Foot types can be classified into one of three structural categories by determining arch height. A foot that appears to have an excessively high arch is classified as a Pes Cavus foot, while a flattened arch is classified as Pes Planus, more commonly referred to as a flatfoot. The third category is a "Neutral" foot which describe a foot that maintains an arch and absorbs impact while walking or running.
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Pronation
Pronation is a natural motion of your foot during walking and running. Your gait can show a pattern of neutral or normal pronation, overpronation, or supination (underpronation). The stresses of overpronating or supinating have been linked to a greater risk of injuries.
Normal or Neutral Pronation
Pronation refers to the natural side-to-side movement of the foot as you walk or run. During the swing phase, normal contraction of the lower leg muscles pulls the foot up and inward in order to clear the ground. This allows the heel to strike the ground on the outside (lateral) aspect of the heel (calcaneus). From the time the heel strikes the ground, the arch begins to flatten to cushion the ground impact. Weight then shifts from the outside of the foot at heel strike then moves down and inward to allow the big toe to hit the ground on midstance. If you have a neutral gait your foot should begin to roll outward with the toe-off.
The arch rises and stiffens to provide stability as the foot rolls upward and outward.
All of the toes aid in push-off in normal pronation, but the big toe and second toe do more of the work while the others stabilize.
During push-off, the sole of the foot is facing the rear of your body in neutral pronation and is not tilted so the sole is facing either inward or outward.
Overpronation
In overpronation, the ankle rolls too far downward and inward with each step. It continues to roll when the toes should be starting to push off. As a result, the big toe and second toe do all of the push off and the foot twists more with each step. Overpronation is seen more often in people with flat feet.
Overpronation leads to strain on the big toe and second toe causing instability in the foot. Excessive rotation of the foot leads to more rotation of the tibia in the lower leg, with the result being a greater incidence of shin splints (also called medial tibial stress syndrome) and knee pain. An increased risk of injury and heel pain (plantar fasciitis) may also be the result of the stress on the ligaments and tendons of the foot due to overpronation. Motion control shoes and orthotics are designed to correct your foot motion in overpronation.
Supination (Underpronation)
Supination is a rolling motion to the outside edge of the foot during a step. The foot naturally supinates during the toe-off stage of your stride as the heel first lifts off the ground, providing leverage to help roll off the toes. However, if supination continues through the toe-off, the weight isn't transferred to the big toe. This results in all of the work being done by the outer edge of the foot and smaller toes, placing extra stress of the foot. Supination is seen more often in people with high, rigid arches that don't flatten enough during midstance and terminal stance/toe off.
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