Do Shoes Truly Make a Difference to Pronation?

Do Shoes Truly Make a Difference to  Pronation? Blog  Gait Disorder

When the topic of pronation comes up, it seems that everyone is interested in what shoes they can buy. Perhaps they start with a discussion of running techniques and foot placement strategies, but soon they’re analyzing the wear of their shoe treads, they’re wondering which shoe will increase or decrease their pronation, and they’re entertaining the idea of minimalist shoes or even barefoot running.

The belief that pronation is determined entirely by one’s choice of shoe is a mistaken one. In fact, there’s a lot more to your feet than the shoes you wear; the mechanics of the foot are intimately affected by the entire body attached to it. I’d like to take the time to go over how your foot relates to your body as a whole, and just where footwear comes into the picture.

Before I begin, I’ll let you know in advance that I will not be recommending any brands. This post’s purpose is to give you an outline for how to think about footwear and pronation in general. The whole point is that it’s about more than the shoe.

Your Shoe as an External Environment

To start with, I’ll describe how I think about the relationship between the foot and the shoe. A shoe is what I call an external environment. It follows that the foot can be called an internal environment.

Problems of the foot arise when these two environments are out of sync with one another. As you walk, the internal and external environments of your feet and shoes work in concert to move you along. If they are well matched, they work in harmony. They can also work counter to each other, creating an unpleasant movement experience and increasing the chances of injury.

Now, since the shoe is the medium through which the foot interacts with the world, it can control the foot’s movement to some degree. This is actually not desirable! Ideally, your foot will be the one controlling the shoe, rather than the other way around. That’s right, I’m saying that choosing a shoe to make your foot behave is the wrong approach.

As it is the primary instigator of motion, the responsibility for proper foot posture and movement begins with your foot itself, and not with the shoe you wear.

The Intricate Anatomy of the Foot

People are quite interested in what shoes do for pronation, but rarely delve into how it relates to your foot itself and what its purpose is.

The fact of the matter is that pronation is created and controlled by your feet. No shoe in the world is going to fix poor pronation. I personally have never witnessed a shoe that improved the wearer’s feet permanently. It’s even the case that a shoe can worsen an already undesirable gait, especially if nothing is done to address the fundamental issue of posture. When someone claims that wearing a barefoot shoe has fixed their pronation, it’s almost certainly because their posture as a whole changed, and not because of the shoe itself.

In order to understand the mechanics of pronation, let’s take a closer look at your foot’s anatomy. You may be surprised to find out that the human foot is composed of a whopping 26 bones, connected with 33 moving joints. Each of these can move along three planes of motion in two directions each. (In case you’re curious, these are called eversion and inversion, dorsiflexion and plantarflexion, and adduction and abduction.) There is also a neutral state, in which the bone or joint rests in the center of these planes.

When your foot steps down and pronates, it stretches and lengthens against the ground. The joints and bones inside all move outwards in one extreme motion along each of the planes of motion. As the foot comes up, everything then moves inwards, which is called supination.

When pronating, your foot is acting as a mobile adaptor. It reacts to the external world, absorbing shock and positioning your body for the next movement. Then when supinating, your foot becomes a rigid lever. It provides the force necessary to move forward. Your feet constantly cycle between these two states while walking.

You want your foot to pronate and supinate equally well, with all the bones and joints moving readily along each available plane of motion in an organized fashion. This will give your foot the strength and ability to dominate your shoe, rather than the other way around.

How Shoes Affect Pronation

Your foot’s ability to pronate and supinate is not something that your shoe can truly improve, although it can certainly hinder the process. The reason for this is because the way that you walk is much more powerful than anything you put on your foot. It affects your entire body as well.

Take a moment to think about the relationship of your foot with your shoe. What happens when you put on a shoe, how does your foot posture change? Does your foot pronate when you’re standing still, and does your shoe change this in any way? This is not something most people typically think about.

Every time you take a step, the pattern of your gait is neurally reinforced. Your steps naturally become consistent and predictable, and then amazingly enough your entire body mirrors this pattern as well, your shoulders and core moving just as predictably and reliably.

Walking is a repetitive motion, and the thing about repetitive motions is that they are very hard to change. This is especially true given the flat nature of the modern pedestrian environment. When your foot is rarely challenged by variable terrain, then your gait more and more consistent over time. Conversely, that also makes your gait less flexible and more difficult to alter. It takes quite a lot of presence of awareness to get your feet out of their comfort zone.

A mere shoe can do nothing against this incredible power of habit. This is because they are simply fabric covering a shaped sole made out of foam or rubber, versus muscle and bone that drive movement. This sole is actually similar in shape to feet that over-pronate, and so it generally encourages pronation. It follows that if you are unlucky enough to over-pronate, most shoes will happily make the problem worse.

Even an anti-pronation shoe won’t help. The external environment of the shoe is going along with the motion of the internal environment, so a shoe with an arch will do nothing to prevent the inward roll of the foot. At best, they may minimize it somewhat, but once the shoe comes off your feet will go right back to the old, bad habits.

And how do barefoot shoes fare when it comes to your foot and pronation? Not as well as you’d think. Interestingly enough, I’ve seen many feet that appear to match in shape the barefoot shoe that they typically wear. My theory is that it’s not because wearers are choosing shoes with the same shape as their feet, but rather, the feet are conforming to these shoes over time. This signifies a weak foot that is unable to master its shoe.

Additionally, I’ve run across plenty of barefoot shoes that have the center of mass in the wrong place. When the center of mass of the foot and the center of mass of the shoe don’t line up, then the more mobile one, usually the foot’s, will move towards the other, in this case the shoe’s. Yes, this means that the barefoot shoe itself might exacerbate pronation, or even cause worse problems if the mismatch is particularly egregious.

Mobility is Key

The takeaway from all this is that, when buying shoes, we don’t really think about these factors. Instead, we think about the shoe’s appearance, how much support it has, and whether we’re wearing the recommended type of shoe for our exercise. We’re thinking of our yoga routine, the marathon we’re training for, how much muscle we’re going to build and fat we’re going to lose.

The last thing on our minds is the mobility of our foot and how the shoe will affect that. However, it’s an important part of the entire exercise experience. It’s not as simple as choosing an anti- or pro-pronation shoe. You won’t find a shoe anywhere that teaches your foot to pronate properly.

The only way to do this is for you to personally address your general foot posture. Think about your whole body and how it affects the movement of your feet. Think about the bones and joints down there, and how they move when you pronate and supinate. Research how you can attain maximum mobility for your foot, and work on developing the habit of a solid, healthy gait.

If you can strengthen the internal environment of your foot such that it is equally facile at pronation and supination, then no shoe will be a match for it. You’ll be able to freely choose whichever shoes you like and can prioritize comfort and color, rather than any misguided notions of how the shoe will improve your pronation.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

Buy now 3D Gait
Payment Success
iconRequest Telehealth Request in office visit Book now
You can call
or Send message