Flat Feet — A Problem for Runners

• People with flat feet often have problems with their feet twisting inward, also known as overpronation. When there is more weight or impact placed on the feet while running, it could increase the risk of injury. It could also cause greater risk of knee and back pain.
• Research has shown that having flat feet does not significantly impact the risk of injury for runners. However, if there are recurrent or repeated injuries that are not treated or corrected, this could result in a more painful injury in the future.
• Using motion control shoes specifically designed for flat-footed runners is one way to help reduce the risk of injury and pain from running.

Many runners have heard about a particular characteristic present in some people’s feet, called “flat feet”. It’s an issue because flat feet cause the feet to twist while running. Consequently, there is increased stress or pressure on the wrong parts of the feet. Over time, this can eventually lead to injuries or pain.

You can do a wet test. This requires you to place a wet foot onto a flat piece of paper to test. Alternatively you can use any other surface where the footprint can be clearly seen. If your footprint looks like a complete foot, with barely an inward curve, then you likely have flat feet. If you are unsure, see a doctor for further confirmation.

• Normal Arches: A good foot should have a neutral pronation with fairly straight ankles and a moderate foot arch. Normal arches are the proper height to absorb and distribute weight and impact well. People with normal arches can wear almost any type of shoes.
• Flat Feet: A clear, complete footprint with no clearly visible inward curve in the center of the footprint. In other words, a very minimal curve indicates flat feet. Those with flat feet generally have problems with the ankle and foot rolling inward, also known as overpronation. When more weight or impact is placed on the feet while running, it could increase the risk of injury.
• High Arches: Feet with high arches tend to roll outward (supinate). This can be observed from the very large inward curve in the center of the footprint. High-arched feet have an extra hard time absorbing impact, which can result in ankle injuries.

Research by Jasper W.K. Tong at the KK Women’s & Children’s Hospital in Singapore found that runners with flat feet had only a slightly higher risk of injury than those with normal feet and arches. Research by Bradley Neal from Queen Mary University, London, found that flat feet were associated with greater risk of shin splints and patellofemoral pain syndrome, which is a condition well known to most runners, but that it had no real effect on the risk of injury to other areas such as the feet or ankles.

Research has shown that flat feet do not greatly impact the risk of injury among runners. But if there is repeated injury that is not treated or corrected, it could result in greater injury in the future. This is because when someone has flat feet, there is a tendency for their feet and toes to roll inward, resulting in greater risk of injury to the calf and the heel, due to greater pressure placed on the heels. Those with flat feet also tend to place greater weight on the inside of the knees, which can be a cause of knee pain and back pain.

Choose the Right Shoe Type: Those with flat feet should choose shoes with soft soles that aid the tendon in supporting the arch and stabilizing the heel. They should also use shoes that cover both the sides and the back of the foot to prevent the heel from twisting or the foot from rolling inward.

Reinforce and support the tissue covering the inside of the bottom of the foot (plantar fasciitis) by using shoe inserts that are appropriate for the specific condition of your feet. This will help provide support and reduce force and impact to the foot. It will also help prevent the feet from twisting while running or walking.

Nowadays there are many different types of shoe inserts, including silicone insoles, foot pads and insoles made from a wide variety of materials. Runners should wear insoles with shoes they use regularly and ensure they are the best fit and the most suitable for their individual feet shape. Those with very flat feet should see a doctor for more specific diagnosis and to help choose the best and safest accessories for their use.

Stretching: This is helpful particularly for those with minimal flat feet. With your hands on a wall in front of you, start by leaning forward. From there, bring one leg forward in front of the other. Place the heel of the front leg flat on the ground and bend that knee. Extend and straighten the knee of the leg at the back. The toes of the back leg should be facing the same direction as the heel of the front leg. Then press the heel of the back leg down to the ground and hold the stretch in that leg for 15-30 seconds.

Choosing the right running shoes for those with flat feet will help reduce injury and pain on the inside of the soles of the feet, as well as to other parts of the body, including tendons, knees, hip joints and back. Important is:

• Focus on choosing shoes that provide good stability to help prevent falls while turning, as running requires the use of the inner part of the foot for support.
• Choose shoes with insoles that are neither too soft nor too hard.
• Look for shoes with a thick, cushioned sole, so as to prevent collapse when weight is placed on them.
• The front part of the shoe should be neither too narrow nor too loose. When wearing shoes, you should still be able to move your toes around in them a little.
• Use arch supports to help distribute weight and impact and to minimize pressure on the soles of the feet.
• Use motion control shoes specifically designed for flat-footed runners in order to reduce the risk of injury and pain from running.

In addition to using special running shoes, people with flat feet can also learn some simple techniques for purchasing other types of shoes that will also help reduce the problems of shoes pinching your feet, foot pain, corns and ankle inflammation.

1. Choose good quality, durable shoes by looking at the stitching and materials used both on the inside and outside of the shoe.
2. Try shoes on in the evening, when your feet are the most swollen and expanded due to the blood flowing into your feet from weight-bearing activities throughout the day. This will help keep you from buying shoes that are too tight.
3. When buying shoes, make sure you try wearing them yourself, with socks if necessary, and make sure they are neither too tight nor too loose. From there, try walking, taking steps backward and forward, and try jumping, to ensure that the shoes do not slip or fall off while doing so.