Complications of Flat Feet for Heel Strike Runners

One of the complications of flat feet in heel strike runners is lower back pain because low arches were found to intensify impact loading at heel strike. The good is news however, low arch runners can seek back pain relief just by switching to forefoot running.

Complications of Flat Feet

Complications of Flat Feet for Heel Strike Runners

Perhaps contributing to all the excitement about forefoot running is the fact that it reduces the loading rate associated with heel strike running, no matter if you have low or high arches.  It is also a powerful tool for heel strike runners with low arches.

Why runners should avoid heel striking if they have low arches?

  • A study by Orgon et al. (1999) found that low-arched heel strike runners had a higher acceleration rate and amplitude at the lower back compared with high-arched heel strike runners, which suggests that high arches may not be a major risk factor for injury as once thought.
  • Lower arches might not be well-adapted to accumulated loading during heel strike running. Williams et al. (2003, 2001) identified that low-arched runners were more susceptible to soft tissue injuries compared with high-arched runners.

Forefoot Running is Safer for Both High and Low Arches

Until now, one of the best explanations of running-related injuries was a matter of having too high or too low arches. However, in a telling study, Lees et al. (2015) found that the sequence in load reduction at touchdown in forefoot running was related to individual characteristics other than arch height.

  • The researchers reported that foot mobility characteristics, not arch height, affected loading and concluded that arch height, high or low, is a non-significant relation to dynamic loading. Thus, arch height was not an indicator of excessive loading in forefoot running.

Because loading rate was not related to arch height in forefoot running, signifies that arch height is not a direct causal factor for injury in forefoot runners. Comparatively, arch height is problematic for heel strike runners as low arches seem to intensify loading. The fact that an arch-height dependent pattern of increasing injury appears in heel strike runners, suggests that humans haven’t evolved the capacity to manage the high load demands of heel strike running.

More from Run Forefoot:

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The Cause of ITBS – Understand how running shoes that are stiff and inflexible increases a runner’s risk of ITBS.

Expensive Shoes Doesn’t Mean More Protection – A study found that cheaper running shoes were linked to less injury rates than pricier ones.

Protecting Your Joints – Discover how the best joint protection technique for running is to avoid heel strike.

Born to Run…Forefoot? Here I talk about why humans are anatomically suited for forefoot running, and not heel strike running.

Are Heel Strikers Slower? Here I uncover the 2 main reasons that may slow a heel striker down.

The Neuroscience of Running….Barefoot – An overview of how barefoot running boosts motor coordination patterns in the brain, helping you run with better mechanics.

Shoes for Forefoot Strikers – Read about the barefoot-inspired running shoes that help avoid heel strike.


Lees et al. Shock absorption during forefoot running and its relationship to medial longitudinal arch height. Foot & Ankle Int, 2015;26(12):1081-1088.

Ogon et al. Does arch height affect impact loading at the lower back level in running? Foot & Ankle Int, 1999;20(4):263-266.

Bretta Riches

"I believe the forefoot strike is the engine of endurance running..."

BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.
Bretta Riches

P.S. Don't forget to check out the Run Forefoot Facebook Page, it's a terrific place to ask questions about forefoot running, barefoot running and injury. I'm always happy to help!

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