Running with Flat Feet

Running is one of the most common forms of exercises and the motion of running is involved in a variety of sports and competitions around the world. Feet play a very important role in contributing to the body’s ability to run, whilst running up to 3 times your bodyweight can be absorbed by the foot. The foot both stabilizes the lower limb and also provides shock absorption. Everyone has different shaped and positioned feet, all these different foot types affect both the function of the foot and the surrounding structures. Flat feet are common and can potentially create problems in your feet and other components of your lower limbs due to the medial longitudinal arch collapsing and creating excess pressure in the region. Although not all runners with flat feet will develop any issues nor experience any pain.

What are Flat Feet

Flat feet or a pronated foot type, is when the arch is lower to the ground or in some cases completely flat and touching the ground which reduces the bodies ability to absorb the shock. The scientific name for a flat foot is pes planus. With this flattening of the arch, the surrounding structures also become affected. These structures include the foot, ankle, knee, hip and lower back. This occurs as the altering of the position of the foot places increased pressure on these surrounding structures. For example pronation of the foot can cause the knees to internally rotate which can lead to pain on the inside of your knees. If you are curious about how your feet are looking and want an opinion on their position then go see your podiatrist as they will be able to identify your foot position.

Flat feet do differ from person to person and they are often described as two types of flat feet, rigid flat feet or flexible flat feet. A flexible flat foot is a term used to describe a flat foot which is able to function normally during gait, but this does not exude a flexible flat foot from causing pain.

A rigid flat foot is usually the cause of abnormal foot development, this may include coalition (or natural fusing) of joints.

What causes flat feet?

Flat feet can be as a result of a variety of reasons but most commonly they are the result of your genetics. However it is important to note that if your toddler does not have an arch then there is no reason to panic as arches develop after a few years. There are medical conditions that affect development and result in flat feet such as muscular dystrophy and cerebral palsy. Damage and issues with the nerves of the foot can also result in flat feet, this can be directly linked to those who are living with diabetes. Pregnancy is also a risk factor for developing flat feet as during pregnancy there are a lot of changes occurring in the body. Both tendons and ligaments become lax as well as increased and rapid weight gain contribute to the collapsing of the arch as the muscles also begin to collapse. Continuing on with the weight gain, obesity is another risk factor for flat feet, the greater the load your body has to support the more likely your muscles are going to be unable to adequately support the foot.

Injury and trauma to the feet and lower limb can also result in a flattening of the medial longitudinal arch. There are a variety of bones, muscles, ligaments and tendons that all play a role in supporting the medial longitudinal arch. So damage to structures such as the calcaneus, the plantar aponeurosis and the posterior tibial tendon can all potentially lead to the medial longitudinal arch collapsing or lowering. Trauma and injury are not the only things that can result in a flattening of the arch, weakness in the muscles, ligaments and tendons can also contribute to flat feet. Over time both through consistent strain and aging, we can see that the ligaments and tendons stretch which can also lead to the flattening of the medial longitudinal arch. The shoes that we wear as well as the type of exercise and activities that we undertake can contribute to the function and trauma on the muscles, ligaments and tendons.

There are also some risk factors that can increase your chances of developing a flattened medial longitudinal arch. As briefly mentioned earlier those living with diabetes have an increased chance to develop flat feet due to the implications that diabetes can have on the nerves if both poorly controlled and over a long period of time.

How Does Flat Feet Affect Running?

Flat feet can affect running both in the feet and also the surrounding structures in the lower limbs. Due to the intense nature of running and the load (up to 3 times your body weight) that your feet must withstand, having flat feet can potentially be problematic. As a result of being flat footed, runners are more likely to have a movement within your foot called overpronation occuring. Overpronation is when your medial longitudinal arch collapses even further to the ground whilst weight bearing and through the motion of running. This normally results in the inside of your ankle rolling in as well as internal rotation of both your knees and hips. As a result due to the biomechanical changes, certain structures are required to bear an increased load such as the plantar fascia and posterior tibial tendons. Some common conditions associated with over pronation and running can be medial tibial stress syndrome (shin splints), medial knee pain, lower back pain and pain in your arches which could be plantar fasciitis or posterior tibial tendinopathy. However just because a runner has flat feet does not mean that you will over pronate to the point that it becomes problematic, some runners have nil issues with their feet even though they have a lower arch.

Is It Bad to Run with Flat Feet

You are fine to run with flat feet as long as you are aware of a few things. If you have a pronated foot type and have been running for years without any issues then this is a good sign you are not having too much pronation occurring. If you have flat feet and have pain whilst running it would be a good idea to go visit your podiatrist so they can help you get back to running pain free. Also it would be advised to reduce your running load if you are in pain as we want to avoid developing an injury. Footwear is very important for a runner and having the right shoes when you have a pronated foot type. Even if you are pain free and a runner with flat feet it would be advised to have a nice supportive shoe with some built in arch support to reduce any over pronation.

Can you Fix Flat Feet

Flat feet do not need to be fixed but rather improved, if we can improve the overall function of a flat foot and its surrounding structures then that should allow for pain free movement and in particular running. Flat feet in children will often fix themselves as they develop and grow stronger. Not all children will however develop an arch and instead will require some help from a podiatrist to improve their overall foot function. There are a variety of options that can be used to improve the function of a pronated foot. Footwear is a key component as running in non supportive and flat shoes does not help to reduce the amount of pronation that may occur in someone with flat feet. Your podiatrist may also develop a strength and conditioning program for the muscles around your feet. They may also look into some form of insole/orthotic device to help correct your foot position.

Techniques for Running with Flat Feet

Running with flat feet can potentially be problematic for some individuals and even if there are no issues at the current time, there is a chance that a problem may develop later down the road. Your podiatrist will be able to offer you some advice and give you some techniques to help improve the function of your flat feet.


Your podiatrist will begin by assessing your feet, both how they function when standing and also whilst in your gait (walking/running technique) by getting you onto the treadmill. They will take you through a series of related exercises to assess muscle, tendon and ligament strength such as calf raises and single leg balance. All the exercises will directly relate to foot function to see if there is an area of concern that needs to be directly addressed within a strength and conditioning program. They will also directly assess and test all of your intrinsic foot muscles which are responsible for supporting your medial longitudinal arch. There are exercises that can be prescribed to improve your intrinsic foot strength such as toe yoga. Your podiatrist will be able to make a program specifically for you. Depending on your running style, they may look into some form of orthotic intervention. Through the use of an insole, we can improve the position of the foot in order to allow the structures to perform their designed roles and the overall function of the foot. Speak to your podiatrist to see if any of these treatment methods may be applicable to you.


Footwear is very important for running in general regardless of your foot type. One thing to consider is if you have orthotics then these should be tried on with all shoes and ideally in a neutral shoe. A couple of things to look for in shoes are a nice firm heel, plenty of room in the toe box (front of the shoe) and the only bend in the shoe should occur where the toes would be bending whilst pushing off when walking/running. You also want a shoe with a good amount of stability and also cushioning to aid with shock absorption. Support types of running shoes for flat feet individuals can help to reduce the amount of overpronation seen in the foot and ankle. Your shoes will also depend on if you have a pair of orthotics you want to fit into the shoe. You may require a runner that is deep and wide to fit the orthotic device into the shoe. Some running shoes for flat feet to consider include the New Balance 880’s or 1080’s, Brooks Adrenaline and Asics Gel Kayanos. Other brands that are good include saucony and mizuno. It would be a good idea to talk to your podiatrist about the best shoes for you or to go down to places such as active feet or the running company to try on a variety of pair of shoes.

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