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Basic Foot Types in Runners

Just as a body structure varies from person to person, so too does the basic foot type and functional capacity.  One’s performance in jogging, to a large extent, is determined by the various physical parameters, which exist in the lower extremities.  Obviously, there are cases where these positional and functional limitations have been overcome but for the most part, without professional care, the performance of such a runner can be seriously hampered.  In order to understand this topic more fully, let’s take a closer look at what some of the more common limiting factors are. 

       

Essentially, we have three basic foot types, which are distinguishable both clinically and by radiographic studies.  The high arched foot or “pes cavus” type resembles two pillars of weight supporting an overlying curved beam.  This type of foot is rarely flexible and its inherent rigidity causes it to be a poor sock absorber.  When exposed to distance running, the high arched foot will often break down and develop such common ailments as metatarsal head and heal pain, knee problems, and Achilles tendonitis. 

 

A second common foot type is the low arched or flat foot “pes planus.”  Within this category, a structural versus positional type must be further distinguished.  A structural flat foot is one where the bony relationships determine the lowered pitch of the arch.  In other words, regardless of an individual’s foot motions, the foot structure is still flat or of a low arch type.  The positional flat foot is usually a medium arch type, which excessively pronates or rolls in at the arch upon weight bearing.  Although the final appearance is that of a flat foot, a simple test can usually distinguish the difference.  A weight bearing x-ray taken at the podiatrist’s office will often reveal a lowered arch height and/or an excessively pronated foot. However, when the individual sits down and thus, assumes a non-weight bearing position, the apparent flat foot changes to a medium arch type. 

       

Our last foot type is the medium arched foot.  As the name implies, this type of foot has an arch height which is neither too high nor too low. I purposely avoid the use of the words normal and abnormal, since their application in discussing foot types is both confusing and misleading.  The medium arched foot is structured to allow for maximum weight distribution and dissipation of stress and pressure.  However, we now know that it is the functional performance of the foot and ankle throughout the gait cycle, which actually determines the overall results. 

       

An interesting subject of discussion concerns the relationship of foot type and treatment.  In short, which type of foot structure requires which type of treatment?  The most important point to keep in mind is that we do not treat foot types but rather foot conditions.  Being able to assign a particular foot structure with a label is convenient and of some descriptive value.  However, as a foot specialist, I am more concerned with how that particular foot type functions throughout the gait cycle.  It is true that from experience, it is possible to make certain statistical predictions as to the need for treatment.  As stated previously, the high arched foot type is a poor shock absorber.  Thus, its ability to withstand the repetitive stress and pressure of running is often a problem.  Patients with such a foot type often require treatment in the way of supportive devices in order to better cope with the rigors of running.  The excessively pronated foot is the one which presents with a wide assortment of compensatory problems ranging from knee pain to calluses.  This type of foot, when problematic, usually requires supportive treatment geared toward limiting the excessive motions. 

 

The flat foot and the medium arched foot, which do not excessively pronate, may often times not be a problem requiring any kind of treatment.  These feet may function very well throughout the gait cycle and may well be ideal for marathon running.  But, as expressed earlier, it is the functional performance and not the structural type of foot which determines the need for treatment. 



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