Why Do I Keep Getting the Same Injuries When I Run? – Part 2

In last week’s blog post we discussed how your knee is usually not to blame when it hurts during runs. And we specifically addressed how often over-pronation issues can really impact the knee.

There is an old saying that is ‘as the foot goes so does the knee.’ This is very true.

Pronation is not inherently a bad thing. In fact we need to pronate through our feet. It is how we properly transfer forces through our body.

Pronation is the foot movement in which your foot rolls in causing your arch is getting to get lower. But when we over-pronate we put our other joints as risk for injury … including our feet.

But how do you know if you pronate too much? Do you know if your shoes are enough to provide the support you need?

Try this: Get the bottom of your feet damp and then step on a piece of paper. If your footprint has no gaps/indentation in it, you most likely have flat feet and need more support than you could get from most shoes.

[Aside: if you read Born to Run and think everyone should be running around barefoot, we have about 100 past patients that were injured by running in minimalist shoes who would tell you differently. Barefoot running can be appropriate for some runners, but certainly not all of them.]

Over-pronation can often be caused by having flat feet. The arch is NOT meant to be a weight-bearing surface of your foot. When your arch becomes a weight-bearing surface, problems begin to happen. The knee collapses and the hip begins to rotate inward. If you repeat this enough, injury is not far off.

So what can you do if you over-pronate and are at risk of injury (or already hurting)? A good pair of supportive shoes is a great place to start. Since every foot, body type, and running style is different, we can’t suggest specific shoes here in this article without evaluating your feet. So our best advice is to make sure you choose your running shoes with the assistance and guidance of a professional who has a lot of experience working with runners and shoe selection.

Though strength is very important, when your full body weight is coming down on one foot during your running stride, there’s only so much that the muscles in your feet can do. For those who severely over-pronate and collapse through the arch, even strong feet and supportive shoes may not be enough to avoid running injuries at the foot, ankle, knee, hip, or low back.

In this situation, Custom Orthotics are your best bet. They are an assistive device that are placed in your shoe to provide the exact level of support you need and to help distribute forces more evenly through the foot and up the leg. We have seen people with debilitating foot, knee, hip and back pain get amazing relief and the ability to return to running once they started using custom orthotics.

The market is filled with many options of what to put under your feet. Most over-the-counter shoe inserts and arch supports do not provide the support needed by someone who has significantly flat feet.

At Manual Medicine Spine & Sports Physical Therapy, we are experts in evaluating the foot and in the creation of custom orthotics. If you have any foot, knee, hip, or back pain when you run, it may have something (or everything) to do with your feet. If you’d like to have a free assessment of your feet and whether or not you would have less running pain with custom orthotics, call me at 202-670-8874.

Trupti Mehta, PT, MS, OCS

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