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Question: Why do you wear pronation control shoes?

Answer: Because someone at a shoe store told you that you need them, and they were told that you need them by a shoe company rep.

The above Q&A basically describes my feelings on the topic of overpronation. You might think that you wear such shoes because you need support for your “excessive” foot movement to prevent injury, but the reality is there is scant evidence at best that these shoes accomplish this goal, or that excessive pronation is even strongly linked to increased injury risk.

Unfortunately, the pronation control paradigm has come to dominate the world of shoe fitting, and judging by the number of people asking for shoe advice on online forums who start by claiming they are an “overpronator,” it’s not a topic that seems to be dying off as rapidly as it should.

The reality is that pronation is completely normal. If you walk in a shoe store and their sole basis for choosing a shoe for you is how much your pronate and what your arch looks like, turn around and walk out the door. You’re probably just as well-off choosing a shoe at random from an on-line store. The science simply does not support this protocol (I wrote an entire chapter in my book explaining why), and in fact may contraindicate this practice. Given this, I was pleased to see a post come across my blogroll by sports podiatrist Ian Griffiths.

The post, published on the Kinetic Revolution website, describes why Griffiths thinks that “the term “overpronation” is neither accurate, descriptive nor meaningful, and should therefore be erased from modern day usage in both the lay and the medical communities.” Griffiths covers a lot of ground in his article, pointing out such interesting tidbits as the fact that with regard to pronation:

Across many studies, all of the data collected from pain free and injury free subjects and athletes shows that very few individuals actually meet the historical definition of ‘normal’. One study examined 120 healthy individuals both non weight bearing and weight bearing. Not one subject conformed to the historical criteria of a ‘normal’ foot. Further searching through the literature shows that the majority of data collected from sampled populations suggests that the normal (average) foot position at rest is actually mildly to moderately pronated, as opposed to ‘neutral’.

Regarding injury risk due to “overpronation,” Griffiths has this to say:

It is a commonly held belief that pronation will increase the risk of lower extremity injury. However (perhaps surprisingly) this is not particularly well supported by the literature, with very few studies which actually show pronation increases injury risk. Instead, there are numerous pieces of work which have shown there is no association with foot type and injury and some research exists which even suggests that a pronated foot type is actually protective against injury.

And I love and fully agree with the conclusion regarding what to do with the term “overpronation”:

Hopefully it is now clear that this is a term which contributes nothing to our understanding – it is not definable, not reliable or valid, not diagnostic, its relationship to injury is not fully understood, and it does not dictate what the most appropriate management plan may be. It should not be replaced, it should be removed.

Griffiths feels that pronation is simply one factor to consider when dealing with an injured patient, and this is in line with my view as well. It’s one factor among many that could contribute to any given injury, and it has been given a primacy in the footwear world that it does not deserve. It would be like deciding all of a sudden that we should assign shoes to runners based on their amount of hip adduction and internal rotation because excessive amounts have been linked to increased patellofemoral pain syndrome risk – at least in this case there would be some science supporting the practice.

Anyway, I highly recommend heading over to read Griffiths full post at the Kinetic Revolution website. Hopefully the article will help to free you or your running friends and loved ones from the shackles of the pronation-control paradigm!