Feet can develop lots of different issues, but if you’re simply experiencing a “sore foot” it can be difficult to pinpoint exactly where the problem lies and what it might be. Enter: The Feets. We like to get into the nitty gritty of pesky foot problems and the little niggles that can start to impact our training, so here, we’re putting two common causes of foot pain under the microscope: Low arches, and plantar fasciopathy.
Let’s take a look at what they both are, how they’re similar, how they’re different, which one you definitely shouldn’t ignore, and how you can improve your symptoms at home or by visiting a specialist.
Firstly, what are ‘low arches’?
Low arches are sometimes referred to as ‘flat feet’, or ‘pes planus’, and it basically means your feet press flat on the ground when standing, and there is no visible arch.
Low arches are very common and usually nothing to worry about. They won’t need treatment unless there are issues with function and they are stopping you from taking part in activities or training, or they are causing pain around your ankle or where the arch of your foot should be. There are various types of low arch, including:
- Flexible – This is the most common, and it’s when you have low arches only when standing, not when sitting, so the arch disappears when you apply weight. This can develop from childhood or during adolescence.
- Rigid – This means you have low arches when standing or sitting. This type often develops during adolescence and gets worse as you age.
- Adult-acquired (also known as posterior tibial tendon insufficiency) – This is when the arch of the foot unexpectedly collapses, which can cause the foot to turn outward. This is most commonly caused by tendon insufficiency due to high stress on the tendon, or a tear in the posterior tibial tendon that supports the arch.
Sometimes low arches run in the family, or they can be the result of an injury or being overweight causing the tissue in the feet to stretch. Low arches are also associated with older age, according to studies.
If you do experience symptoms from low arches, they are more likely to be exacerbated by:
- Being overweight
- Applying excessive loads to the feet (more than the soft tissues can cope with)
- Deconditioning
- Having an abnormal gait or biomechanical pattern
What is plantar fasciopathy?
Plantar fasciopathy is another common foot condition (sometimes called Policeman's Heel), but one that is more likely to cause pain. It can lead to inflammation in the tissue that runs along the bottom of the foot (the plantar fascia), and around 1 in 10 people will experience this in their lifetime.
The plantar fascia helps to support the arch of your foot and absorb any shock while walking, so symptoms can include a dull ache or stabbing pain in the heel or the bottom of the foot which often feels worse when you take your first few steps in the morning, or after sitting down for a long time.
Plantar fasciopathy tends to develop from repetitive stress (from things like running or other physical activities), and women are at a higher risk of developing it. Other risk factors include being over the age of 40, having reduced ankle mobility, having muscle tightness in your calves, having a reduced fat pad, or being overweight.
You are also at a higher risk of developing plantar fasciopathy if you have irregular foot mechanics, which can include a reduced fat pad, high foot arches, an atypical walking pattern that affects weight distribution, or *drum roll please*... low arches.
Yes, having low arches puts you at a higher risk of developing plantar fasciopathy, which is worth keeping in mind so you can keep a close eye on potential symptoms and catch any pain early.
How are they similar, and how are they different?
Low arches aren’t necessarily a problem unless they are causing you pain or discomfort, so you are more likely to experience issues from adult-acquired low arches, otherwise known as posterior tibial tendon insufficiency. Posterior tibial tendon insufficiency and plantar fasciopathy have some similarities and differences when it comes to the symptoms they might produce. Let’s compare:
|
Posterior Tibial Tendon Insufficiency |
Plantar Fasciopathy |
|
|
Location of pain |
Pain where the arch of the foot should be |
A dull ache or sharp pain along the arch of the foot |
|
How quickly the condition develops |
Posterior tibial tendon insufficiency typically develops after an injury (in around 50% of cases) |
Pain can develop quickly or over time |
|
Other symptoms |
Swelling along the inside of the foot, or the ankle rolling inwards |
The plantar fascia can feel tender or thickened (although this can only be confirmed with a diagnostic ultrasound or MRI scan) |
|
When pain occurs |
Pain could occur when standing, walking, running or exercising, and when standing on toes |
Pain can be worse when taking first steps in the morning after waking, or after sitting for a long time. As you increase movement, discomfort may ease. If you feel your foot pain getting better when you exercise, this could be plantar fasciopathy |
|
Difficulty moving feet |
Difficulty walking in certain areas, such as up stairs or on uneven ground |
It can be difficult to lift toes off the ground due to pain |
|
One or both feet |
Posterior tibial tendon insufficiency mostly affects both feet |
Plantar fasciopathy will mostly affect one foot, but an estimated 30% of patients report bilateral symptoms |
|
Long-term or short-term |
Posterior tibial tendon insufficiency is considered a short-term condition that can take several months to heal |
Plantar fasciopathy is usually a short-term condition. With treatment, symptoms can improve |
Can I ignore plantar fasciopathy?
Sometimes it can be tempting to think the pain will go away on its own if we just ignore our symptoms, most often because we don’t want to interrupt a training plan or take too much time off. Unfortunately, untreated plantar fasciopathy can lead to even more painful complications down the line, so it’s important to address it sooner rather than later.
Research suggests that with treatment, 80% of plantar fasciopathy patients will see symptoms improve within 12 months, so if you want to get back to running as soon as possible, try some of the prevention tactics and at-home treatments mentioned below.
Can I ignore low arches?
When it comes to low arches, these are usually nothing to worry about. However, if they are causing you discomfort, pain, or affecting your balance or gait, it’s best to visit a specialist who can check that low arches is definitely the problem, and that there is no evidence of plantar fasciopathy or another condition.
Can I reduce my risk of developing low arches?
Fun fact: All babies actually have flat feet when they’re born, and arches don’t usually form until later, typically by age 6. That said, around 2 in 10 children will still have low arches as adults, and it is thought there is no way of preventing this. Some adults have arches that collapse when they are older, and although there is no known way to stop this happening, it can help to remain at a healthy weight to ease potential pain from low arches.
Although you cannot prevent or reduce your risk of low arches, you can keep an eye on any pain they may be causing – remember, having low arches puts you at a higher risk of developing plantar fasciopathy, so be mindful of how your foot feels and be aware of any potential symptoms.
Can I reduce my risk of developing plantar fasciopathy?
Our philosophy at The Feets is to address as many foot conditions as possible before they start to ruin your training, rather than dealing with them after the fact. So, picking up on potential plantar fasciopathy early is the best way to enjoy uninterrupted training.
To reduce your likelihood of developing plantar fasciopathy, avoid putting excessive strain on your feet every day – only what is necessary. Plan rest time between training activities to allow your muscles to fully recover, and take preventative steps such as:
- Wearing cushioned footwear
- Keeping your BMI within a healthy range
- Increasing ankle mobility and calf strength
- Only increasing training volume and intensity gradually (never suddenly)
- Doing regular preventative foot stretches
- Avoiding overuse of the same muscles with regular cross-training
- Avoiding walking or standing for prolonged periods of time
- Avoiding wearing high heels, flip-flops or backless slippers
What can I do at home to help with low arches?
It is important to note that low arches are only an issue if you are experiencing pain or if they are affecting the function of your feet, so if this is not the case for you, there may be no need to address low arches.
If you are keen to avoid developing pain or discomfort in future due to low arches, you could benefit from seeing a podiatrist to discuss what you can do. This might include things like wearing wide, comfortable shoes with a low heel, orthotic insoles to support your feet where your arch should be, doing specific foot stretches and exercises, and more. These interventions won’t change the shape of your foot, but they can help stave off any pain or stiffness that could develop down the line.
A few exercises that can help with low arches include:
- Ball rolls – Sit on a chair and place a tennis or golf ball under one foot. Keep your back straight, and roll the ball under the arch of your foot for 2-3 minutes on each foot. This is a handy one you can do at your desk while working.
- Arch lifts – Stand straight with your feet under your hips, keep toes on the floor, and roll your weight to the outer side of your feet, lifting your arches up as you go. Doing 10-15 repetitions of this 2 or 3 times will exercise the muscles that help to support your arches.
- Towel curls – Sitting down, place a towel under your feet, keep heels on the floor and curl your toes inward to scrunch the towel. Hold for a few seconds and release, and do 10-15 repetitions 2 or 3 times.
- Toe raises – While standing, press your big toe to the floor and lift the other four toes, then switch so your big toe is lifted and the others are pressed to the floor. Hold each lift for 5 seconds, and repeat 5-10 times on each foot.
What can I do at home to help with plantar fasciopathy?
If plantar fasciopathy is causing you pain, there are a few things you can do at home to manage this. We’ve covered plantar fasciopathy extensively in our article What The Heck Is "Policeman's Heel?", so head over there for our top tips on things you can do to improve your plantar fasciopathy pain from home.
When should I see a podiatrist?
If you believe you have low arches, you do not need to see a doctor or podiatrist for this unless it’s causing you pain, discomfort or affecting your balance or gait in a negative way.
If you have experienced pain from plantar fasciopathy for around 2 weeks and have not felt improvements from trying some of the at-home remedies mentioned, then you may want to consult a specialist who can confirm a diagnosis of plantar fasciopathy (if relevant) and offer other options. A podiatrist will be the best person to help with this.
Book an appointment with one if you notice pain or discomfort that is interfering with daily activities, redness, swelling or bruising on the heel, tingly or numb feelings in the foot, or the pain keeps getting worse or keeps coming back. Treatment for plantar fasciopathy often includes things like stretching, massaging, taking anti-inflammatory medicines, and shockwave therapy (shown to be the most effective way to reduce pain and speed up recovery). The sooner you see a specialist about any pain you are experiencing, the better.
Remember, the longer you ignore any little niggles, injuries or conditions, the more pain these could cause in future. Prevention is always better than cure, especially as resting foot-related conditions make it very hard to continue any training plans you have. This means something as seemingly insignificant as a niggle of potential pain from plantar fasciopathy or low arches could end up affecting one of your biggest life goals – if that isn’t reason enough to address issues early, I don’t know what is.
Take care of your feet like they’re the only two you have, and go get it.
Logan
We’re The Feets. We know what it’s like to set the alarm for 5am, drag yourself out of a warm bed, lace up the shoes that are starting to show the miles, and head out in the grey morning to clock a few Ks before work. We’ve been there, we are there, and we’ve got your back. Follow us on Instagram for stories, motivation, tips and tricks, or just to be part of the growing community of those wanting to make something of themselves.
