Arch height. Talk to people with high arches and they will tell you their foot issues are due to their high arches. Talk to people with low arches or flat feet and you hear the same thing. People with normal height arches don’t say a thing about their arches being the cause of their foot issues, yet they still have foot issues.
Want to know a secret? Arch height is typically not a contributor to your foot issues. For a small percentage this may be true, but certainly not the majority.
Regardless of arch height, runners consistently have the same common injuries when it comes to the foot and ankle complex: posterior tibial tendinitis, peroneal tendinitis, and plantar fasciitis, just to name a few. Unless addressed on a very basic foot strength and control level, the issues will continue to occur in your body. Yes, there are ways to support and brace the foot using orthotics and shoes, but those can cover up the real issues for a period of time and eventually create other issues/injuries in the body.
So, why is this?
Most foot and ankle injuries are due to both mobility issues in the ankle and weakness and instability in the muscles in the lower leg and foot that control what our foot does when it is on the ground. Regardless of your arch height, these issues are present in most humans.
Why you ask?
The primary reason (in my opinion) is…shoes!
Most shoes are made with a slightly elevated heel, also referred to as a drop. Unless you make an effort to find shoes that do not have an elevated heel, the shoes you wear on a daily basis for work and recreation tend to have elevated heels. This slight elevation can contribute to our ankles being held stiff in a slightly pointed position, making it difficult to pull the front of our foot up. Ideally, for both running and walking, we need to be able to get our ankle past a neutral position; many people can’t get past neutral.
On top of that, when we wear shoes, our feet do not have to work like they were intended to work. The requirements for the muscles to control our arch and toes are not there when wearing shoes. Over time, we develop two issues: 1) the muscles that control the foot become weak, and 2) the muscles forget what they are supposed to do because they aren’t required to do their job on a regular basis.
Unfortunately, we are required to wear shoes on a daily basis for our jobs, in order to go into public buildings, and in order to protect our feet against the elements.
So, what is the solution?
First and foremost, creating a more resilient and robust foot and ankle complex is key. Performing exercises to improve the mobility in your ankle as well as strength in your foot is essential to maintaining a healthy foot and ankle complex that can withstand any and all activities you do in your day-to-day life, especially your running.
Secondly, try to be barefoot more often. You may not be able to tolerate it for long initially if you aren’t used to being barefoot, but attempt to spend as much time at home without shoes on as you can. You will find the more you do this, the stronger your foot will get and the less fatigued it will become over the course of a day.
Footwear is also an important element. Ultimately, I would love to see everyone in a minimalist or zero drop shoe. However, from working with runners on a daily basis, I know that is not something that everyone can tolerate. I also know that it can take a long time to safely transition to zero drop or minimal shoes, even if you do choose to go that direction.
If you are dealing with foot pain, initially just find a shoe that works for your foot. A proper fit is important — both length and width. You need a good amount of room in front of the toes so you aren’t hitting the front of the shoe as your foot expands when running. You also need to have shoes that fit snug enough in terms of width so that your foot isn’t moving around from side to side, but not so snug that you’ll feel pinched. And remember, running shoes should not require a break-in period. If it is not comfortable from the start, it will likely not feel any better later.
Once you’ve got a proper fit and are running comfortably and pain-free, you can think about transitioning to a lower drop shoe. I advise this to be a slow and gradual process. If you are currently running in 10 mm drop shoes, pick up a second 6-8 mm drop pair. Run in the lower drop shoe for no more than 10% of your weekly mileage initially. As long as that feels good, increase to 20% the next week. Continue increasing weekly until you can run 100% of your mileage in that lower drop shoe. At that point, you can work to transition to a slightly lower drop shoe again.
If you choose to transition, it can be a long process, but you’ll definitely feel the benefits in the health of your feet and ankles, which will also be felt all the way up the chain to your knees, hips, and back!