Consequences of an unsupported flat foot

As someone who takes care of a wide variety of athletes, I get to see a lot of people who participate in various sports come in with many types of repetitive or sometimes traumatic injuries of the lower extremities.  One of the most common causes of repetitive strain injuries to the lower extremities is people who are pronated or flatfooted.  If you are a pronator and you know it, and you do not use arch supports in your sneakers when you run.  You open your self up to a wide variety of injuries as a result of the altered biomechanics of the foot.  Just a few of the possible consequences that can be a result of running without the proper support are; shin splints, plantar fascitis, knee pain, ITB pain, hip pain, and lower back pain.  These areas can become injured or over strained due to the compensations that happen posturally above the foot to make up for the altered biomechanics from the foot.  Over time arthritis of the bones of the foot and toes, and other deformities of the foot like bunions, and hammertoes often accompany an uncorrected or unsupported pronated foot.


The risk of a Triathlete suffering any of the above is not uncommon during a season or career.  If you are a person who chronically suffers from plantar fascitis, shin splints, runners knee, ITB syndrome, or any other lower extremity or back injury the sooner you get into the right store bought support or custom made arch support the sooner those chronic aches and pains may go away.  Lower extremity aches and pains that do not go away with conservative treatment like orthotics, foam rolling, massage, or physical therapy could be a sign of adhesion and scar tissue build up in the muscles above the foot.  This is due to the long-standing altered biomechanics in the foot; in addition to the rigorous and repetitive training that triathlete’s endure.


One of the worst consequences of an unsupported flatfoot deformity in someone who is active is a stress fracture.  Stress fractures can occur in any of the bones of the foot, ankle, or leg.  As I sit here writing this article I have a cam walker boot on my foot due to a stress fracture of my Navicular bone in my foot.  I will have to wear this for 4-6 weeks while my bone heals.  I didn’t get this running, but rather twisted my ankle while in sneakers that didn’t have the proper support, and I have a very flat foot.  Initial x-rays did not show a fracture so I wasn’t put in a boot, just an air cast.  After 2 weeks I felt better and stopped using the brace.  After 2 long days on my feet with no brace (including HVTC race #1) I couldn’t walk again and went back to the podiatrist.  An MRI was ordered and low and behold I had a stress fracture, and a torn ligament in the bottom of my foot. I tore the calcaneal – navicular ligament (spring ligament), which will make my flat foot even worse, and being in custom orthotics even more important.


So the moral of the story is if you are a pronator and want to be the most biomechanically invincible Triathlete, get in the proper support and footwear fast. Then watch those aches and pains go away, as well as your times going down.


Dr. David Ness is a certified sports chiropractor practicing in New Paltz, N.Y.  Dr. Ness is the official chiropractor and Active Release Techniques provider for the Vassar College Athletic Dept.  Dr. Ness  has worked at the Lake Placid Ironman event as part of the ART treatment team since 2004.  Dr. Ness has been the ART provider for the Hudson Valley Tri Club since 2005 years providing free ART care after club races.  Dr. Ness also provides treatment at NYTC races around the NY metro area, and continues to work as part of the SOS Triathlon post-race care team, and at American Zofingen Ultra Duathlon.