It is estimated that about 50% of all runners will experience an injury that will necessitate a break in their running programme for at least one week. Most running injuries are limited to the lower limb with injuries to the knee being the most common at 25%. The incidence of injuries reported at other anatomical sites includes: foot (2-22%), ankle (9-20%), lower leg (2-30%), hip (2-11%) and lower back (3-11%). Running injuries have been statistically associated with previous injuries and training errors in a review by van Mechelen 1992, of the factors commonly implicated in the aetiology of running injuries. Anecdotally excessive pronation has been associated with running injuries by sports physicians.

However, there has been a lack of consensus in the literature as to a causative association between excessive pronation and running injuries. Furthermore biomechanists have been unable to demonstrate changes in the running style of runners with sports shoes that vary in the grade of motion control. This has shed doubt on the role of sports shoes in the correction of excessive pronation

Consequently, the future of the motion control features of sports shoes may be limited. However, the natural selection and continued use of sports shoes that have strong motion control features and neutral features by runners that appear to have excessive pronation movement and have a neutral movement respectively, suggest that the current design of sports shoes may not be without merit. It may be in runners best interests to continue to use the current sports shoe designs until they have been scientifically proven to have a negative effect on running biomechanics and the incidence of running injuries. In this article I will review the dynamics that occur during the gait cycle, the current understanding of excessive pronation and the possible mechanisms by which pronation is thought to cause running injuries.