Strong Feet: Why they matter
Our feet, the appendages upon which we rely on to walk, run, stand, swim, and climb. The parts of us we care for by not only trimming the toenails, but painting them, too. We go so far as to care for our feet by scraping off the calluses, trimming away unwanted hair, and paying for a regular massage simply to seek the simple pleasure of that ever-so-glorious foot rub.
For all the efforts we go through to make our feet presentable for flip-flop season, we might actually benefit more from caring about the deeper characteristics of our feet. Considering the fact our sheer ability to remain upright depends upon how strong they are, why haven’t we spent more time conditioning them like we do our deep abdominal muscles, arms, and legs?
Those intrinsic foot muscles (IFM) deep inside the foot play an important role in supporting and stabilizing the medial arch, which actively works to cushion the foot.(1) These muscles adapt and change in length depending on the phase of locomotion, such that they lengthen upon initial impact to produce negative work before they shorten just before push off to actively support the arch and produce positive work.(2)
Some studies suggest that foot and ankle strength, or therelackof, may be closely correlated to fall risk in the elderly. For those making their way into their 60s and 70s, poor foot strength can have serious implications when the risk for falling is concerned. It has been suggested that at least 30% of those 65 years and older experience one or more falls every year, and that percentage increases to 40% when people reach and exceed 75 years.(3)
Yet if you think this issue is only pertinent to those well older than you, then let me tell you why I, even as a 36-year-old retired professional triathlete, work so hard to keep my feet strong. It has been shown that the human foot has the capacity to contribute up to 17% of the energy required to power a single stride.(4) When you think about the work the intrinsic muscles of the feet must put forth just to facilitate the demands of locomotion, perhaps you can appreciate why those of you who run and bicycle might benefit from keeping your feet strong, too.
Regardless of whatever age you currently find yourself enjoying, we have stand to lose a lot by not attending to the strength of our feet, and we have even more benefits to gain. Whether your aim is to prevent or rehabilitate from injury that has resulted from partaking in an exercise or sport of your choice, or perhaps you hope to minimize your risk of falling so that you might continue to partake in regular, daily activity into your golden years: here are two exercises you can use to determine your foot strength. If you notice difficulty and wonder if your nagging foot, ankle, knee and EVEN hip and back pain might be a result, I guarantee you are probably right. Weakness in the feet translates all the way up into the back. Yet I would be negligent if I did not also say that similar deficits in strength in your hips can also exacerbate pain in your feet. (Welcome to my world of solving the revolving human puzzle!)
Exercise #1: Timed Single Leg Stand
First, how long can you stand on one foot with your hands on your hips? Clinicians often use this test, called the Timed Single Leg Stance test (SLST), as a measure to determine fall risk. In Table 1, you will find normative values based on age. Those unable to perform the SLST for at least 5 seconds double their risk for falling and sustaining an injury.(5)
Table 1. Interpretation - SLST Normative Data
Table by OP Solutions. Found at: http://opmarketing.com/storage/OM%20PDFs/Single%20limb%20stance%20test%20%20for%20the%20Clinician.pdf
Exercise #2: Short Foot Exercise
Second, how much control do you have over your feet and toes? In Figure 1, you’ll see the Short Foot exercise, an activity that challenges you to shorten your foot by actively pulling your medial arch up off the floor using only the IFM. Start by sitting, and watch your foot to ensure you are not curling your toes. I often see this faulty compensation when people begin to work to start to feel their IFM. It’s a very subtle exercise, and once proficient when done sitting, progress to standing on both feet when you do it. Finally, work your way to maintaining your balance well enough to stand only on one foot. Your goal is to maintain your balance on an engaged foot for at least 1 minute.
Figure 1. Short Foot Exercise (6)
Exercise #3: Toe Yoga
In Figure 2, the Toe Spread Out exercise (aka Toe Yoga) is demonstrated, whereby the first/great toe is pulled off the floor while maintaining contact with the floor by the lesser toes, and then the lesser toes are pulled off the floor while keeping the great toe anchored to the floor. This is an exercise of coordination, control, and if you do it long enough, strength.
Figure 2. Toe Yoga (6)
Some may agree there exists no better compliment than someone who points out the lovely appeal of the perfectly manicured and pampered foot. However, do yourself a favor and devote some quality time to enhancing the functional strength of your feet. There may not appear to be anything visually impressive about strong feet, at least nothing that can stand up to the bulging biceps and impressive quads we have grown accustomed to admiring from afar. Yet your health and wellbeing depend on strong feet, and I argue the places you’ll go and the quality of your experiences depend more on them than your arms, at least.
References
1. McKeon, P. O., Hertel, J., Bramble, D., and Davis, I. (2015). The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br. J. Sports Med. 49, 290-290. doi: 10.1136/bjsports-2013- 092690.
2. Fourchet, F., and Gojanovic, B. (2016). Foot core strengthening: relevance in injury prevention and rehabilitation for runners. Swiss Sports Exerc. Med. 64, 26–30. Available online at: https://sgsm.ch/fileadmin/user_upload/ Zeitschrift/64- 2016- 1/1- 2016_3_Fourchet.pdf.
3. Michael Schwenk, Elise DeHaven Jordan, Bahareh Honarvararaghi, Jane Mohler, David G. Armstrong, and Bijan Najafi (2013) Effectiveness of Foot and Ankle Exercise Programs on Reducing the Risk of Falling in Older Adults. Journal of the American Podiatric Medical Association: November 2013, Vol. 103, No. 6, pp. 534-547.
4. Kelly, L. A., Farris, D. J., Cresswell, A. G., and Lichtwark, G. A. (2018). Intrinsic foot muscles contribute to elastic energy storage and return in the human foot. J. Appl. Physiol. 126, 231–238. doi: 10.1152/japplphysiol.00736.2018.
5. Vellas B, Wayne SJ, Romero L, Baumgartner RN, Rubenstein LZ, Garry PJ. One-leg balance is an important predictor of injurious falls in older persons. J Am Ger Soc. 1997; 45: 735-738.
6. Tourillon R, Gojanovic B and Fourchet F (2019) How to Evaluate and Improve Foot Strength in Athletes: An Update. Front. Sports Act. Living 1:46. doi: 10.3389/fspor.2019; 00046.