T Nation

Training with Flat Feet

This is annoying. I have minor knee pain in both my knees. the pain is located on the inside portion of my thighs. I dont know anything about physiology but I think (based off of this picture) the thing that is bothering me is the Medial Collateral Ligament. I rarely get knee pain when I squat, but I very easily and frequently get it whenever I do any kind of single leg training. Also, I just started doing German Volume Training (or the 10-set method).

I have never trained like this in my life and for the first time in a very long time I had knee pain in the aforementioned location. Affirming my suggestion that the pain is from flat feet, performing farmers walks after the squat is what really hurt them. The pain isnt bad, just annoying at this point, but bad knees run in the family (my father is getting a knee replacement in 2 months and he is in his mid 60’s)

Knee Picture

So, am I right about the culprit being flat feet? What kind of work could I do to help correct the problem?

Could be a few things. I have to admit, I laughed a little bit when I clicked on the link expecting a picture of your knees and finding an anatomy diagram.

If your problem is, in fact, flat feet, then an orthotic, structural taping, short foot exercises, and proprioceptive work should all be considered.

“If your problem is, in fact, flat feet, then an orthotic, structural taping, short foot exercises, and proprioceptive work should all be considered.”

what the hell does this mean lol?

I have flat feet too, and my knees were hurting because of it. I’d recommend getting insoles if you don’t have any. I use walkfit, but there are a bunch of brands out there. It helped me and it could help you. No guarantees though.

[quote]David98 wrote:
I have flat feet too, and my knees were hurting because of it. I’d recommend getting insoles if you don’t have any. I use walkfit, but there are a bunch of brands out there. It helped me and it could help you. No guarantees though.[/quote]

Me too. Try these (over the counter) and watch if your feet roll to the inside as you squat while using them (might need some load). If so, you might need to get good orthotics from a doctor (cost like $500 a pair). Why spend this? Because if your feet roll (overpronate) you cannot get in correct form for a squat since your feet are never quite right on the floor. The forces in the squat will never go through the legs right and other structures in the knee will take a serious beating. This will cause a ton of problems in the long haul plus a lot of knee pain (front, side, back you name it). Got really good ones a few years ago and they are totally worth it if you need them.

YMMV,

– jj

With an orthotic 100% try an over the counter first. I’ve heard good things about the Dr. Shoal’s one’s that read the bottom of your foot in the store then suggest which one to buy. You’re looking at 20-60 dollars for store brand compared to 350-600 for a custom orthotic.

“Rebuilding” the foot is very tedious. Youtube “short foot exercises” as they have been shown to be effective in restoring the longitudinal arch. Work on ankle dorsiflexion as well. Ankles lacking dorsflexion will cause the foot to collapse.

I’ll give it a shot. Perhaps this is why I have struggled to perform correct squats without injury but picked up the deadlift very quickly.

Oh, would squatting with no shoes help?

[quote]Aero51 wrote:
Oh, would squatting with no shoes help?[/quote]

No, not at all if you need arch supports. Indeed, in my case I know for a fact it makes it worse.

– jj

Hi Aero51, I have flat feet also. A possible explanation for your knees not hurting during squats but only with single leg work could be that you push your knees out during the squat? This creates torque and will create an arch in your feet, this is what I notice with myself. With single leg work it’s hard to do this and probably your knees move inward and thats why you have pain at the medial side.

I’ve noticed that when I train barefeet I’m better in keeping an arch just because I see my feet being flat and by pushing my knees out I can create the arch. This only works for me if the surface isn’t slippery though.

BUT I do wear insoles in my regular shoes.

Hi Aero51, I have flat feet also. A possible explanation for your knees not hurting during squats but only with single leg work could be that you push your knees out during the squat? This creates torque and will create an arch in your feet, this is what I notice with myself. With single leg work it’s hard to do this and probably your knees move inward and thats why you have pain at the medial side.

I’ve noticed that when I train barefeet I’m better in keeping an arch just because I see my feet being flat and by pushing my knees out I can create the arch. This only works for me if the surface isn’t slippery though.

BUT I do wear insoles in my regular shoes.

I’ve always considered the whole arch support thing to be bullshit. Just a way to sell crap. Humans are born and designed to have their feet on the ground. Raised heel shoes and insoles shorten your heel cord and eventually make your feet flatter, which leads to a decrease in ankle, knee, and hip mobility.

Try to wear Chuck Taylor’s or Vans. Something with a flat sole and regain your Achilles.

[quote]Alrightmiami19c wrote:
I’ve always considered the whole arch support thing to be bullshit. Just a way to sell crap. Humans are born and designed to have their feet on the ground. Raised heel shoes and insoles shorten your heel cord and eventually make your feet flatter, which leads to a decrease in ankle, knee, and hip mobility.

Try to wear Chuck Taylor’s or Vans. Something with a flat sole and regain your Achilles.[/quote]

Humans are also born to live on grass/dirt, be barefoot our whole lives, and be a whole lot more active and less out of shape then most of us are. Since we don’t do these things, and really haven’t since birth, our bodies and environment are different then what they were “designed” to be when we first came around. Look at a simple diagram of someones ankles/feet with and without orthotics. They make a difference in alleviating pain.

Try insoles, no need for custom ones. Most people I have met (and I’ve likely met way more people with insoles then most people ever will in their lives) get by just fine with over the counter insoles. I’ve met many people who hated the custom insoles and did better with over the counter.

If you have flat feet (which I do), then your alignment becomes off. Repeated force being applied (everything from light walking to running and jumping) means the force isn’t being absorbed by your arch correctly and is being distributed over your body incorrectly because the alignment’s off. This can cause ankle, knee, and back pain. Having orthotics is designed to align everything and help distribute that force in the “correct” way even though you don’t have an arch really.

I used to get random ankle pain, and some knee pain. After using orthotics, I don’t get that weird pain anymore.

I’m not really a fan of the Dr. Scholls. I’ve talked with quite a few foot doctors, and have a lot of experience working with people with insoles, and all of the doctors recommended to go to a sporting goods store and get insoles from there. They’re like $30-40 dollars. They felt it was much better quality then the ones found at Walmart. I even specifically asked about Dr. Scholls and was told sporting goods stores have better ones.

For brands, I know of three that are good: Sole, Powestep, and Superfeet. Powerstep is what my doctor gave me from his office, and Sole and Superfeet are just two “higher end” insoles im familiar with. Sole is more popular and more comfortable in my opinion, powerstep works but doesn’t feel as soft to me, and superfeet has an interesting design where they try to support the bones in your foot before the arch instead of actually supporting the arch itself. Some people like that, I don’t.

Side note: if you’re paying 300+ dollars for a custom orthotic, do some research on the company and make sure it’s actually custom. Some companies will charge big bucks for a “custom” orthotic that isn’t.