The Truth About Pronation: Is It Really a Problem for Runners?

If you’ve ever shopped for running shoes, chances are you’ve heard the word pronation tossed around—often with a tone of concern. Runners are told they “overpronate,” “underpronate,” or need specific shoes to “correct” their form. But how much of this is science—and how much is outdated marketing?

At Princeton Sports and Family Medicine, P.C. in Lawrenceville, New Jersey, we help runners of all levels understand their movement, biomechanics, and injury risks. In this blog, we’ll debunk the myths about pronation, explain why it happens, and help you know when (or if) shoe correction is actually needed.

What Is Pronation, Really?

Pronation is the natural inward rolling motion of the foot and ankle that occurs during the stance phase of running. It’s not a flaw—it’s a fundamental part of human movement.

During pronation:

• The arch flattens slightly

• The ankle rolls inward

• The foot absorbs shock and adapts to the surface

It’s normal. It’s necessary. It’s how the body attenuates impact.

The Myth of Overpronation

For years, runners were told that overpronation causes injury—and that stability or motion-control shoes are required to fix it. But recent research tells a more nuanced story:

• Many elite runners pronate without issue

• There is no consistent link between overpronation and injury rates

• The foot’s movement is part of a larger chain involving the hips, knees, and core

In fact, trying to block natural pronation with stiff shoes can sometimes increase stress on the knees or hips.

✅ Takeaway: It’s not about how much you pronate—it’s about how your body adapts and distributes load.

When Is Pronation a Problem?

While pronation is normal, excessive or uncontrolled pronation combined with poor strength or motor control can contribute to injury, especially when paired with:

• Weak glutes or hip instability

• Poor single-leg control

• Excessive training volume or poor recovery

• Inadequate or worn-out footwear

Examples of issues possibly linked to excessive pronation:

• Posterior tibialis tendinopathy

• Shin splints (medial tibial stress syndrome)

• Plantar fasciitis

• Knee tracking issues in certain cases

Should You Buy a Stability Shoe?

Maybe—but not always. Here’s how to think about it:

You might benefit from a stability shoe if:

• You have a history of overuse injuries

• You fatigue easily and collapse inward late in long runs

• You have hypermobility and need mild support

• You feel more comfortable and confident in one

You probably don’t need one if:

• You’re injury-free with a neutral gait

• You pronate mildly or symmetrically

• You feel stiff or restricted in structured shoes

✅ Tip: The best shoe is often the one that feels most natural over the long run—not the one that claims to “fix” you.

What You Should Do Instead

1. Get a gait analysis – Video or treadmill-based assessment can give more meaningful insights than a quick glance in a shoe store.

2. Focus on strength and control – Glute, core, and calf strength help manage pronation far more effectively than any shoe.

3. Rotate your shoes – Different shoes for different runs can reduce repetitive stress and help your body adapt more broadly.

4. Replace worn shoes – Old shoes may not support your natural movement, even if they once did.

Final Word: Pronation Isn’t the Enemy

It’s time to rethink the fear around pronation. It’s not a defect—it’s part of a well-tuned, shock-absorbing system. What matters most is how your entire kinetic chain functions, and how you train, recover, and adapt.

Want to better understand your foot mechanics?
Schedule a gait analysis at Princeton Sports and Family Medicine, P.C. Our team can help you find the right shoes, the right form, and the right strength program—so you can run smarter, not scared.