Insoles for Underpronation

Underpronation and foot pain: what’s going on?

Pain in the feet, shins, knees, hips or lower back that keeps coming back can wear you down, especially when there is no clear reason for it. For many people, the way the foot moves when it hits the ground is a major part of what is going on. Underpronation is one of the patterns that can contribute to these aches and sharper pains.

With underpronation, the foot tends to roll outwards. Instead of the foot and arch helping to soften each step, more of the impact travels straight up through the legs and spine. Over time, that extra strain can show up as discomfort in several parts of the body.

What underpronation is and how it changes your gait

Underpronation (also called supination) describes the way the foot moves when you walk or run, where it rolls outwards more than is ideal.

In a more typical walking pattern:

• the heel touches the ground first,
• the foot then rolls inwards a little, and the arch lowers slightly,
• weight moves forward through the middle of the foot,
• and you push off through the ball of the foot and toes.

That small inward roll lets the arch work a bit like a spring. As the arch lowers, it spreads your body weight across more of the foot and takes some of the jolt that would otherwise go straight into the ankle, knee and hip.

With underpronation, the inward roll is reduced. Instead:

• the heel often lands more on its outer edge,
• the arch tends to stay higher and feels stiffer,
• and more weight is carried along the outer side of the foot.

Because the arch is not taking as much of the strain, smaller areas of the foot take more force. The outer corner of the heel and the outer forefoot often take the brunt of this, step after step. Less of the impact is absorbed in the foot, so more of it travels up into the ankles, shins, knees, hips and lower back.

Underpronation is more likely in people with higher arches, as these are often less flexible. Stiffness after previous ankle injuries and very rigid footwear can also make it harder for the foot to roll inwards. It can help to notice how your feet move when you walk or run.

How underpronation tends to feel day to day

Everyone’s pain pattern is slightly different, but there are some common signs that your feet may be rolling outwards more than they need to. These are not diagnoses, but they are useful to tell a clinician about.

Foot and heel patterns

• The outer side of the heel and the outer forefoot wear down more quickly on your shoes than the inside. This usually means your heel is striking on its outer corner with every step.
• There is recurring pain or aching along the outer edge of the foot, where more of your body weight is travelling.
• You get pain under the heel or in the arch, often sharp with the first few steps after getting out of bed or standing up, then turning into a deeper ache if you are on your feet for a long time. This often relates to strain on the band of tissue under the arch (the plantar fascia) and where it joins the heel bone.

Forefoot and toe patterns

• There is sharp, aching, or burning pain under the ball of the foot, just behind the toes. This is where the heads of the long bones in the forefoot take your weight as you push off.
• You notice tingling, numbness, or “electric” pain in one or more toes when walking or in certain shoes. This can happen if a nerve between the forefoot bones is pinched repeatedly.
• A bony lump develops at the base of the big toe (a bunion). The joint around it may look red, feel sore to touch and become stiff, especially in narrower shoes.

Leg, hip and back patterns

• Your shins ache during or after running or walking, often along the front or inner edge of the shinbone. The muscles and bone in this area may be taking more impact than usual.
• You notice knee pain linked with walking, standing or using stairs. This may feel like a deep ache around the front of the knee or soreness on the outside.
• Your hips or lower back feel tired and sore by the end of the day, as the muscles higher up have to work harder to keep you upright over feet that are rolling outwards. It is understandable if this sort of ongoing discomfort has started to wear you down.

Only a clinician can assess your gait and make a diagnosis, but if you recognise several of these patterns it is reasonable to suspect that foot mechanics may be part of the problem and that extra support might be helpful.

Why orthotic insoles are often used for underpronation

Underpronation does not always cause pain by itself, but it can make other problems more likely or more stubborn. Orthotic insoles are often used to ease some of the extra stress that this pattern creates on vulnerable areas.

Orthotic insoles are shaped supports that sit inside your shoes. They usually have:

• a raised, contoured area under the arch,
• a deeper, cup‑shaped section to hold the heel,
• and cushioning under key contact points, such as the heel and ball of the foot.

Together, this kind of insole aims to:

• support the arch so that more of your body weight is shared along the inner side of the foot instead of staying on the outer edge,
• hold the heel more snugly so it does not tip as far onto its outer corner when it lands,
• and spread pressure more evenly under the sole, rather than leaving it concentrated on one small patch.

In everyday life, many people describe changes such as:

• the outer heel feeling less “jabbed” with each step because the heel pad and insole cushioning are both taking some of the impact,
• less pulling or stabbing under the heel and arch because the band of tissue there is not being stretched quite as hard,
• a more balanced feel through the ball of the foot when pushing off, so one or two joints under the toes are not taking all the pressure,
• and a steadier feel through the ankle and leg, which can make knees, hips and the lower back feel less overworked.

These supports do not reshape the bones, but they can guide the foot into a better position and change where pressure goes up the leg. That is often enough to ease pain and make movement more manageable.

How underpronation can affect different parts of the body

Underpronation tends to stress certain structures again and again. Grouping problems by area can make it easier to see how they are linked and how insoles may help.

Heel and arch problems

Pain under the heel and along the arch is one of the most common issues seen with underpronation. The plantar fascia—a strong band running from the heel bone to the toes, which helps support the arch and heel—plays a key role.

When the heel keeps landing on its outer corner and the arch does not lower smoothly:

• the plantar fascia is pulled more sharply where it anchors into the heel bone,
• the outer side of the heel bone takes a harder hit,
• and the natural fat pad under the heel can be pushed out to the sides, so less of it sits directly under the bone.

Over time, this can lead to:

• plantar‑fasciitis‑type heel pain, often sharp with first steps after rest and then aching if you stay on your feet,
• bony outgrowths under the heel (often called heel spurs), which form where soft tissues have been pulling on the bone for a long time; these are not always painful themselves, but can sit in an already irritated area,
• and a bruised, “walking on pebbles” sensation if the fat pad has thinned and the heel bone is closer to the ground.

Orthotic insoles can help by:

• lifting and supporting the arch, which changes the angle and distance the plantar fascia has to span and can lessen the tug at the heel,
• using a deep heel cup to hold the heel bone in the centre of the fat pad, so the natural cushioning sits directly underneath it,
• adding extra cushioning under the heel, so impact is spread between the heel pad and the insole material rather than being taken by the bone alone.

These changes can make walking on hard surfaces feel less harsh and, over time, give irritated tissues under the heel and arch a better chance to settle.

Pain in the ball of the foot and toes

The front of the foot can also be affected by underpronation. As more weight travels along the outer side, the area used to push off becomes smaller and more focused.

This often shows up as:

• aching, burning or sharp pain under the ball of the foot (metatarsalgia), especially under one or two of the long bones behind the toes where your weight rolls forwards,
• pain and swelling under the big toe from repeated pressure on the small bones beneath it (sesamoiditis), making it sore to bend or push off through that toe,
• nerve‑type pain, such as tingling, numbness or shooting sensations between the toes, which can happen if a nerve running between the long bones in the forefoot is squeezed again and again,
• more irritation around the big toe joint in people prone to bunions, as load is focused on the side of that joint and the soft tissues there.

Underpronation contributes by:

• narrowing the area of the forefoot that takes your weight when you push off, so a few joints carry more pressure,
• and altering how the toes press into the ground, which can pinch the nerve between the bones and strain the joints.

Orthotic insoles can ease these problems by:

• offering support not just under the arch, but also under the inner part of the forefoot, so some weight is shared away from the most overloaded outer metatarsals,
• giving a broader, more even platform under the ball of the foot so the pressure is spread across more of the forefoot,
• and reducing the amount the foot rolls out, so the same small patch under the ball of the foot is not hit as hard on every step.

Many people with forefoot pain notice that walking, especially on firm ground such as pavements, becomes more tolerable when pressure is shared more fairly.

Tendons, outer foot and lower leg

Tendons and the outer side of the foot and lower leg often have to work harder in underpronation.

The Achilles tendon, which links the calf muscles to the heel bone, is a good example. When the heel tips outwards:

• the tendon can be pulled slightly off centre,
• some fibres are loaded more heavily than others,
• and the repeated pulling can make the tendon sore and stiff just above the heel, especially after a spell of rest or when going uphill.

The muscles and bone in the shin can also be affected. If the arch is not absorbing much impact:

• the muscles along the front and inner side of the shinbone have to work harder to control the foot as it comes down,
• and the shinbone itself can be exposed to higher forces with each step.

This can lead to aching or sharp pain along the front or inner border of the shin during or after activity and, if the stress is high and long‑lasting, small stress‑type changes or cracks in the bone.

Further down, the outer mid‑foot and tissues around the heel can become sore. Repeated tipping onto the outer side of the foot can:

• squash the small cuboid bone on the outer middle of the foot and the joints around it,
• and irritate the small fluid‑filled sacs (bursae) near the heel bone, causing deep aching and swelling at the back or underside of the heel.

Orthotic insoles can support these areas by:

• holding the heel more securely in a deeper cup so it does not tip as far outwards, helping the Achilles tendon pull in a straighter line,
• softening the impact under the heel and along the foot so the muscles and bones of the lower leg do not have to absorb such a sharp jolt,
• and giving more consistent support under the outer mid‑foot, which can ease the squeezing of the small joints and surrounding soft tissue.

Insoles do not replace exercises or other treatment you may be given, but they often make those exercise plans more comfortable to carry out.

Knock‑on effects at the knee, hip and back

The way the foot sits on the ground affects the whole leg. When the heel tilts and the foot rolls along its outer edge:

• the lower leg may angle outwards slightly,
• the knee can twist a little to keep your foot pointing ahead,
• and the hip and pelvis have to adapt to keep you upright.

Over time, this pattern may contribute to:

• knee pain, such as aching around the front of the knee or soreness down the outer side, as the way the kneecap tracks and the pull of the outer thigh tissues change,
• hip discomfort, often a dull ache on the outer side of the hip or deeper in the joint after longer walks, because some hip muscles are working harder to keep the leg in line,
• and lower back ache, as the pelvis and lower spine are asked to correct small twists and tilts with each step, especially if you already struggle with stiffness there.

Underpronation is usually one factor among several. Age, previous injuries, muscle strength and joint health all play their part too.

Orthotic insoles that support the arch and guide the heel into a more neutral position can:

• bring the lower leg back over the foot more evenly,
• reduce the small twist that the knee has to deal with on each step,
• and help the hip and pelvis sit a little more level, which may mean the lower back does not have to work quite as hard.

Many people find that, alongside suitable strengthening and stretching exercises and sensible changes to how long they are on their feet at a time, this makes walking to the shops, using stairs and standing for longer spells more manageable.

Higher‑risk feet, including diabetes

In some people, underpronation does not just cause pain; it can add to the risk of more serious problems.

If you have diabetes, for example, you may have reduced feeling or poorer blood flow in your feet. When a lot of weight is carried through a small area because of underpronation:

• that area is more likely to develop rubbing, callus or small breaks in the skin,
• you may not feel these early changes as clearly,
• and healing can be slower, so small problems are more likely to turn into ulcers.

If you already have arthritis in your feet, ankles, knees or hips, repeated extra stress on one side of a joint can also make that joint more irritable. Arthritis has many causes, but how forces are spread through the joint is one piece of the puzzle.

Some insoles are designed specifically with high‑risk feet in mind, using materials and shapes that spread pressure as evenly as possible. In these situations, insoles to spread pressure and support the foot may still be very useful, but they should be chosen with professional input. People with diabetes, poor circulation or significant joint changes should have regular foot checks and advice from a GP, podiatrist or other specialist about the safest type of insole for them, rather than selecting insoles alone.

Why this orthotic insole range is designed for underpronation

This range of orthotic insoles is chosen specifically to suit outward‑rolling feet. The focus is on supporting the way your foot moves, rather than simply adding a layer of softness.

Clinicians regularly report the same pattern in people who underpronate: higher, stiffer arches, heels that land on their outer edge, and forefeet that are overloaded on a small area. The insoles in this range are selected and developed with that in mind, by:

• giving firmer support along the arch to help stop the foot drifting further outwards and to share weight away from the outer edge,
• cradling the heel in a deeper cup so the heel bone sits in the middle of the natural heel pad instead of tipping onto its outer corner,
• combining that structure with cushioning under the heel and ball of the foot so impact is softened without the insole quickly flattening.

Designs in this range have been shaped and refined in line with feedback from clinicians who manage underpronation‑related problems, such as heel pain, forefoot overload and tendon irritation.

There are options from several manufacturers, including the NuovaHealth line, so you can choose:

• slimmer profiles for everyday shoes, where space is limited but some support is still needed,
• designs with more cushioning for very sensitive feet or thinner fat pads,
• and more supportive styles for higher‑impact use such as running or long shifts on your feet.

Materials are made to hold their shape in regular use, so the arch support and heel cradle continue to feel present, rather than sinking or compressing after a short period.

Off‑the‑shelf or custom: what’s sensible to try first?

Many people wonder whether they need custom‑made insoles or whether ready‑made ones are enough.

Ready‑made orthotic insoles are shaped to suit common patterns, such as higher arches and feet that roll outwards. If your feet broadly match this pattern and your shoes can accommodate the insole, they can offer a straightforward way to improve comfort and support.

Custom orthotics are made after a detailed assessment and are tailored to your individual foot shape and needs. They may be more appropriate if:

• your foot structure is very unusual or significantly altered by conditions such as severe arthritis,
• your pain is severe, complex or has not responded to simpler options such as off‑the‑shelf insoles and basic footwear changes,
• you have other health issues that make your feet higher risk, such as significant diabetes‑related changes.

It can be difficult to judge your own foot type from online descriptions alone. For many adults with underpronation‑type mechanics and mild to moderate pain, trying a well‑chosen off‑the‑shelf orthotic is a reasonable first step. If pain does not improve, gets worse, or if you have other medical concerns, a GP, physiotherapist or podiatrist can advise whether a custom device or different approach is needed.

How to choose and use these insoles

There are a few practical points that can help orthotic insoles work better for you:

• Check that your shoes have enough depth and, ideally, a removable insole or liner. Taking this out lets the orthotic sit flat in the shoe and stops your foot being pushed up too high.
• If the orthotic can be trimmed, use the shoe’s original insole as a template. Trim small amounts from the toe end only, checking the fit as you go. Do not cut into the arch or heel area.
• Start by wearing the insoles for a short time each day, such as one to two hours, and build up gradually over about a week. This gives your feet, ankles, knees and hips time to adjust.
• Wear them for activities that usually bring on your pain, such as long walks, running, or periods of prolonged standing. Some people find it useful to have more than one pair so they do not need to keep swapping between shoes.

It is common to notice mild changes in how your feet and legs feel in the first few days. You might feel a different type of muscle ache in the arches or calves as your body gets used to the new support. That should ease as you adjust. If you feel sharp pain, clear worsening of your symptoms, new pain in areas that were comfortable before, or any numbness or tingling, it is sensible to reduce wear time or stop and seek advice.

What to realistically expect

Orthotic insoles do not cure every cause of pain, and they do not change joint shape. What they can do is alter how your foot sits and how forces are shared, which often reduces the strain on irritated tissues.

When the insole is a good match for your foot and shoes, many people notice over the following weeks that:

• pain that used to flare quickly with standing or walking takes longer to build or feels less intense,
• they can manage daily tasks or exercise with less payback afterwards,
• everyday movements such as walking on hard surfaces, going up and down stairs, or standing at work feel more manageable.

Everyone is a bit different in how quickly this happens. Some feel a change within days; for others it is more gradual as tendons, joints and muscles have time to calm down and adapt to the new way of loading.

Insoles usually work best as part of a wider plan. That might include exercises to strengthen foot, ankle and leg muscles, stretches to reduce tightness, and sensible changes to how long you stand or what type of activities you do in one go. A physiotherapist or other clinician can advise on this.

Safety and when to seek advice

Underpronation and the problems linked with it are straightforward in some people and more complex in others. It is important to know when to get things checked rather than adjusting things on your own.

Speak to a GP, physiotherapist, podiatrist or other appropriate clinician before relying on orthotic insoles if:

• you have sudden, severe or unexplained pain in your foot, leg, hip or back,
• you cannot put weight on the limb, or walking is very difficult,
• there is marked swelling, redness or warmth that does not settle,
• you have diabetes and notice any numbness, colour changes, ulcers or infections in your feet,
• you have been told you have poor circulation to your feet,
• you have had recent surgery to your feet, ankles or legs, or have been told you have major structural changes there.

If you start using orthotic insoles and notice:

• worsening pain,
• new areas of numbness or tingling,
• changes in colour or temperature in your toes or foot,
• or persistent rubbing, blistering or broken skin that does not improve,

stop using the product and seek advice before continuing. In these situations, it is safer to have your feet and footwear assessed properly rather than trying to adjust things alone.

Summary and next steps

Underpronation keeps more weight along the outer edge of the foot and reduces the natural shock‑absorbing role of the arch. Over time, that can contribute to pain under the heel and arch, in the ball of the foot, and higher up in the shins, knees, hips and lower back.

The orthotic insoles in this range are selected to address those mechanics. They support the arch, hold the heel in a more balanced position and spread pressure more evenly under the foot. For many people, that means walking and standing on hard surfaces feel more comfortable and longer spells on their feet are easier to manage.

If you suspect underpronation is playing a part in your pain, it may be worth trying a suitable orthotic insole in shoes that can accommodate it. If you are unsure, or if your pain is severe, persistent, or linked with conditions such as diabetes, poor circulation or recent surgery, it is wise to discuss your symptoms and options with a GP, physiotherapist or podiatrist before making changes.

Disclaimer

The information on this page is intended for general informational and guidance. It is not a substitute for personal medical advice, diagnosis or treatment. If you have concerns about your feet, legs, hips or back, or are unsure whether orthotic insoles are suitable for you, speak to a doctor, physiotherapist, podiatrist or other appropriate health professional. While many people find orthotic insoles helpful, individual responses vary and no particular result can be guaranteed.