By Paul Freary
Foot shape and structure play an important role in running performance and injury prevention. Variations such as flat feet (pes planus), high arches (pes cavus), and broad feet can influence biomechanics and your running gait, affecting how forces are distributed during the gait cycle.
Recognising these differences is an important factor for runners aiming to optimise performance and minimise the risk of injury.
Flat Feet (Pes Planus)
While many people may have been told at one time or another that they have ‘flat feet’, it is important to consider the FUNCTION of the foot as well as the shape of the arch.
The 26 bones in the foot and 33 joints, there are many factors and considerations to be aware of, than simply the shape of the visible arch!
Flat feet are characterised by a collapsed medial longitudinal arch, resulting in the entire sole of the foot coming into near contact with the ground. This condition can be congenital or acquired over time due to factors like ageing, injury, or prolonged stress on the foot.
Biomechanical Implications
Individuals with flat feet can often exhibit overpronation, where the foot rolls inward excessively during the gait cycle.
Although being ‘flat-footed’ doesn’t mean you will always over-pronate. The flexibility of the foot is also a consideration. * See research insights below.
Overpronation can lead to:
Injury Risks
Overpronation associated with flat feet can predispose runners to various injuries, including:
Research Insights
A study with Royal Australian Air Force recruits found no significant correlation between flat feet and increased injury risk during basic training. Interestingly, some military studies suggest that individuals with flat feet may experience fewer stress fractures compared to those with high arches.
https://academic.oup.com/milmed/articleabstract/170/7/623/4578164?redirectedFrom=PDF
Footwear Recommendations
For runners with flat, overpronated feet, consider the following types of footwear.
Good examples of footwear that I have found to help control overpronation include Brooks Adrenaline GTS24: A great value supportive shoe with ‘GuideRails’ to support the rear foot.
Brooks Glycerin GTS22
As with the Adrenaline GTS, the Glycerin uses the same type of support/control, but with a higher stack of cushioning.
New Balance 860v14
An everyday trainer with a dual-density midsole that is slightly firmer on the medial aspect to control overpronation.
Saucony Guide
Thanks to the geometry (shape) of the midsole cushioning, this shoe ‘guides’ the foot into a neutral position through the gait cycle. It works very effectively without additional elements and therefore keeps the shoe light in weight.
Mizuno Wave Inspire
Thanks to the brand’s WAVE technology, the shoe reduces overpronation, with the WAVE being stronger on the medial side.
This isn’t a complete list, and most major manufacturers have shoes in their running-specific lineups which are designed to control pronation.
High Arches (Pes Cavus)
A high arch is indicated by an exaggerated elevation of the medial longitudinal arch, leading to a hollow appearance of the foot. This condition can be rigid or flexible and is less common than flat feet.
Biomechanical Implications
High arches often result in underpronation or supination, where the foot rolls outward during the gait cycle. BUT, like a flat foot, the flexibility of the arch is a major contributor to the movement of the foot. Put simply, a rigid, inflexible foot would supinate, and a very flexible foot would be more likely to overpronate.
Consequences of the inflexible, high arch include:
Injury Risks
Supination associated with high arches can lead to:
Research Insights
Stress fracture of the distal fibula in flatfoot patients: case report
https://pmc.ncbi.nlm.nih.gov/articles/PMC4484018/#:~:text=Conclusion,to%20contribute%20to%20this%20condition
Injury-reduction effectiveness of prescribing running shoes based on foot arch height: summary of military investigations
https://pubmed.ncbi.nlm.nih.gov/25155917/
Footwear Recommendations
For runners with high arches and more rigid feet:
When fitting runners that have a supinated gait with running shoes, I have found the following work well, thanks to their natural flexibility. The following shoes tend to have softer midsole cushioning and be more flexible than many neutral models. The combination of soft cushioning and flexibility helps to add a little pronation to the otherwise ‘stiff’ foot and gently pronate it into a more neutral position.
New Balance 1080
Its deep stack and soft midsole can bring a rigid foot into neutral.
Saucony Triumph
Again, its softer midsole foam helps neutralize the foot.
HOKA Clifton
Another soft, well-cushioned shoe that adds a little flexibility to an otherwise stiff foot.
Brooks Adrenaline GTS
While considered a support type shoe, the natural of the GuideRails can help bring the foot into a more neutral position (try in store if possible)
Again, aim for softer cushioned shoes that are more flexible in the midfoot section to aid natural pronation.
Broad, Wider Feet
Broad feet refer to a wider foot structure, often requiring more space in the forefoot and toe box areas. This can be a natural anatomical variation or develop over time due to factors like weight gain or pregnancy.
Biomechanical Implications
While broad feet don't directly affect pronation, ill-fitting shoes can lead to:
Injury Risks
Improper footwear for broad or wide feet can cause:
Footwear Recommendations
For runners with broad feet:
The first consideration for broader or wider feet would be to determine the type of shoe required to provide the correct level of cushioning and control and then check if this model is available in various width fittings.
For example, a very popular neutral running shoe such as the Brooks Ghost 16 or soon to be released (June 2025) Ghost 17 is available in men’s widths B (narrow) D (regular) 2E (wide) and 4E (extra wide) and women’s widths; A (narrow) B (regular) and D (wide).
Other brands, including New Balance, Saucony and HOKA, all offer width fittings in some of their more popular models.
Some brands, such as Altra, Topo and INOV8, offer shoes with what they describe as a ‘foot-like’ last. These generally have a slightly broader fit across the mid and forefoot.
The Role of Pronation in Running
Pronation is the natural inward roll of the foot during the gait cycle, essential for shock absorption and propulsion. Variations include:
Understanding one's pronation type is crucial for selecting appropriate footwear and preventing injuries.
Research Insights
A study was published in the British Journal of Sport Medicine. The authors monitored 372 recreational runners during 6 months for injuries (average weekly training = 2 x 9km at 6min/km or 10min/mile). Runners were randomised to either neutral cushioned shoes or motion control shoes. The study concludes that runners with pronated feet show a decreased risk of injury while wearing motion control shoes compared with neutral cushioned footwear.
Injury-reduction effectiveness of prescribing running shoes based on foot arch height: summary of military investigations
https://bjsm.bmj.com/content/50/8/481.short?rss=1
Footwear Selection and Comfort
Recent research emphasises the importance of comfort in shoe selection. A study published in the British Journal of Sports Medicine suggests that runners should prioritise comfort over traditional motion control features, as comfortable shoes may reduce injury risk more effectively.
What are the perceptions of runners and healthcare professionals on footwear and running injury risk?
https://bmjopensem.bmj.com/content/bmjosem/6/1/e000767.full.pdf
In Conclusion
Recognising and understanding your foot type, flat feet, high arches, or broad feet, is important for optimising running performance and minimising injury risk. By selecting appropriate footwear and considering individual biomechanical needs, runners can enhance comfort, efficiency, and overall enjoyment of the sport.
Note: For personalised advice based on your natural running gait, consider visiting a specialist running store with educated staff and gait analysis equipment to assess your foot structure and running gait. If in doubt, consult a medical professional before undertaking physical activity or continuing to take part in any activity when you are injured.
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