Run with Flat Feet
Raise your hand if you have been to a running store or our primary care physician’s office and they have told you that you have flat feet? Have you ever wondered if you can still run with flat feet?
Pes planus, or flat feet, is a fairly common issue in the general population. In fact, it is estimated that 20-30% of the population has pes planus and many of those are runners.
Typically my answer is a resounding YES! You can run if you have flat feet. I say typically because there are always those exceptions but we aren’t going into those today.
What is Pes Planus/Flat Feet
When we talk about being “flat footed” we are referring to the condition of the arch of the foot. The arch helps to absorb the shock of your footfall during running.
With pes planus, the arch of your foot is “collapsed”. It is sitting low or completely flat against the ground. A quick at home test is the wet test where you dip your foot in water and then step on a piece of paper towel. If the outline of your foot shows little to no inward curve on the inside of your foot, then you probably have flatter feet.
But with flat feet, the arches are collapsed, sitting low or completely flat against the ground. A foot doctor can determine if you have flat feet, but you can also check your arches yourself at home with the wet test. First, dip the sole of one of your feet in the water, then step on a piece of paper towel. Put all your weight on that foot, then remove it from the paper towel.
There is also a different type of flat foot that we aren’t going to address today. Some people have flat feet because of their bone structure instead of the tissues. These are called rigid flat feet because and the feet are flat even when they aren’t stepping and putting pressure on the foot.
What Causes Flat Feet?
First of all, flat feet in toddlers are completely normal and a part of development. This is due to the fact that the arches haven’t formed yet at this point. Just like until the age of 3 we don’t have kneecaps…..Mind. Blown.
There isn’t a clear definition of what causes flat feet in adults but there are some common factors. It usually develops when the tendon that supports the foot arch gradually stretches over time.
One of the beliefs by some experts is that standing or walking in high heels for prolonged periods may be the cause in some women.
Other risk factors for flat fee include:
- The natural aging process
- Arthritis or Rheumatoid Arthritis
- Foot or ankle injury
- Nervous system or muscle diseases
- Decreased strength
- Decreased mobility
Pes Planus in Relation to Running
When we think of flat feet we often hear the term pronation or over-pronation and shoes that correct them. But what does pronation mean and is it necessarily bad?
During the first half of your stance phase in running, there are multiple events going on that can be affected by pes planus. The motions include ankle dorsiflexion, forefoot abduction, and hindfoot eversion. However, pronation of the foot is vital during running as well. It allows impact forces to be attenuated over a period of time when running.
Some belief is out there that too long pronation during running causes undue stress on the knee joint and can cause patellofemoral pain and other running injuries. But how can we prevent “prolonged pronation”. Strengthening and mobility. Things we will discuss later.
Does a Flat Foot Predispose a Runner to Injury?
A recent study shows that in an athletic population that is representative of collegiate athletics, the existence of flat-footedness does not predispose the athletes to subsequent lower extremity injury.
In addition, the routine prophylactic use of orthotics in flat-footed athletes to prevent future injury may therefore not be justified based on the data available. This means that orthotics don’t necessarily help to prevent injury when you have flat feet.
Just because you have flat feet doesn’t mean you can’t run and be successful at it. There are some amazing elite runners that have had known pes planus and been able to set world records.
Some elite runners out there with flat feet are Haile Gebrselassie, Alan Webb, and Said Aouita.
Do Flat Feet Cause Pain with Running
Pain can occur in someone with flat feet. However, the issue isn’t due to your feet themselves but from over-pronation. As I said before pronation is normal in the running gait cycle. What it means is that normally during a run (or walk) your foot will roll in slightly to absorb impact.
Over-pronation happens when your foot rolls inwards too much. Excess is not good people! Stop being an over-achiever here.
When your foot over-pronates during a run the ankle joint is extended which in turn causes the lower leg bones (and up the chain to the upper leg bones and pelvis) to rotate inwards. Resulting in increased stress and eventual pain on the ankles, leg muscles, knees and hips.
Many people with flat feet don’t have pain when they run because they don’t over-pronate and that is going to be the partial aim of how to fix flat feet in runners. However, I do want to note that the chances of over-pronating are higher for someone with flat feet.
Physical Therapy Exercises for Runners with Flat Feet
Strengthening your feet’ intrinsic muscles is key to helping you prevent injury when running. Not only will it help prevent injury from flat feet but it can also help rehab pain from flat feet when you run.
1. Arch Lifts for Flat Feet
2. Sole to Sole
Best Running Shoes for Flat Feet
There is a lot of research out there about running shoes for different foot types. In fact, companies have spent the last few decades developing and trying to perfect to prevent injury.
Unfortunately, there isn’t much proof out there that a running shoe can prevent injury.
There is good news though. The only time a running shoe has helped prevent injury or actually made a difference in a runner is someone with flat feet that overpronates.
If you are a runner with flat feet you could possibly benefit from a stabilizing shoe. Notice that I didn’t say you will. It just depends on your individual body mechanics and what feels right.
Final Thoughts on Running with Flat Feet
There is a lot of information out there on whether people with flat feet should run or not. My go-to answer is always a resounding YES with a few exceptions. Every body is different. Luckily we are moving out of the outdated way of thinking that if you have something “not perfect” about your body you should stop doing the activity you love!
To run with flat feet all you need to do is work on your mobility and strength to keep you injury-free!
Articles Related to Flat Foot Runners
- Types of Heel Pain in Runners
- How to Fix Plantar Fasciitis in Runners
- How to Fix IT Band Syndrome in Runners
- Do Runners Need Insoles
- How to Fix Tight Calves
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|Michelson JD, Durant DM, McFarland E. The Injury Risk Associated with Pes Planus in Athletes. Foot & Ankle International. 2002;23(7):629-633. doi:10.1177/107110070202300708
How To Run if You Have Flat Foot and Reverse It!
Dr. Abby Siler, PT, DPT is a Physical Therapist with 10 years of experience in a variety of settings. She has spent the majority of her time treating athletes in orthopedic clinics and worker’s compensation cases. She is a runner herself for the past 15 years and a lifelong athlete. Dr. Abby loves to teach runners how to stay injury free and out of her clinic.