Do Flat Feet Lead to Chronic Foot Problems For Runners?
As I mentioned before, I have decided Friday’s post will deal with foot related topics. I have coined the phrase “Fit Foot Friday”. I apologize that this foot related posted is actually coming out on Saturday verses Friday. I wanted to talk today about the myth regarding flat feet affecting runners. I have been asked many of times by my patients if flat feet lead to chronic foot problems in runners. My answer is not really. Sure there are some cases of feet where the structure of the arch is so bad that the person may have a difficult time with normal walking and functioning, however they have been dealing with this condition their entire life. In other words you typically won’t have someone who’s has lived with flat feet their whole life, suddenly at the age of 30 develop severe tendinitis that is directly caused by their flat foot. If it was truly related to the arch’s structure they would have been suffering through out their life.
The podiatric community has categorize arch height into three separate categories- flat, normal, and a high arch. I feel there is a large misconception surrounding flat feet. In all reality, there is only a small degree of flat feet that really due lead to mechanical problems of the foot.
I like to think of arch height as a spectrum, you have the outliers on either ends of the spectrum, high arch on one end and low arch on the other end, but most feet fall some where in the middle. So only a small percentage of individuals have a severe enough flat foot to result in injury and the same hold true for a high arch. The remaining foot types are variances of normal feet which themselves do not directly relate to any increase in injury.
The literature also does not support the theory that flat feet inherently causes injury. Our society is fixated on the foot’s appearance and as soon as any lower extremity problem arises, they blame the foot. We all want a “good shoe”, with “good support”. Even those with high arches will sometimes say, “I have a high arch so I need to support it”. Do they?
Very rarely do people blame their training patterns. Consider the person who just ran a 5k and had a great experience and now wants to train for a half marathon. They present to my office asking for advice on shoes or if they need orthotics because they have knee pain from training. They completely ignored the fact that they just doubled the amount of miles they have been running, without allowing for ample time to adapt to the increase in mileage. Or the runner who suddenly adds speed workouts or intervals training to a training program in hopes of shaving some time off their PR. I can assure you I see more runners who have developed an injury from their training patterns rather than from a biomechanical condition such as a hypothetical flat foot
I “pronate” is frequently described by many runners. In the running society as a hole, pronation gets a bad rap. There is a hole line of running shoes that try to limit pronation. However, what people fail to realize, is that our foot was made to pronate. Pronation is our bodies way to absorb shock during locomotion. Placing the term “pronation control” on a running shoe is analogous to having a catcher’s mitt that doesn’t bend. Your hand needs the ability to move freely to squeeze the mitt to grab the ball, just as your foot needs to bend and flex to absorb shock. Why do we have 26 bones and multiple joints in our feet if they weren’t meant to move?
Prior to the 1970s running shoes with motion control and rigid supportive midsoles did not exist and runners were still breaking 4 minute mile and running 2:10 marathons.