By Rehan Iqbal
The arches and heels of my feet hurt, what do I do?
A simple no nonsense summary of why your feet hurt and what you should do about it.
In our previous article we discussed arch pain. The anatomy and biomechanics involved, the causes of the pain and how it can affect your running and training in general. In addition to this we paid special attention to the most common causes of arch pain in runners:
Both of which affect a significant population of runners and are unfortunately causes of arch pain that cannot be fixed with a simple pill or new exercise technique. Additionally we also concluded that these two causes are usually involved with arch pain symptoms that affect said arch in isolation. All in all, arch pain has proven to be a complex condition that doesn’t get the time of day it deserves.
But what happens in the instances when arch pain isn’t the main symptom? When arch pain forms part of a group of symptoms you might experience. We are now looking at our feet as a collective, for those times where your arch pain isn’t an isolated incident. So join us as we approach foot pain from a few different angles while answering some of the most searched, foot pain related questions on the internet!
“Why do my feet hurt when I get out of bed in the mornings?”
“Is flat feet a cause of arch pain?”
“What’s the difference between flat feet and pronated feet?”
So without further adieu, let’s get straight into it shall we?
This is a loaded question to be fair, because all feet kind of look flat when you're doing a posture analysis. You have foot posture during stationary stance (standing) and during movement (gait).
However, the term flat feet is used interchangeably, referring to our feet posture when standing still but also how our feet make contact with the ground during movement. This is wrong as there is a marked difference between someone who has flat feet and someone that has pronated or overpronated feet. But more on that a bit later.
When you speak about flat feet, you are referring to the anatomical structures of your feet. These structures determine the postural orientation of your feet. So if you have very rigid bony structures and short and tight connective tissues, your arch usually maintains its shape during a stationary stance. However, in people with flat feet this isn’t the case, in fact the opposite is true;
People with flat feet lack rigidity in their arches during load bearing. In layman’s terms, your arches completely collapse when standing.
But What Causes Flat Feet?
This is completely unique to the individual struggling with the condition. Because flat feet have multiple causes but they aren’t all applicable to every single person suffering from flat feet.
The most common cause of flat feet is congenital issues stemming from a lack of proper development as a toddler. Now before you throw a fit, please understand that no one is suggesting that your lovely children are by any means less than; nor are we suggesting that you are in any way or form a bad parent. Every child develops in their own unique way and the fact remains that some children struggle with developmental limitations. And unfortunately this can lead to your child’s arches never properly developing which leads to them having flat feet in their adolescent and adult life.
Some less common causes of flat include:
These causes of flat feet aren’t as common as developmental limitations but they still cause flat feet in a limited demographic of people.
So how do you know you have flat feet? Well, if your foot arches collapse while standing then you have flat feet.
That being said, if flat feet are characterized by collapsed arches during stationary load bearing, what are arches that collapse during movement?
Pronation and Overpronation During Running
When you’re standing and your feet arches collapse, you have flat feet. But when this happens when you’re walking or running, it is known as foot pronation or in some cases overpronation.
During your walking or running cycle, your foot makes ground contact. This contact will have a specific pattern or shape depending on multiple factors.
Now for those of you suffering from pronated or overpronated feet, if I were to do a full gait and posture analysis and examine your foot contact pattern, I am willing to bet that your foot pattern during a stationary position would resemble the pattern of your foot contact during your gait analysis. This is because flat feet lack a rigid arch during the contact phase with the ground. And it is in cases like this, where we as nerdy scientist dudes classify your feet posture as pronated or overpronated depending on your gait analysis.
But Why Do My Feet Hurt in the Mornings?
The simple answer here is that 9 times out of 10 you’re dealing with a case of plantar fasciitis. Now this is a topic that is extensively covered on the internet. But not so much as to why exactly you experience the symptoms you experience. I mean why are painful feet characteristic of plantar fasciitis. Well let’s find out together shall we?
Plantar Fasciitis - A Quick Recap!
Your plantar fascia is a connective tissue sheath that originates at the base of your heel and attaches to the base of your tarsals (toe bones). It acts like a bowstring that assists in the biomechanics of our feet. The primary purpose of the plantar fascia is to act as a shock absorber as your feet make contact with the ground. So essentially, the plantar fascia provides stability at the base of your feet during movement.
Plantar fasciitis is an inflammatory condition that affects the connective tissue fibers of the fascia. The fascia may become irritated due to overuse or acute loading and cause damage to the connective tissue fibers resulting in a painful inflammatory response.
Causes of plantar fasciitis:
In a nutshell, these causes result in micro tears in the fascia tissue. As this progressively worsens over time it causes irritation and ultimately your body will have an inflammatory response. And that ladies and gentlemen is plantar fasciitis.
What are the Signs and Symptoms of Plantar Fasciitis?
All of the above are quite specific to plantar fasciitis, however some of these are also associated with other injuries such as stress fractures, achilles strains or ankle ligament sprains. But from this list of symptoms, one remains very unique to plantar fasciitis - Excessive pain in your heel area upon waking.
But why does this happen? Well it all has to do with circulation also known as blood flow. You see when we rest or sleep in this case, our body dictates where blood flow is needed most. Blood flow is sent to vital organs to ensure we don't die during our sleep. And because we aren’t moving our body restricts blood flow to the extremities. This lack of circulation results in your plantar fascia, which is already inflamed and irritated, to become stiff and poorly perfused.
And that is why when you wake in the mornings your symptoms appear significantly worse and progressively gets better the more you move. IE: There is increased blood flow to your plantar fascia.
Our final thoughts…
In a nutshell, our feet are complex structures. Injuries to our feet can be both nagging or debilitating. Everyone’s feet are unique, meaning that the risk factors associated with each persons’ feet will depend on many different factors.
And that is why understanding your feet and the potential conditions you could suffer from is a good tool to have in your tool box. So from here on out, you guys have no excuse. Because now you have the knowledge and the practical tips to ensure that your feet aren’t going to hold you back!