Angel asks: I have arch pain after I run for 30 minutes. I have several pairs of shoes that I rotate, and I'm good about replacing them. Do you know what could be causing this?
The foot is an amazing structure. It absorbs some of the shock with each foot strike with rarely a peep. But when it hurts, you really notice.
The foot has 26 bones and many more joint-surface contacts or articulations. Every joint has to be moving properly through each of these articulations for the foot to function pain-free. The bones form an arch that helps with shock absorption and keeps the foot aligned it softens with pronation (rolling in) and tightens with supination (rolling out).
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The plantar fascia completes the tension-compression structure of the arch. It keeps the arch from falling flat. It hooks to the toes in a way that tightens the fascia and the arch as the toes bend in the toe-off stage of running or walking.
Two things can happen in the arch: The fascia can overstretch—like a spring—and not return to normal length, which can result in injury (usually plantar fasciitis). Or the bone articulations can be injured or shifted, which changes the normal motion of the foot and arch. Both can result in pain, and neither will heal well until the foot is moving normally through the phases of running or walking.
Without knowing more about your pain and your training, it is difficult to guess the cause. It could be related to your choice of footwear, it could be an over-stretch injury, it could be a loss of normal motion in the foot articulations, or it could be the result of a mechanical dysfunction that's rooted higher up, like in your knee or pelvis.
I would suggest you see someone who is familiar with running and the kinetic chain problems of the back, pelvis, and lower extremities. It may be a simple fix—manual therapy may help. Or it may require more in-depth imaging and other interventions to fix the problem. You may want to find a non-surgical provider, either in physical therapy or primary-care sports medicine for your initial evaluation.
