Do Flat Feet Lead to Chronic Foot Problems?

Do Flat Feet Lead to Chronic Foot Problems? 

 The 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 been dealing with it their entire life.  In other words you typically won’t have someone who’s has lived with flat feet their whole life and then all of sudden at age 30 develop severe tendinitis that is directly caused by their flat foot. If it were 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 are small degrees of flat feet that really lead to a problem. As mentioned above there are obvious structural abnormalities that makes it difficult for a person to  walk  let alone run.

I like to think of arch height as a spectrum, you the outliers with either high arch or low are but most 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 to 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 slowly transitioning and allowing a gradual adaptation to occur. Or the runner who suddenly adds speed workouts or intervals to a training program to shave 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.

Pronation. I have “pronation” or I “pronate” is frequently described by many runners. In fact, this was just discussed in a recent Runner’s World article focused on selecting a running shoe. Not only are these statements using the term pronate or pronation completely out of context, but they are implying that pronation is bad. Our foot was made to pronate. Pronation is the innate shock absorber for our bodies 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.

Focus on training patterns and form. Not shoes. You may be surprised as to not only how your pain miraculously resolves, but more so at how much your running will improve.