June 5, 2024

Foot instability and helping athletes get ‘two feet ahead’ in their sport

Identify patient biomechanical problems that start on the ground with foot instability

Athletes and active lifestyle individuals of all levels will touch our practice in some form or another during our careers as chiropractors. Even if one does not specialize in treating sports injuries, it never fails that the opportunity to treat someone in this category will arise frequently.

These days athletes come in all ages, shapes and walks of life. Young children often begin sports at an early age, and we see people staying active well into their elderly years. Most of these patients begin playing sports without realizing the extent of the physical demands that will be placed on their bodies.

Caring for patients engaged in sports and athletic performance does not have to be complicated or even convoluted. Most of the time these individuals can have a unifying theme where we see patterns exist in the biomechanics or movement patterns of their bodies. These observations can offer not only an explanation of how they injure themselves but how we as chiropractors can treat them and help prevent future ailments as well.

The role of the arches

Let’s start by examining what starts to happen to most of us when we are young. The 26 bones constituting the feet are the foundation of our human house. The feet not only support the weight of the body but also perform vital biomechanical functions during all weight-bearing activities like standing, walking and running.

The three functional arches, forming the plantar vault under each foot, are fully formed by ages 6-7. No matter how much longer the foot grows as we mature, the arch support is set by age 7. The existence of the three arches is often unknown by the general public because it is simply not taught by the medical professionals from whom people generally seek care.

As chiropractors we are trained to look outside the proverbial box for the cause of a patient’s pain and dysfunction and not just chase symptoms. Bearing that in mind, let’s investigate a situation I have observed in my practice for upwards of 87% of the population whose arches have fallen to some degree.

This is referred to as excessive or overpronation, and this phenomenon will initiate the collapse of all three arches in a mild, moderate or severe state. After age 7, factors like genetics, activities/sports, injuries, types of shoes worn, etc., play a role in how quickly and how severely the arches fall. Keep in mind that the arch collapse occurs slowly over time, so patients usually don’t realize it is happening until years later.


To keep this in perspective, let’s look at the numbers. In my experience, I have seen that 85-87% of people excessively pronate; 3-5% supinate (feet roll out instead of in); and 10% have healthy arches and weight-bearing function. This means at least 8 out of 10 people walking into your clinic, including those playing sports, have flat feet to varying degrees.

That is a lot of patients exhibiting excessive foot pronation for us to identify. Since most of the patients seeking care in our clinics have flatter feet, we also see common clinical problems that present with them. Are you looking for this in your patients? Why should you?

By Kevin Wong, DC