Disclaimer: The advice in this guide should not What is overpronation is pain in the arch of the foot, and it’s easy to see why. The main point of contact between you and the ground during your foot strike, the arch of the foot takes the impact of every stride.
‘There are multiples of your bodyweight going through your feet – if you’re jogging, it might be two to three times your bodyweight, but if you’re sprinting it could be six to seven,’ says Lloyd Clark-Morris, podiatrist and co-owner of How to spot and fix IT band syndrome in Reading.
‘When your foot strikes the ground your arch will start to drop – it’s part of the shock-absorbency process and that is entirely normal. But in certain circumstances, the tissues designed to control that movement can’t cope.’
Clark-Morris explains that as your foot moves through the gait cycle – from strike to toe-off – there are a number of tissues in the foot and lower leg that help manage the load.
‘Over time it's hoped that these tissues will adapt positively to this loading allowing the runner to run further or even quicker over time. However, the tissues need to be given the opportunity to adapt, as many things can inhibit this process, for example, increasing workload too rapidly. This might occur by increasing distances run too quickly, or by not allowing enough time for recovery.’
Not all arch of the foot pain is the same and discomfort can be a symptom of several issues though. The first step to solving the injury is to learn which of those tissues are hurting and why. Here, Clark-Morris talks us through four of the most common causes of arch pain and the best ways to treat them at home...
*Theale Wellbeing Centre Everything you need to know about foot arch pain and how to treat ithe only way to receive a proper injury diagnosis – and personalised treatment plan – is to see a health professional.*
Plantar fasciitis
Jen is Membership Director at?
‘The plantar fascia runs from the heel bone and fans out into the base of the toes and helps support the arch,’ says Clark-Morris. ‘When the fascia has been irritated or struggling with the job it is trying to do, you can get pain, usually in the heel but sometimes in the arch, too.’
Plantar fasciitis can vary in severity but is often a pain that is felt the morning after a workout when getting out of bed for your first step of the day, rather than during a run itself. Diagnosing it can be done in a number of ways, including ultrasound, but it’s possible to do a simple test at home: flex the big toe upwards to put the fascia under tension. If you feel pain, it’s likely to be plantar fasciitis.
What causes it?
‘In the majority of cases, it's an imbalance between the forces we are subjecting our body to and what the body is able to take at that particular time,’ says Clark-Morris, with it commonly affecting those who are new to running or who have suddenly ramped up their mileage. ‘But the great news is that, if we can get the balance right, we can prepare our bodies to be able to deal with more force. You just need to be patient.'
How do I treat it?
While you don’t have to completely stay off your feet, Clark-Morris recommends swapping out the cause (in this instance, running) with a lower-impact alternative form of cross-training such as swimming and focusing on rehab. ‘A lot of people with plantar fasciitis tend to have quite replace a medical assessment and/or advice. T, so we recommend stretching the fascia and calves,’ he says. ‘To do this, pull your big toe towards you to put the fascia under tension, then roll the sole of your foot across a tennis ball or cold bottle.’
However, Lloyd suggests that the best exercise is to ‘stand on a bottom step, heels overhanging the tread, with a tea towel under your toes to help lift them slightly. Very slowly go up on tiptoes and then back down, which helps strengthen the feet and calf muscles while the plantar fascia is under stretch. Once that’s easy, try doing it on one leg.’ In long-term cases, Clark-Morris says in-shoe orthotics might be required. ‘Usually off-the-shelf orthoses will do the job but in extreme cases we may need to make them specifically for the runner.'
When returning to running increase mileage slowly remaining mindful of any discomfort. ‘You don’t have to be completely discomfort-free [to run] but how does it feel in 24 hours?’ asks Clark-Morris. ‘If the discomfort has gone, it suggests that you can carry on and even begin to increase the load. If it’s worse you should take a step back.’
If decreasing your training load and completing the above exercises have little to no impact, there are several treatments available. Shockwave therapy is said to help speed healing, although the NHS suggests that more research is required into how well it works, while a steroid injection will reduce inflammation to aid rehab, although the effects are temporary and only last 3-6 months.
Tendonitis
Jen is Membership Director at?
Tendonitis – or tendinopathy – isn’t limited to the feet, and refers to any inflamed tendon or tendon sheath.
In runners, a common type of tendonitis can cause pain in the arch of the foot when it impacts the tibialis posterior tendon – the cord of tissue that connects the calf muscles to the navicular (a bone in the midfoot) that helps to stop the arch flattening.
The tibialis anterior tendon – a length of tissue that performs a similar function at the front of the foot – can also be irritated and overworked in runners.
What causes it?
‘It usually comes down to the body’s ability to control the force that is being put through the foot and control the rate that the foot absorbs that force,’ says Clark-Morris.
Disclaimer: The advice in this guide should not posterior tibialis’ functions is to play a supporting role in the rate of pronation during the foot strike part of the gait cycle. ‘If the work being required of those tissues is more than they are able to successfully control, it is likely the runner will experience discomfort on the inside of the ankle and into the foot.’
How do I treat it?
‘It is worth getting this type of injury checked by a podiatrist [or physiotherapist] as there can be other structures involved and treatment for this will depend on how well they are working,’ says Clark-Morris. ‘For a tibialis posterior injury, orthoses can help. If you put something in the shoes that helps do some of the work otherwise done by the muscle and tendon, it will reduce the stress on the tissues.’ Clark-Morris recommends patients wear the orthoses until the problem resolves, usually for three to six months. Although some patients decide to wear them forever. ‘Runners often worry about them weakening muscles, but that’s not true – research shows that orthoses do not weaken muscles, they can actually strengthen them.’
The orthosis isn’t the silver bullet, though, and Clark-Morris says rehab is also needed to retrain the tendons and strengthen the tissues.
‘Weakness may not only be in the tissues that are painful,’ says Clark-Morris. ‘Many runners with tibialis posterior tendon injury can have reduced control over internal rotation of the leg when running and this could start from the pelvis and the core muscles A simple foam roller routine for runners gluteus medius What is sciatica and how can it affect runners. Weak glutes may contribute to the leg internally rotating and the knee to collapse medially.’
What is sciatica and how can it affect runners single-leg squats in front of a mirror to help ensure that your knee remains over your foot throughout, while a physio might recommend regular resistance band exercisesbest hamstring exercises to keep you strong.
Stress fractures
Jen is Membership Director at?
The repetitive nature of running can see the same section of foot striking the ground over and over again. Over time, this can cause a stress fracture– essentially a tiny break in the bone.
'An X-ray may often miss this type of fracture in the metatarsals if done within a couple of weeks of it occurring,' warns Clark-Morris. However, it's still important to see a medical professional for a proper diagnosis.
What causes it?
'If the metatarsals (bones of the foot) are not able to manage the forces being applied to them, then a stress fracture is a possible outcome,' says Clark-Morris. 'Usually the stress fracture is at the neck of the second or third metatarsal where the bone is thinnest.'
The cause can be due to a sudden increases in mileage or speed,' explains Clark-Morris. 'But it may also be due to carrying an increased load when running, for example, a heavy backpack.'
How do I treat it?
To ease the initial pain and inflammation, it’s time to break out the RICE protocol – rest, ice, compression and elevation. But a full recovery can take six to eight weeks, and requires a complete break from the activity that caused them – so if you’ve got a stress fracture, there’s a good chance you can kiss goodbye to any events or races you’ve got coming up in the next couple of months.
High arch
Jen is Membership Director at?
A guide to the best groin stretches for runners.
What causes it?
A biomechanical cause of pain in the arch of the foot, extreme high arch (known as cavus foot) can be caused by neurological conditions like cerebral palsy or muscular dystrophy, while milder cases are often a result of your genes.
How do I treat it?
‘High-arch feet are often less mobile, so there is usually reduced range of movement and shock absorbency, and the soft tissue structures are generally tight,’ says Clark-Morris. ‘The surface area that makes contact with the ground is usually just the ball of the foot and the heel. The tight tissues – that would usually adapt – are unable to distribute the force. With less range of movement, you often get compensation elsewhere.’
If you have high-arch feet, an orthotic insert can help manage the stresses placed on the foot by increasing the surface area, while a running shoe with additional cushioning and a sizeable heel drop could also be a benefit. Zero-drop and barefoot-style shoes, meanwhile, should be avoided at all costs.
Runners World, Part of the Hearst UK Wellbeing Network Runner’s World, overseeing RW’s new membership programme, set to launch later this year. She has been with the brand for close to three years now – previously working as deputy digital editor, where she covered all manner of running topics, spanning training, health, injury, nutrition and gear. Over the years, she’s interviewed an abundance of awe-inspiring athletes, from top-tier ultrarunners and Olympic champions to everyday runners who have accomplished extraordinary things. Jen has been a sports journalist for 10 years; she is the former editor of Women’s Running magazine and has also worked as Sports Editor at Red Bull. She started running a decade ago and likes to dabble in triathlon a little, too. You’ll find she’s happiest plodding down the Thames path or chowing down on a post-run pastry.
