Exercise of the week: Foot Strength Part 2

Updated: Oct 11, 2020

We recently put out a short blog post hinting about the idea that foot and arch strength could be in some ways linked to glute activation and injury prevention.

We talked about how doing this quick ankle pronation/supination test could help start to illustrate the point that good mechanics at the ankle, knee and hip, are linked! Notice, when you try this video'd test below, that you can possibly even feel your glutes more when you are on the outside edge of your foot.

If you strengthen your glutes in isolation, and then go back to double leg or single leg movements, but your knees collapse in, do you simple need more glute strength than you trained?

Could ankle strength be the missing puzzle piece?

Often, possibly because of our societal tendency to "cast" our feet in socks, shoes, boots, skates, etc, people's feet are weak. Young athletes especially, we find, have a hard time even balancing on one foot when you get them to take their shoes off.

Is it possible that they are simply relying too much on their shoes to create a good arch in their foot? Is it possible that strengthening the arch could help them prevent some of the mechanics in running, jumping, and landing, that are more injury-prone, and perform those that are more injury-adverse?

Take the following examples:

When the athlete supinates the feet with an effort to make a strong, high arch, the knees push out, the femurs and shins externally rotate, and the pelvis will tend to posteriorly tilt. When the athlete makes an effort to pronate the feet excessively and collapse the arches, the knees drop in, creating internal rotation of the femurs and shins.

The athlete is asked to do some single leg 1/4 depth squats, she visibly pronates her feet and collapses both of her arches. Subsequently, she internally rotates the shins and femurs, leading to knee genu valgum throughout the squats.

When we add speed to the test, this athlete demonstrates the more injury-prone mechanics when she collapses through her arches on the loading phase and on the landing phase of her jump-to-single-leg-stick effort.

So far, the work we have integrated in strengthening feet and arches with clients has seemed to make a difference in their loading and landing mechanics, subjective feelings of being able to feel their glutes working more, and in their ability to get less jammed in the ankles compared to pre-strength-training.

Furthermore, we have dug into some of the research on intrinsic foot and ankle strength research, and the results seem to suggest similar results to what we would hypothesize:

One of the arch muscles (the flexor digitorum brevis) contributes significantly to force development in running and jumping.
Lacking either toe flexors or plantar fascia will decrease the force under the toes, shifting pressure to the metatarsal heads of the foot.
8 weeks of intrinsic foot muscle strengthening affects running mechanics and suggests it may improve running performance.
Running induced fatigue shifts the pressure in the foot from the lateral edge to the inside/big toe edge of the foot.
These changes may indicate increased stress on joints and tissues when individuals are fatigued.

Well don't these results look promising....

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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.

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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