Foot pain? Start with how you walk.
If your feet, knees, or hips are feeling sore — and no shoes seem to help — the problem may be how your foot moves through its stride. Your pronation. Some people’s feet tend to roll outward (called underpronation or supination), others roll inward (overpronation), and some are more neutral.
In this section:
A simple self-assessment to learn more about your stride — a step to finding the best shoes for you.
Getting to a formal diagnosis of your pronation type and any issues.
Related resources: Pronation and diagnosis
What is pronation
Pronation is the natural rolling motion of your foot as it lands and pushes off with each step. It’s how your body absorbs impact and distributes weight. A balanced, healthy stride helps protect your joints, improves movement, and reduces the risk of injury.
Watch: Walking and Pronation (OrthoInfo, American Academy of Orthopaedic Surgeons). This short video offers a simple, visual explanation of how pronation works — and why it matters.
Three main pronation types
Neutral pronation - The foot rolls inward slightly to absorb shock, with weight distributed evenly. This is considered the most efficient gait pattern.
Underpronation (also called supination) - The foot rolls outward too much. This reduces shock absorption, and pressure carried along the outer edge of the foot can increase risk of strain or injury, especially to the ankles and legs.
Overpronation - The foot rolls too far inward. This places stress on the inner foot and can lead to alignment issues, joint fatigue, and discomfort up through the knees and hips.
Self-assessment: Are you mostly an underpronator, a neutral pronator or an overpronator?
Knowing your pronation type will highlight if you have any issues to deal with.
The table below highlights 8 factors that may contribute to a person’s stride and pronation type.
Read the factors listed on the left-hand column.
For each factor, select the descriptor on its right which best describes you.
| Factors to consider | Underpronation | Neutral | Overpronation |
|---|---|---|---|
| 1. Shoe Wear Pattern | Outer edges worn | Evenly worn | Inner edges worn |
| 2. Walking Barefoot | Ankles roll outward | Ankles stay straight | Ankles roll inward |
| 3. Arch Shape | High arches | Normal arches | Flat or low arches |
| 4. Wet Footprint | Thin footprint | Moderate curve | Full, flat footprint |
| 5. Family History | High arches, hip/knee issues | None or unsure | Flat feet, knee/hip issues |
| 6. Leg Shape | Bow legs (knees outward) | Straight alignment | Knock knees (knees inward) |
| 7. Discomfort Areas | Outer foot/ankle/shin | None | Inner arch, knee, hip pain |
| 8. Long Walks or Runs | Feel unstable outward | Feel balanced | Ankles collapse inward, feet tire easily |
Self-assessment results - any trends?
If your answers were mostly in…
The underpronation column - it means that your stride may tend to roll outward. It may be worth getting some expert advice on what’s happening with your stride and start making some changes to improve your stride and reduce stress on your feet and joints.
The neutral pronation column - it means that your stride stays naturally aligned. While not perfect, your stride is likely to be balanced.
The overpronation column - it means that your stride may tend to roll inward. It may be worth getting some expert guidance to identify any issues you may be dealing with, and what changes and improvements to focus on to reduce stress on your feet and joints.
Getting to a formal diagnosis
Getting a formal diagnosis is important for tailored treatment - from rehab exercises and orthotics to selecting the best shoes.
But it can take some time and perseverance and require a multi-professional approach. Different professionals bring different knowledge and skills, and it is often only by combining these, that you get a full picture of what is happening to your stride.
Multiple experts who help include: GPs, physical therapists, podiatrists, and sports doctors, sports shops each bring a unique perspective and set of tools such as:
Gait analysis
Scans,
X-rays
By combining expert insight, biomechanical analysis, and practical support, you can get a strong baseline for making changes and improvements to any issues, based on a full picture of:
Your pronation type (underpronation, neutral, overpronation)
Why it’s happening (e.g. foot shape, muscle weakness, skeletal alignment)
What to do next (shoes, orthotics, strength training, or medical care)
Some of the experts involved in the diagnosis process
Below are some of the professionals you may seek advice from, and how they may contribute to your diagnosis. Your entry point is often determined by your symptoms. For example, with injuries or chronic pain the GP or a Physical therapist is often contacted in teh first instance.
General practitioner (GP)
Often act as a first point of contact and assess your symptoms.
Refer you to the relevant specialists such as a physiotherapist or sports medicine doctor.
Physical therapist (physiotherapist)
Assess your mobility, joint function, muscle strength, and pain triggers.
Identify mechanical imbalances through observation and hands-on testing.
May recommend temporary supports, for example a moon boot to promote rest of a joint, and prescribe exercises.
May refer you for medical imaging or a specialist review if structural issues are suspected.
Sports medicine doctor
Provide a medical diagnosis supported by imaging, for example x-rays and MRIs.
Identify underlying skeletal contributors such as bow legs or joint misalignment.
Often lead an overall treatment plan and works closely with physical therapists and podiatrists to implement it.
Podiatrist
Specializes in foot and lower limb biomechanics.
Performs gait analysis (often using treadmill video capture or pressure mapping).
Can use 3D foot scanning to evaluate arch type, foot pressure zones, and structure.
Prescribes custom orthotics tailored to the individual’s pronation pattern.
Advises on footwear features for your pronation type.
Specialist footwear fitter (such as a sports shoe retailer)
Often have analysis tools to evaluate the stride and pronation type and match this with appropriate footwear.
Helps translate clinical recommendations into practical shoe choices.
Ensures shoes fit both foot shape and orthotics properly.
Offers brand and model options that support alignment goals (for example you may need cushioning or motion control features).
Related resources
Explore these resources to build understanding of pronation
‘Walking and Pronation’ (OrthoInfo - American Academy of Orthopaedic Surgeons) - This short video explains how pronation works and the different pronation types.
Two helpful articles from MedicalNewsToday explore pronation issues:
What to know about supination of the foot - explains causes, symptoms, and treatments for underpronation (supination).
Your guide to understanding overpronation - outlines the effects of excessive inward rolling of the foot and how to manage it.
Pronation Guide: What is Pronation and Why Does it Matter? (ASICS) A clear explanation of pronation types, with guidance on selecting ASICS footwear that suits your stride.
Our related blogs about the diagnosis journey:
A case study following an individual’s path from early symptoms to diagnosis. It highlights how long the process can take, the value of different professionals, and how understanding develops over time.
A process to identify your pronation type (underpronate, overpronate, or neutral gait) describes a process starting with simple self-checks and progresses to expert evaluations, showing how diagnosis often involves a multi-disciplinary team.
Why the big toe is a game-changer for underpronators and overpronators reinforces the importance of the big toe engaging to support your stride and tips for helping it working well.