Do You Need Special Running Shoes for Flat Feet?
If you have flat feet and you are troubled by it, then we have two good news for you. One is that you may not actually have flat feet – this is something that people are not always reliable in judging themselves. Secondly, if you have flat feet, it’s probably nothing to worry about.
Runners suffering from problems related to flat feet are often advised to purchase running shoes with added stability elements to combat overpronation. However, it is not exactly set in stone. We talked to Alex Townsend, a musculoskeletal (MSK) specialist and sports podiatrist, about flat feet and whether they need special running shoes.
A flat foot is just a foot that has a low arch profile. There is less space between the inner arch and the ground. There is a lot of hype around arch height among patients and runners and it is often, unfairly in my opinion, blamed for being the major cause of everything.
How do you know you have flat feet?
The first thing to do is to inspect it. Just look below – you can see if you have flatter feet. However, many people are not particularly good at self-judgment. There is also a test recommended by magazines and shoe manufacturers, called the wet paper test or wet paper towel test.
Place a wet foot on a piece of paper and you will be able to see if you have a high profile as there will be less contact; If you have a low arch profile then you have more contact and therefore more paper will get wet. It’s not a good, reliable test — it doesn’t really hold any diagnostic value — but it’s something shoe manufacturers often recommend to help you select the right shoe.(Image credit: Getty Images / Filippo Bachi)
How does having flat feet affect running?
Flat feet are attributed to many of the main injuries that runners suffer – including plantar fasciitis, Achilles tendinopathy, tibialis posterior tendinopathy – or stress fractures. In my opinion, this is a pretty deep claim. I see many of these issues with a high-arch foot, most of these issues are seen with a high arch. So the hardcore profile, in my humble opinion, doesn’t seem to have much to do with it.
The theory proposed by a lot of non-physicians is that the arch acts as a spring, doesn’t it? Yes and no When we are weight bearing and loading through the foot, the arch acts as a sort of shock absorber aspect, but it is not a spring. That’s not how it works. Realistically, despite what people say, flatter feet don’t affect posture a significant amount.
Often when I have a patient who is afraid that they have flat feet, I say Google Eliud Kipchoge’s feet or Haile Gebrselassie’s feet, and you will see that their feet are really flat because it is often congenital. It can be hereditary with certain ethnicities, and if you look at sub-Saharan African populations, they will generally have a flatter posture than Caucasian populations or East Asians. And there are all the top marathon runners in sub-Saharan Africa!
How do brands design shoes for flat feet?
Over the years, they have attempted to increase the stability of the shoe’s inner range. And he has done so in many ways. One is with Varus Tilting. This means that they will have the shoe lying on a platform where it is slightly inverted so it is essentially pushing the foot outward.
Another way to achieve varus tilting is with a guardrail – the plastic that comes through the mid-layer of the shoe or even the upper material of the shoe acts as a support bar around the arch of the foot. Some manufacturers build more of an arch profile into the shoe, and some increase the density of the foam in the midsole of the shoe.
A lot of brands seem to have reduced the stability level of shoes released in the last one to two years compared to 10 years ago, as running injuries have not decreased since the invention of the stability shoe. Simply controlling pronation speed hasn’t really done much for the running injuries that people are getting, because the biggest risk is simply being a runner.
Are most running shoes for flat feet designed to combat pronation?
Yes, generally speaking, a flatter foot posture results in a more pronated position. But being in pronated position often doesn’t mean a great deal in a well-conditioned runner.
Do You Need Running Shoes for Flat Feet?
Yes and no I would not suggest buying a stability shoe directly to a patient as it is not necessary that you are going to tolerate it. I have a flatter foot posture. I don’t tolerate an orthotic when I run fast and I don’t tolerate stability shoes because I don’t move with that contact point in the arch. It’s just my preference.
The most appropriate shoe would be one that they feel comfortable in and can run in, but there are certain qualities that I would instruct some patients on. A patient with, let’s say, a flat foot with midfoot arthritis, I might direct them to shoe with a rocker. The Hoka Clifton has a really nice rocker geometry in the mid-layer around the metatarsals. If someone has midfoot arthritis, that type of shoe may be enough to stabilize and move those small joints.
I might suggest that if they have anterior knee pain that they move to a stability shoe – there is reason to believe that stabilizing the medial part of the foot may help with this.
Overall can you just go with a shoe that feels comfortable?
We have an evidence base to support this. Posted by BM Nigg several years ago who argued that the best shoe is one that is comfortable. Although in recent years where we have more memory foam and more unstable shoes, I don’t agree 100%.
Are carbon plate running shoes bad for flat feet?
Not necessarily. As I said, Eliud Kipchoge argues – his feet are quite flat and the Nike Alphafly is designed specifically for him. He deals with it quite well. Granted, he’s not doing all his slow training that way.
For your five-hour, six-hour marathon runner who has little running experience, maybe don’t go for the Alphafly. One, save your money, but two, you might find a little stability more comfortable. But try it. Try before you buy is the best advice I can give.
If you’re a fast runner and you’re looking for those few percentage points of gain, and you’re willing to pay and experiment – go for it. What I often tell my patients is that we are all looking for this Cinderella experience of the perfect shoe fit. I don’t think we’re ever going to find the perfect shoe fit, because we’re all individuals.
about our expert
Alex Townsend is a specialist MSK and sports podiatrist with Pure Sports Medicine. Since graduating from the University of Southampton with a degree in podiatry in 2015, Townsend has worked in the NHS and the private sector and she volunteers at the London Marathon each year to provide medical aid. He is a member of the Royal College of Podiatry and the Royal College of Physicians and Surgeons of Glasgow.
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