Pronation - Archive - NSI Stem Cell

7 Things To Do If You Underpronate Or Overpronate

When Feet Overpronate Or Underpronate, Lots Of Leg And Back Problems Follow

It gets a bit of a bad rap, but pronation is actually a natural element of walking. Pronation is what aids the feet’s shock absorbing qualities. So pronation, in and of itself, is not what causes foot and leg pain. But when we overpronate or underpronate…well, that’s another matter.

The technical name for under- or overpronation is supination. When the foot underpronates, the natural act of pronation is too abbreviated. When the foot has a tendency to overpronate, the natural roll inward is too much. Over- and underpronation are among the most common reasons for pain and mobility problems related to the feet and ankles. Abnormal pronation accounts for many postural problems that can lead to chronic, painful lower body conditions.

According to Becker’s Orthopedic Review, orthopedic surgeons now exceed cardiologists in annual earnings. This comes as no surprise to the National Stem Cell Institute (NSI), which reports that chronic foot, ankle, knee, and back pain are among the most common reasons patients come to them for therapy. While people are relieved to find an alternative to invasive surgery –which is usually followed by long periods of rehabilitation, they are often shocked to learn that they may have been able to nip their chronic condition in the bud by correcting their feet’s tendency to under- or overpronate.

am i overpronating

It is believed that collapsed arches affect most industrial-world adults.

To one extent or another, collapsed arches (also known as flat feet) are believed to affect the majority of adults in the industrialized world. When feet tend to overpronate, it is usually because of one or more of the following reasons:

  • Footwear doesn’t support the feet properly
  • Weak legs
  • Daily walking on a flat, hard surface

All of the above can contribute to the breakdown of the foot’s soft tissue structures. This can cause joints to become too loose which, in turn, cause the bones in feet to shift.

There is little wonder, then, that feet which under- or overpronate are a regular source of pain. But the foot pain is just part of the story. Walking and posture problems may begin there, but pain and mobility issues regularly migrate upward to affect ankles, calves, and knees. Abnormal pronation can also be the root cause of back pain. When left undiagnosed, over- or underpronation can lead people to misunderstanding the reason for their lower back pain and wondering why they can’t get consistent relief.

Feet that under- or overpronate affect how a person stands, runs, and distributes body weight, increasing the risk of injury during activities like exercising, dancing, or even simply picking up a child or grandchild for a hug.

The Basics Behind Feet That Under- Or Overpronate

Naturally, no one has a body that is perfect in its symmetry and balance. That means that most people’s feet have a tendency to under- or overpronate. The problem occurs when the pronation is excessive to the point that it adversely affects the normal gait cycle.

So what causes the feet to have pronation abnormalities? By and large, it is generally caused by one or more of the following:

  • Muscular compensation that is the body’s response to poor posture or old injuries.
  • Poor running form (particularly common in athletics).
  • When circumstances like too little activity, limited range of motion, or age-related stiffness cause lower body to become weak.
  • Overuse, such as excessive exercise or having to stand for long durations.
  • Cartilage loss in the subtalar joint (where the foot and ankle meet)of the foot.
  • Dysfunction or injury of the tibialis posterior tendon, which attaches the calf muscle to the bones on the inside of the foot.

Typical Symptoms Of Feet That Under- Or Overpronate

Foot pain is, of course, the single most common symptom when a foot tends to under- or overpronate abnormally. Types of pain and other symptoms related to excessive pronation include:

  • Pain that moves from the foot upward. It is usually felt when the sufferer stands for extended periods, walks or runs. It may very well spread from the underfoot to the thighs and even the back.
  • Ankles or heels that swell.
  • Stiffness, loss of function, and a reduction in the foot or lower body’s range of motion.

This all may seem scary. But there is good news. Your feet can be “taught” to improve their function. In most cases, the tendency to under- or overpronate can be “trained” away.

Overpronating Or Underpronating. Which One Is Happening to You?


The tendency to overpronate abnormally happens when the foot rolls excessively when you walk or run. But it can also occur when you stand. Over a period of time, the arches of the feet “collapse” and roll inward, flattening too much toward the ground.

When feet overpronate, the first and second toes are forced to absorb too much shock. When walking or running, the front of the foot must depend too much on the first and second toes to push off the ground. The result of this abnormal pressure can be foot pain. A foot with a tendency to overpronate is more susceptible to injuries such as runner’s knee, stress fractures, plantar fasciitis, and Achilles tendinitis.


With underpronation, the foot insufficiently rolls when it lands while walking, running, or other foot placement activities. Not enough of the outer foot absorbs the shock.

In the case of underpronation it is the outer toes of the foot that must bear the better part of the weight as the foot pushes away from the ground. Again, foot pain can result. Common injuries include iliotibial band syndrome of the knees, Achilles tendinitis and plantar fasciitis. It can also be the underlying reason for general instability and stiffness.

Knowing When You Have A Tendency To Under- Or Overpronate

Make no mistake. The tendency to under- or overpronate abnormally may not be immediately obvious to the untrained eye. The problem can often be caused by very minute changes in ankle, knee, or hip alignment. You may not become aware of abnormal pronation until you notice visible changes in your posture or suffer joint strain.

So, how can the average person be more aware of a tendency to under- or overpronate? One of the best ways is to understand what a healthy posture should look and feel like.

Check yourself before you wreck yourself!

To check for any tendencies to under- or overpronate, begin at the toes:

  1. Stand with your shoes and socks off. Face straight ahead. With hands resting on thighs, straighten the back upright.
  2. Now look down, checking the stance of legs, ankles, and toes.
  3. The feet and knees should be facing forward or with only a minor external rotation of the toes outward.
  4. The toes should be pointing in the same forward direction as the feet and ankles. There should be no rolling inward or outward of either ankles or knees, other than very slightly.
  5. Do the knees seem to roll inward while the toes point outward? This is an indication of overpronation.
  6. Or do the knees face outward? This is an indication of underpronation.

Another way to check for any tendencies to under- or overpronate is to physically draw a line on the front of your legs (remember! Don’t use permanent marker!). The line should run from the thighs, over the knees, and to the ankles.

Does the line curve at any particular area? If it seems to curve inward, that indicates overpronation. If it seems to curve outward, that indicates underpronation.

How Abnormal Pronation Is Diagnosed

A physical examination of the hips, legs, and feet by a trained professional is the first step. Besides looking for signs of excessive pronation and imbalances, special attention is paid to any loss of function. You’ll be examined for any possible nerve damage as well as other problems with functionality and pain.

Whether you show a tendency to under- or overpronate, a common recommendation is to begin with orthotic shoe inserts. By correcting alignment, these are often effective in the relief of foot pain by resolving abnormal pronation or supporting flat feet.

In severe cases, physical therapy, medication, or regenerative therapy may come into play.

When the feet under- or overpronate to the point where severe problems arise, physical therapy (PT) may be in order. The patient will be trained in custom stretches and exercises designed to retrain the hips, legs, knees, ankles, and feet to balance weight properly.

Feet that under- or overpronate abnormally can, in some cases, contribute to tissue and joint inflammation that can be acute or even chronic. When this happens, anti-inflammatory medication might be prescribed. If pain ever becomes very bad, some doctors might also prescribe anti-inflammatory medication to decrease swelling and tissue/joint inflammation.

Today, regenerative medicine methods like stem cell and/or platelet rich plasma therapies are used regularly when abnormal pronation has caused damage to the joints of the hips and/or knees and ankles. It is quite rare today for patients who suffer from acute or chronic joint or foot pain to have to resort to surgery. But, even in cases where this must be done, regenerative therapies are often used as an auxiliary treatment to speed healing and reduce time spent in rehabilitation.

overpronation causes

5 Ways To Resolve Overpronation Naturally

  1. Make Improvements to Posture and Walking/Running Form

Poor posture and form play a large underlying role in leg, heel, and foot pain. Injury and the tendency of the feet to overpronate can arise repeatedly when posture and/or form issues aren’t corrected.

Among the signs to look for that warn you’re not using correct form in walking or running include:

  • The arches don’t roll upward when your feet strike the ground.
  • The heel strikes the ground too hard and abruptly without rolling evenly forward.
  • The toes don’t lift properly as your foot goes into its forward roll to complete the step.

To help correct any tendencies to overpronate, work on the following:

  • Focus on having the outer side of the foot/heel make first contact with the ground.
  • If you’re a runner, consider landing closer to mid-foot, especially if you’re a heavy heel striker. Work on making a softer landing. When you don’t lead with the heel, landing more lightly becomes natural.
  • Increase your number of steps slightly. A small increase per minute can help keep you find a more naturally healthy foot placement.
  • Avoid making your toes do the bulk of the push at the lift-off point.

Keep in mind that you’ll be teaching your mind and body a new habit in form. If you have a tendency to overpronate, you may have using poor form for years. So be patient with yourself as you develop the new form. Eventually your body will get on board with the better gait and it will feel natural and come more easily to you.

YouTube has many good videos demonstrating good walking form.

  1. Give Your Legs Better and More Frequent Stretches

When you overpronate excessively, the muscles of the legs and lower back experience increased stress. They can feel sore and stiff, which can worsen matters. Ensuring that the legs received proper stretching before and after working out helps increase flexibility, motion range, and circulation.

A good stretch session for your calves and hamstrings can include:

Using a foam roller on your calves just before stretching (assuming your doctor gives you the okay to use one). Foam rollers help loosen knots and micro-tensions. When you find tender spots, focus the roll on each one for about thirty seconds. Remember not to roll back and forth too quickly.

Simple and effective calf raises can be done by sitting on the edge of a couch or chair with your feet flat on the floor. Using one leg at a time, keep the heel of the foot on the floor while you lift and point your toes toward the ceiling. You should feel the stretch in your calf. Maintain the stretch for about thirty seconds, so that you feel a stretch in your calf muscle. Hold for 30 seconds, then do the same with the other leg, three times per leg.

Do some old-fashioned toe touches. In a standing position, make sure your legs are straight. Bend from the waist and stretch as far toward the floor as you safely can. Hold the stretch for about thirty seconds. Toe touches can be done with legs together or stretched wide. You can do the stretch against the wall for a little balance support if needed. Repeat a few times.

Ankle rolls can be done lying on your back. Lift your legs in the air and rotate your ankles gently. Do several rolls clockwise, then counter clockwise. You can do both ankles at once, or lift each leg separately. A few sets per ankle will do nicely.

Consider learning yoga. Yoga’s benefits are many, and two of the prime ones is effective stretching that relieves tight legs and improves overall flexibility.


  1. Find a Physical Therapist that Specializes in Soft Tissue Massage

A professional soft tissue massage loosens and activates muscles. When used on the lower back, hips, and legs, it aids in the restoration of proper alignment and breaks up tissue adhesions/scar tissue. When applied to the feet, soft tissue massage can help in the alleviation of arch conditions.

If you presently overpronate to excess, don’t be discouraged. Neither over- nor underpronation has to be a permanent condition. Muscles and joints can be trained to distribute body weight in a healthy manner. Professional assistance can make the “re-set” go more easily.

Professional soft tissue massage/functional rehabilitation is especially beneficial for those who must stand for long periods of time daily, those who are professional or serious amateur athletes, or those who are highly active day in and day out.

  1. Make Sure You Wear Quality Support Shoes

Have you looked at the wear pattern on the heels and outsoles of your shoes? When you overpronate, you’ll see more wear on the inward part than the outward. You may even feel the shoes’ tendency to roll inward, especially if they are very worn down. Choosing the right shoes and sneakers can go a long way in helping you avoid lower back, leg, and foot pain.

Below are tips to help you choose the best footwear for those who overpronate:

  • Select thicker, firmer shoes to help with motion stability. Shoes that are flimsy and too flexible offer poor arch support. If you have fallen arches, this can increase your risk of injury.
  • Look for shoes with multi-density midsoles. These are shoes that have more than two layers of density at the center of the shoe’s outsole. The multi-density can help prevent the foot’s tendency to overpronate.
  • Adding quality arch supports to the inner sole your shoes can help relieve foot pain and pressure. These can be custom-made, but well-constructed arch supports that are mass produced are also available.
  1. Properly Treat Calluses & Bunions

When you overpronate, bunions and calluses can form. This can begin an unhealthy cycle, in that bunions and calluses can rub against the shoe, causing you discomfort which –in turn- can promote even more abnormal pronation. Choose wider footwear and properly padding bunions and calluses to help put a stop to the cycle.

If foot pain from bunions and calluses becomes worse, try applying ice several times daily for twenty minutes at a time. Elevating the sore foot helps to reduce swelling. So does a self-applied foot massage using essential oils that are anti-inflammatory, such as peppermint, eucalyptus, and lavender.

Underpronation The Problem? Try These Natural Treatments

  1. Loosening Muscles that are Susceptible to Injuries Due to Underponation

The stretching exercises outlined above for those who overpronate are also great for people who underpronate. For those with sufficient overall body strength and flexibility, adding a stretch known as the “crab crawl” or “crab walk” to those above can be a real help.

Try, also, rolling a tennis ball across the length of the bottom of each foot to massage the fascia muscles. If you prefer, massaging the fascia with your hands works well, too.

  1. Strengthening Your Legs

To strengthen weak leg muscles, try the exercises below:

  • Squats
  • Lunges (not just the forward kind, but side lunges, too)
  • Calf Raises
  • Uphill Walking
  • Sprinting
  1. Get Rid of Over-Worn Footwear!

Whether you under- or overpronate, footwear that is too worn should be replaced. This is especially important for people who must stand for long periods or who exercise regularly.

A good way to know if your shoes need to be replaced is to set them on a flat surface. Look at the outer edges. If they tilt outward, you underpronate. If they tilt inward, you overpronate. Those who underpronate will likely have better relief from hip, leg, and foot pain by wearing more flexible, lightweight footwear. Lighter weight shoes tend to hold up better with foot motion for those who underpronate, as opposed to overpronate.

What To Do If Pronation Causes Chronic Pain

In most cases, tendencies to under- or overpronate can be overcome by learning better movement form and correcting poor posture. And the importance of quality, properly fitting shoes that fit every level of activity cannot be stressed enough.

But when pain becomes chronic, it can be due to damage that must be addressed in addition to the above solutions. Today, the therapeutic methods of regenerative medicine has greatly reduced the dependency on surgery for chronic joint, muscle, and tendon injuries that can result from years of abnormal pronation.

As with any medical procedure or physical therapy practice, it is essential that your selected regenerative medicine facility (commonly referred to as a stem cell clinic) be fully licensed and employ trained physicians, therapists, and staff. With that in mind, the National Stem Cell Institute (NSI) offers the tips below to help you with your research.

What to Look for in a Stem Cell Medical Clinic

When searching for a qualified stem cell therapy center it’s important to remember that not all of them are created equal. Stem cells, when used properly, are your body’s most powerful means for healing that can repair everything from ligaments, tendons, and cartilage to organs including your liver, pancreas and lungs and even neurological tissue like your brain, nerves and spinal cord.

Unfortunately, the majority of so-called “regenerative medicine clinics” in the world aren’t trained in the latest, most technologically advanced procedures and will, therefore, provide poor results if any.

The good news is the National Stem Cell Institute (NSI) has established the most advanced stem cell and platelet rich plasma procedures on the planet which has drawn patients from all over the world as well as professional athletes and celebrities because they are recognized as the best in the world at stem cell therapy.


What makes NSI Stem Cell the top stem cell clinic in the world is demonstrated in 5 key areas:

1. Highly trained and experienced, board-certified doctors and team members who have performed stem cell procedures on thousands of patients with incredible results.

2. Cutting edge procedures utilizing all that regenerative medicine has to offer for many chronic degenerative conditions.

3. Leading scientific researchers who follow the advanced guidelines to maximize the healing potential of your stem cells and to maintain compliance and ethics

4. Use of only the most potent and viable resource of living, viable stem cells and harvested on the same day. No vial that you can purchase will contain living stem cells. If there is no harvest then there are no stem cells.

5. Post-operative guidance for supporting stem-cell growth including rehabilitation, diet and supplement protocols. NSI is a full-service healthcare center focused on patient outcomes. Stem cell therapy is only one tool used to help improve patients’ lives.

Patients have raved about their experience at NSI Stem Cell Clinics testifying that it was their unique cutting-edge procedures that helped them experience a breakthrough when nothing else worked.

If you want to learn more about NSI Stem Cell Clinics, you can set up a complimentary consultation today to see if you are a candidate. You can contact the National Stem Cell Institute at (877) 278-3623.