Q+A: How can I strengthen fallen arches?

Q I’m an overweight beginner who can now run three to four miles every other day at a steady 10 minute/mile pace. But a few years ago I suffered fallen arches, which caused quite considerable pain. My GP recommended arch supports, which I stopped using when the pain diminished. Now, though, I suffer acute pain in my left heel after running. Obviously, I’ll start using my arch supports again, but I wondered if there is any alternative treatment or an exercise that can strengthen my feet. Also, should I change my shoes?

A The original brief for Homo sapiens did not envisage footwear or pavements, neither of which we have adapted particularly well to, and both of which place unnecessary strain on the feet. Some individuals are less able to cope with this strain, and the end result is often arch and heel pain. This may explain why you found arch supports helpful when you were first diagnosed with flat feet, and why you find an arch support helps your heel.

If you find your current running shoes comfortable, continue wearing them. Your painful heel needs medical attention, not different shoes, and you should start by having an x-ray taken to rule out a fracture of the heel-bone. If there is no fracture present (and it would be unusual if you had a fracture), you should seek the services of a good chartered physiotherapist who will treat the painful heel. Treatment should be carried out in conjunction with wearing your arch supports. If you still experience problems after treatment you may have to make use of a pair of prescription supports (orthoses), and you should see a podiatrist for this.

Provided that there’s no fracture present, there’s little likelihood of you doing much damage, even if you continue to train. Generally speaking, however, the longer these conditions continue, the longer they take to resolve, and of course this may well interfere with your training as you become fitter and increase your training.

David Holland, consulting podiatrist