Feet come in all different shapes and sizes and are prone to many problems, especially when running is involved. Physical therapists can provide a detailed analysis of your feet and running style to help you prevent and treat the foot problems that often result from running.

Essential Functions of the Foot

• Feet provide your base – they play an important role in balance and support.
• Feet absorb shock – their flexibility helps to minimize impact when the foot hits the ground.
• Feet propel you forward – in addition to its role as a flexible “shock absorber,” the foot stiffens at a certain point in the running cycle to help move you forward.

Common Foot Problems

Physical therapists often see foot problems related to the way in which a runner’s foot is built:

• A very flat foot typically has too much mobility and not enough support. Individuals with flat feet (low arches) are often more at risk for pain in the tendons on the inside of the ankle, pain on the inside of the knee, or pain in the arch of the foot near the heel (plantar fasciitis).
• A foot that is too stiff usually has a high arch and is likely to be poor at absorbing forces from running. Pain in the arch and heel (heel spurs and plantar fasciitis) can result from poor shock absorption. If the foot is poor at absorbing shock then that shock often affects the individual’s low back, knees, or hips.

Common Solutions

Proper shoe choice is important for the most efficient foot function:

• Individuals with poor shock absorption (stiff feet with high arches) typically need more cushion in their shoes.
• Those who have highly flexible feet (usually low arches) often require a stiffer shoe with more support and control.
• People who have more severe problems may be candidates for orthotics (shoe
  inserts designed to support weak or ineffective muscles or joints and to provide
  necessary mobility)—either purchased over-the counter or customized.

Other Reasons for Foot Pain

There are a variety of things you can do to reduce the risk of running-related foot pain:

• Start slowly and increase your runs in increments – both in distance and speed.
• Address pain and discomfort as soon as it appears – with ice, rest, or by modifying your training program. Ignoring symptoms is a sure way to develop a permanent or recurring problem.
• Choose your running surface carefully. Hard surfaces, uneven terrain, and too many hills can lead to problems. Again, build up to them slowly if these surfaces are part of your running goal.
• Consider other types of endurance exercises to give your feet a rest and to provide a better balance to your fitness routine.
• Keep an eye on skin issues such as redness or blisters.

How a Physical Therapist Can Help
Physical therapists are experts at analyzing a body’s structure, alignment and
movement. For foot pain, this involves a detailed examination of your foot and how it
relates to the rest of your body. Many physical therapists have advanced skills in
prescribing proper footwear and orthotics. A physical therapist can provide a detailed
analysis of your running style – often using a treadmill with special video equipment.
Recommended modifications to get back to running after an injury may include special
exercises to improve strength and muscle balance as well as proper shoe choice.

Acknowledgment:
All contents © 2011, 2009 American Physical Therapy Association.
All rights reserved.