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Exercise of the week: Foot strength considerations in ankle pronation and supination

This morning, on our instagram account, we posted a few "snippets" of information around foot and arch strength considerations.


If you've been training with us over the past year, you may have noticed that we have started to incorporate a lot more foot, arch, and lower limb strengthening exercises.


Do this quick test to illustrate a point we make often. TRY THIS, then keep reading:

When you stand upright normally, and rock your foot/ankle onto the outside edge of your foot, you will notice that your shins externally rotate towards the outside of your body, and your kneecaps and femurs do the same. You might even notice a change in your hips/low back towards more posterior pelvic tilt, as the motions are linked.


When you do the second half of the mini-experiment, and rock your foot/ankle to the inside edge of your foot, you will notice that your shins internally rotate towards the midline of your body, and your kneecaps and femurs do the same. Your hips/low back will have a tendency towards more anterior pelvic tilt, and you might notice your low back arching.

Most people we see in the gym have a greater tendency towards the lateral experiment. The problem is, creating a knee'd-in position tends to create knee genu-valgum, simply a term that means the knees collapse inwards, which some research has shown puts our knees at risk for some soft-tissue injuries (namely, ACL tears, medial meniscus damage, MCL tears, or even IT band syndrome or patello-femoral pain).


Traditionally, strength coaches and trainers might look at the solution for knee genu valgum as glute strengthening. You'll often see the use of mini-bands around the knees used to prevent this collapse.


But, we will argue, that while isolating the glutes could be helpful, but is not addressing the bigger picture. When, in sport, are you standing balanced on both feet at the same time with the knees pressing out? How many times do we have individuals coming to us saying that the knee, hip or ankle pain has not gone away with "glute strengthening". When you get your client out of the mini band, and ask them to use their glutes while in a unilateral stance, how many report the ability to still feel their glutes?


Perhaps you are readying this thinking, "this is me!".


What if the glutes, in isolation, are just a piece of the puzzle.


Could ankle strength be the missing puzzle piece?











References:


Hamel, A. J., Donahue, S. W., & Sharkey, N. A. (2001). Contributions of Active and Passive Toe Flexion to Forefoot Loading From the *Center for Locomotion Studies, the **Depart-ment of Mechanical Engineering, the † Department of Ki-nesiology, and the. In CLINICAL ORTHOPAEDICS AND RELATED RESEARCH Number (Vol. 393)


Kudo, S., Sakamoto, K., & Rpt, S. (2020). Comparison of foot kinematics and the morphology of intrinsic musculature of the foot using a foot-type classification based on function. Journal of Physical Therapy Science, 32(1), 238–242.


Ross, S. A., Rimkus, B., Konow, N., Biewener, A. A., & Wakeling, J. M. (2020). Added mass in rat plantaris muscle causes a reduction in mechanical work. The Journal of Experimental Biology, jeb.224410. https://doi.org/10.1242/jeb.224410


Taddei, U. T., Matias, A. B., Ribeiro, F. I. A., Bus, S. A., & Sacco, I. C. N. (2020). Effects of a foot strengthening program on foot muscle morphology and running mechanics: A proof-of-concept, single-blind randomized controlled trial. Physical Therapy in Sport, 42, 107–115. https://doi.org/10.1016/j.ptsp.2020.01.007


Tosovic, D., Ghebremedhin, E., Glen, C., Gorelick, M., & Mark Brown, J. (2012). The architecture and contraction time of intrinsic foot muscles. Journal of Electromyography and Kinesiology, 22(6), 930–938. https://doi.org/10.1016/j.jelekin.2012.05.002


Yue, S. W. (2007). Influence of the abductor hallucis muscle on the medial arch of the foot: A kinematic and anatomical cadaver study. Foot and Ankle International, 28(5), 617–620. https://doi.org/10.3113/FAI.2007.0617

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