Pronation, far from being a problem in skiing, is crucial to the ability to assume a dynamically tensioned base of support from which to move from the foot of one turn to the foot of the next turn. So how did pronation become an issue? One plausible explanation is that the publicity associated with running injuries and pronation in the ’70s segued into an easy sell marketing opportunity in skiing. Now, a new well done Danish study (1) has further debunked the benefits of a neutral shoe and pronation as a predisposing factor in running injuries.

During 1 year of follow-up, the 1854 feet included in the analyses ran a total of 326 803 km until injury or censoring. A total of 252 participants sustained a running-related injury. Of these, 63 were bilateral injuries. Compared with a neutral foot posture, no significant body mass index-adjusted cumulative risk differences (RD) were found after 250 km of running for highly supinated feet (RD=11.0% (-10% to 32.1%), p=0.30), supinated feet (RD=-1.4% (-8.4% to 5.5%), p=0.69), pronated feet (RD=-8.1% (-17.6% to 1.3%), p=0.09) and highly pronated feet (RD=9.8% (-19.3% to 38.8%), p=0.51). In addition, the incidence-rate difference/1000 km of running, revealed that pronators had a significantly lower number of injuries/1000 km of running of -0.37 (-0.03 to -0.70), p=0.03 than neutrals.


The results of the present study contradict the widespread belief that moderate foot pronation is associated with an increased risk of injury among novice runners taking up running in a neutral running shoe. More work is needed to ascertain if highly pronated feet face a higher risk of injury than neutral feet.

1. Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe: a 1-year prospective cohort study – Nielsen RO1Buist IParner ETNohr EASørensen HLind MRasmussen S. – Br J Sports Med. 2014 Mar;48(6):440-7. doi: 10.1136/bjsports-2013-092202. Epub 2013 Jun 13