, 2023.

2 BM Nigg et al., "Running Shoes and Running Injuries: Mythbusting and a Proposal for Two New Paradigms: 'Preferred Movement Path' and 'Comfort Filter'," British Journal of Sports Medicine, July 18, 2015.

3 Kaiser Permanente doesn’t endorse the medications or products mentioned. Any trade names listed are for easy identification only.