A New Year’s resolution: support patients in their stride, foot foundation

A supportive foot foundation is crucial to help the body deal with that additional weight pressure, impact and stress …

January signals a fresh start for many patients. For almost 75% of the American public last year, this included making traditional New Year’s resolutions.¹I’m sure you can guess what the prevailing resolution centered around, because statistically, many of our patients made a similar one — it was improving their health. And when it comes to exercise, one of the most popular forms is running, where the foot foundation is key.

In the U.S. alone, 60 million Americans report engaging in some form of running.² Like any exercise, proper form and function is essential to keep them safe and able to run for many years. The mechanics behind the act of running are interesting – especially if one considers all the forces that a runner must overcome, the foremost being gravity.³

There are three primary, gravitational forces at play when a person begins the act of running:

The horizontal force due to the contact between the runner’s foot and the ground
The vertical force due to the contact between the runner’s foot and the ground
The force due to gravity which pulls down on the runner

The propulsive force and gravity

The runner must overcome the vertical force in order to accelerate horizontally, and for a true run, the force of gravity has to be overcome in order to propel the runner in the air. The force that propels the runner is aptly called the propulsive force.

A runner’s speed is directly related to the explosiveness of this propulsion. Olympic sprinter Usain Bolt can push off with a peak force of 1,000 pounds, which is almost double the average person. This allows for pretty incredible speed in a sprint.⁴

One of the most interesting aspects of running is the surprising amount of time the runner’s feet come into contact with the ground. Remember, running does have to compete with gravity, and a sprinter can truly defy gravity for a portion of the running cycle. An average sprinter’s foot makes contact with the ground for only .12 seconds. An Olympic sprinter? Try .08 seconds.

So why is so much emphasis put on proper footwear and stabilization with running if the feet are only touching the ground for a split second? It all comes back to those forces. The vertical force of a runner’s feet on the pavement is anywhere from 5-12 times their body weight.⁵

Supporting the foot foundation

No matter whether your patient is an elite athlete or simply a person who is exploring a running program for proactive health, there is one thing all of them need. A supportive foot foundation is crucial to help the body deal with that additional weight pressure, impact and stress, while helping reduce the risk of injuries during training and their regular runs.

You can give that to them by recommending custom flexible orthotics to balance and align all three arches of the body, as well as quality shoes that provide the proper support. Choosing the right stabilization should be based on their arch height, foot type and fit. We can help by educating our patients.

Let’s break each of those down more:

Arch height — Ask your patient to imagine their footprint in the sand:

Neutral arch is considered “normal” and displays an even weight distribution on both the balls of the feet and heels caused by an appropriate amount of inward foot roll. This is known as pronation.
Flat arch or “low arch” is caused by excessive inward movement, or overpronation.
High arch is caused by minimal inward movement, or underpronation.

Foot shape — look at the bottom of any of your patient’s shoes and examine the soles. Chances are you’ll be able to determine their foot shape by the wear pattern on the shoes:

Wear pattern is even = neutral arch/normal pronator.
Wear pattern is thinner on the inside portion of sole = flat or low arch/overpronator
Wear pattern is thinner on the outside portion of sole = high arch/underpronator

Shoe Fit – How the shoe feels with activity. For an ideal fit, an easy rule of thumb is that there should be about one finger’s length between the longest toe and end of the shoe, and the same space between the heel of the foot and back of the shoe.

Now that your patient has identified their foot type and arch height, focusing on the fit becomes more about isolating the style of running shoe. The options for shoes align with the foot shapes and arch types we have already discussed.

Neutral arch (Stability) — Stability shoes are most often constructed with high-density foam which supports and stabilizes the rear-foot while allowing flexibility in the forefoot. They are best for runners with “normal” arches and minimal foot/ankle control issues.

Flat arch (Motion Control) — Motion control shoes characteristically have a more rigid framework and can be made from materials such as fiberglass or plastic, but typically high-density foam. The arches are built up for increased foot foundation stability, as these cater to those with flat or low arches. They are also a good solution for heavier runners who, due to low arches, tend to overpronate as the built-up arch keeps the foot from rolling inward.

High arch (Cushioning) — Cushioning shoes are more lightweight and extremely flexible. This combination of minimal stability and maximized comfort is suited for runners with high arches and rigid feet who tend to underpronate. Allowing more flexibility at the ankle will encourage more inward roll.

Support the patients’ kinetic chain

Shoes alone, however, may not provide the complete foot foundation support to suit your patient’s individual foot type or fit. The addition of custom flexible orthotics can truly elevate their running and support the kinetic chain through all phases of the gait cycle as well as to reduce shock during heel strike and increase propulsion on toe-off.

So, what’s the secret to keeping a New Year’s resolution to stay active? Ask your patients to invest that holiday bonus into their health, their foundation and their feet.

ERIN STUBBLEFIELD, DC, is a 2006 graduate of Palmer College of Chiropractic in Davenport, Iowa. After years of private practice in Illinois, she moved to full-time teaching in Overland Park, Kan., a suburb of Kansas City. She is an associate professor, author and presenter. For additional information, she can be reached at stubblefield.erin15@gmail.com.