Pes planus, or flat feet, is a condition in which the foot does not have an arch. Pes planus is a normal occurrence in babies and toddlers, as the arch does not build until childhood. In some individuals, the arch never builds and in others the arch falls later in life. Flat feet may cause difficulty running, depending on the type of flat foot present and your foot biomechanics. In many runners, flat feet cause the foot to roll inward excessively during running and walking -- a condition known as overpronation. Overpronation disrupts the normal biomechanics of the foot which places undue stress on the foot and leg, and can even lead to injury.
Types of Flat Feet
Flat feet can be categorized into "flexible" versus "inflexible." Most individuals with flat feet have flexible flat feet, meaning an arch is created while standing on the toes. Flexible flat feet rarely cause arch pain while running and typically only require shoe inserts to correct overpronation. In individuals with inflexible flat feet, the arch fails to develop while standing on the toes. Runners with inflexible flat feet usually complain of pain while running or walking and may have difficulty running. Inflexible flat feet are always due to an underlying medical condition of the foot or leg, such as tarsal coalition, that requires medical treatment.
Foot Biomechanics
While most individuals with flexible flat feet will not experience arch pain while running, they may be predisposed to injuries created by abnormal foot biomechanics. Pronation is the term used to describe normal movement of the foot in which the foot rolls inward as it strikes the ground. Normal pronation is about 15 degrees in most people. When you run, the heel strikes the ground first and the foot rolls inward slightly onto the ball of the foot. The weight is then distributed evenly to the ball of the foot and the foot is pushed off the ground. In flat footed individuals, the foot rolls inward too much and the weight is distributed to the inside of the foot instead of the ball of the foot. This movement can be a problem for runners as it causes the foot to become off balance. When the foot becomes off balance, the leg and hip are also thrown off balance and excessive stress may be placed on the tendons and muscles of the leg.
Complications
Overpronation is considered a risk factor for several orthopedic conditions of the foot and leg, including shin splints, Achilles tendonitis, plantar fasciitis, Morton's neuroma, posterior tibialis tendonitis, patellofemoral pain syndrome and iliotibial band syndrome.
Recommendation
See your podiatrist if you have painful flat feet so that he or she can determine and correct the underlying cause for the condition. If you have flat feet that are not painful, but are unsure as to whether you overpronate while running, see a podiatrist or sports therapist to have a gait analysis done. They may also be able to recommend a good running shoe or orthotic for overpronation which will help to stabilize the foot and prevent it from rolling inward too much while you run.
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