Supination, also known as Underpronation, is a condition where the foot is unable to move toward the midline of the body as the foot progresses from heel strike toward toe off and stays more to the outer edge of the foot. The foot strikes the ground in a supinated position and goes back to a supinated position at toe off but should pronate in between. This foot typically has a high arch which can be rigid and also has less contact with the ground reducing the surface area available to absorb pressure on the foot. Two of the conditions which can lead to a high arch foot are Charcot-Marie-Tooth disease, and a Stroke leading to muscle imbalances. A rigid plantar flexed first toe can also contribute to this condition by not allowing the forefoot to pronate or come to the ground completely.



People with a high arch foot may experience pain on the bottom of the foot due to reduced ability to distribute pressure. There may be excess pressure on the 5th toe causing calluses or corns on the toe or under the metatarsal head. Those with a supinated foot may have trouble adjusting to uneven ground and may be more likely to roll over the ankle. As the arch is unable to absorb pressure to the foot the pressure will be moved to other places on the foot such as the Metatarsal heads.


Pedorthic Management

  • Proper Footwear with a strong heel counter and lateral support to control excessive motion
  • Severe cases may require a lateral sole flare to restrict motion
  • Custom orthotics to provide lateral support and a cutout for an excessively dropped or plantar flexed first toe
  • Added cushioning under high pressure areas such as metatarsal heads