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Underpronation, Supinated and High Arched Foot


Supination, also known as underpronation, is when the foot doesn't pronate much. It is often refers as the outward roll of the foot as part of the normal gait motion during push-off phase to propel the body forward.


When your feet roll out excessively, the feet will appear with an extreme high arch contour. Supination is considered natural for some people, but in cases when the feet are over supinated, it can place extra stress on the foot and leg and can cause issue such as ankles instability and problems elsewhere. (Picture ref. https://www.spinalandsportscare.com.au)


This is so due to the decrease in shock absorbency - the ground reaction force from the the heel strike is not been properly absorbed and the outside of our foot will need to bear the full force of the step’s impact. It is interesting to note though that, excessive supination is less common than excessive pronation. How do I know if I have high arched feet or underpronation? Most people with excessive supination have structural issues in their feet and tight calf muscles. An abnormally high arch foot is also commonly described as having a cavus foot.


Some common signs you have got an oversupination / underpronation problem include:

  • Frequently rolling or spraining ankles

  • Developing lesser toes deformities, such as hammertoes

  • Achilles tendinopathy

  • Experiencing heel pain, forefoot pain, ankle pain, shin splints

  • Calluses formation in the heel, ball or side of the foot

  • Outer edges of your shoes wear out faster

Why do I get cavus foot or underpronation? There are many causes of underpronation, these include:

  • family history or genetic factors - the mechanics, shape of the foot arch or abnormality in the foot structure.

  • neurological disorders or medical conditions such as cerebral palsy, muscular dystrophy, stroke, spina bifida, polio and Charcot Marie Tooth disease.

  • incorrect footwear - wrong type of shoes such as rigid or tight shoes can lead to supination and other foot problems. Wearing shoes that are worn out or have no arch support can also cause supination.

  • tight calf musculature.

  • past trauma or injuries.

What sorts of treatments are available for high-arched feet? Common conservative treatment for cavus foot includes Good footwear / shoes modifications - for people who supinate, a flexible, straight last, cushioning and lightweight shoes is recommended. Also to replace shoes every 12 months, or more frequently if they show signs of wear and tear on the soles. Custom orthotics devices - to support the arch and heel and to control the motion of the foot. Exercises - to improve strength and flexibility of associated lower limb muscles.

In the event that conservative treatments fail to relieve pain or improve stability, surgical treatment may be considered to reduce pain and enhance the foot’s weakness. Book an appointment with us today for proper diagnose and treatment.


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