Arch height and injury prevention

Even though any injury can occur in any runner regardless of their arch height, the follow generalizations are found in the research:

• High arches tend to be stiffer and can increase the incidence of foot and femoral (upper leg) stress fractures as well as lateral knee/Iliotibial band (ITB) pain or injury compared with runners with flatter feet.

• Low arches tend to be more flexible resulting in excessive stress of the plantar fascia, achilles tendon, calf muscles, tibial (shin) bone and surrounding muscles.
• Recent research suggests that arch height is less relevant than the RATE of pronation during foot strike.  The faster the runner’s rate of pronation, the more likely he/she is to get injured.

• The good news is that the rate of pronation can be reduced and controlled by core, hip and foot strength and stability.

Arch height and performance:

• Although high arches and flat feet exist at elite levels of sprinters and endurance runners, higher arches tend to be found in distance runners and flatter feet are more common with sprinters.  For the rest of us, the good news is that the body can adapt to any foot type if the training program builds gradually enough for the individual.

In summary, a very gradual training progression in addition to core, hip and foot strength exercises are important for runners to integrate into their training so they can help to control their rate of pronation, regardless of their arch type.

Bottom of the foot or heel discomfort often means plantar fasciitis but there are several other diagnoses that you may need to consider and get treated sooner such as entrapment neuropathies, skeletal conditions, inflammatory conditions or soft tissue conditions.

Some traditional self-treatments methods for plantar fasciitis include: ice, stretching foot, calf and hamstring muscles, strengthening (towel pull with toes, heel drops), heel pads/inserts, tennis ball massage, night sock/splint and wearing supportive shoes (outside and at home).

Other self-treatment methods that I and my patients have had success with include:

• Before getting out of bed in the morning (or before taking your first step if you sleep standing up), massage the painful area, usually on/near the heel, for 20-30 seconds, then stretch your calves once you stand up
• Replace your shoes:
  • You may need a new pair of the same model
  • You may need a different brand of shoes or type (i.e. cushioning, motion control, stability)
  • Your shoes may need a different size of shoe (i.e. sliding if too big can cause plantar fasciitis stress)
• Avoid running hills and speed until symptoms subside
• Limit standing and walking until symptoms subside
• Avoid forward lean when running as this puts more of a stress on calf muscles (especially 3^rd layer going into the foot)
• Stretch hip flexor to prevent a forward pull of the psoas (upper hip flexor) muscles on the low back causing a forward lean
• Avoid (or at least wait) to try barefoot running or ‘minimalist’ shoes.

If these methods to not work, you may need to seek help from a health care provider – ideally one who runs and does some sort of hands-on soft tissue technique.  In other words, once an appreciable amount of adhesions (may feel like a small painful nodule at or near base of heel) develop then time off, stretching and/or exercises may not be enough.

We aim to inform you about current running research to help you achieve your personal fitness goals. By providing you with up-to-date information about running technique, injury prevention and treatment, we want to motivate you to practice personal experimentation in order to run better.

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