Runners: Why the inside of your foot hurts - 3 potential causes
One of the more common running gait patterns associated with foot pain is excessive ankle pronation. We typically see this as the leg is accepting body weight after initial contact moving into mid stance. Ankle pronation is when the arch of the foot flattens toward the ground. Ankle pronation is a normal function of the foot and a good thing for our running. When ankle pronation becomes excessive we start to see injuries such as posterior tibialis tendonitis, achilles tendonitis, plantar fasciitis, tarsal tunnel and medial tibial stress syndrome.
In athletes with normal joint alignment, increased ankle pronation occurs for three reasons: lack of ankle range, weakness in the foot and ankle, weakness in the gluteals.
Lack of ankle joint range of motion: When the ankle joint is too stiff and does not bend forward (dorsiflex) as much as needed for running, the foot compensates by pronating.
Weakness in the foot and ankle: Pronation is controlled by the foot intrinsics and posterior tibialis muscles. Weakness in these muscles contribute to poor control during loading.
Weakness in the gluteal: One running compensation for gluteal weakness is the crossover step. The leg crosses over the midline of the body during running, forcing the foot to pronate in order to come in contact with the ground. You can learn more about the crossover step running pattern in this blog article or on our youtube channel.
If increased ankle pronation is a problem, it is important that we first identify the cause of the pronation to guide athletes on the most effective way to resolve their movement impairment.
How can you tell if someone has increased ankle pronation? Below is a diagram of two different standing postures of the foot. In one you can see the arches are collapsed down, the heels are no longer vertical, and the forefoot is angled toward the outside. This foot is excessively pronated. [If you would like to read more about standing foot posture and see many more examples, see this article.]
A small amount of these motions are normal when walking and running to allow for shock absorption. You can see the difference in the runners in the photos below.
Running with normal ankle pronation (neutral foot).
Are you wondering if you can identify this in yourself or your friends? Try with slow motion video to assess your foot posture in running. Check out the videos below to get used to looking at the difference in foot posture during mid stance and loading.
Would you like to know more about your running gait? You can schedule an appointment here.We can even assess it virtually! Learn how to capture your own running gait on video.
Do you have any questions or topics you would like for me to address in a future blog post? Submit your comment and question here.
To your movement health,
Ann
This blog is not intended as medical or professional advice. The information provided is for educational purposes only and is not intended to serve as medical or physical therapy advice to any individual. Any exercise has potential to cause injury or pain if it is incorrectly done or is not the right exercise for an individual’s medical or physical problems. You should consult with a physical therapist or medical provider for individualized advice.
