Interesting study: Does arch height predict your running injuries?

Well, maybe. I'm a high-arched forefoot striker running in lightweight neutral shoes. In 40 years of running I've had exactly one bone-related injury, a metatarsal stress fracture that healed completely and never recurred. But I've had many soft-tissue injuries practically everywhere except the knee, and for the past three years I've been dealing with a particularly stubborn Achilles tendinopathy. Of course, tendencies based on large numbers of cases won't necessarily apply to any individual.

Why don't LetsRun do their own study? It would be interesting to see...

-Female here

-high arches/stiff ankles

-never had a stress fracture or shin splints

-had achilles, ITB, knee and hamstring, PF injuries in the past

Daughter #1

-High arches/flexible ankle

-shin splints but no fractures

Daughter #2

--High arches/stiff ankle

-PF and ankle tendon strain due to fall and never healed probably, no fractures

amkelley wrote:

Well, maybe. I'm a high-arched forefoot striker running in lightweight neutral shoes. In 40 years of running I've had exactly one bone-related injury, a metatarsal stress fracture that healed completely and never recurred. But I've had many soft-tissue injuries practically everywhere except the knee, and for the past three years I've been dealing with a particularly stubborn Achilles tendinopathy. Of course, tendencies based on large numbers of cases won't necessarily apply to any individual.

This is me also. One stress fx but healed and never any other bone issues. But have had many sod tissue problems (low back, hip and calf). I have really stiff ankles in addition to high arches.

How does one differentiate between low and high? I think I have high arches, I've seen way higher..they certainly aren't flat. Is it possible to be in the middle? How does one know?

Sports med running specialized foot and ankle physician here. "Arch height" is overly simplistic. There are flexible high arches, rigid high arches, flexible and rigid low arches, each with their own set of distinct "issues". To further cloud the subject, there are 3 planes of motion of the rearfoot and midfoot, which combine to create the motions of pronation and supination, which also govern arch and foot alignment. For example, there are people with high arches who overpronate tremendously, causing a twisted forefoot on rearfoot alignment, due to transverse plane dominant overpronation. The arches are high when these people are standing, but you'll see a huge bulge on the the instep. People with "flexible" high arches also often overpronate significantly. Their arches are high when seated but collapsed significantly from this alignment when standing. These feet will have issues that do not necessarily fall into the "high arch"/"low arch" black and white compartmentalization that is suggested herein. To further cloud the picture, as one poster suggested, is that feet run a spectrum of alignments and combinations thereof. It's just not that simple. Add leg, knee, and hip alignment, ligament and musculotendinous imbalances or contractures, running form/technique(ex., overstriding), body weight, running shoe choice, running surface, training errors, nutritional errors, underlying medical conditions (osteoporosis, etc.), training environment, lifestyle and occupational influences etc.,, and the influences on what kind of injury is related to "flat vs. high arch" becomes ridiculously murky.

BUT, all that being said, of the thousands of running injuries I've evaluated over the past 20 years, it has become clear that there are certain injury patterns more associated with rigid, underpronating high arched foot types and others more associated with flexible, overpronating foot types.

Rigid high arches: sesamoid injury, peroneal tendon injuries, navicular stress fractures, insertional Achilles tendinitis/Haglund's

Flexible overpronating feet: medial tibial stress syndrome (shin splints), medial tibial stress fractures, posterior tibial tendinitis, 2nd metatarsal stress fractures, plantar plate injuries of 2nd mtpj, 1st mtpj arthritis and stiffness.

All foot types: 3rd and 4th metatarsal stress fractures, Achilles tendinitis, plantar fasciitis, Morton's neuroma (often a shoe issue!), lateral ankle instability(maybe a little more with the rigid high arch foot type).

Feet with long 2nd or 3rd metatarsals/short 1st metatarsals (regardless of arch height): 2nd or 3rd mtpj plantar plate injuries, 2nd or 3rd metatarsal stress fractures.

Gaaay a s s study.

I agree way more with Dr. Liberman has to say on runninng.

Mustache ride wrote:

How does one differentiate between low and high? I think I have high arches, I've seen way higher..they certainly aren't flat. Is it possible to be in the middle? How does one know?

The authors of this study used the FPI.

internet advice wrote:

The authors of this study used the FPI.

They actually used the Arch Height Index, which has a relatively high correlation with the FPI but is not the same: "AHI was measured as the vertical height of the dorsum at half of the total foot length divided by the truncated

foot length."