02

December

Stability from the Ground up


The inability to control the stability of the foot has paramount implications on the rest of the leg and whole body posture. I may be biased here, but this is a must read for anyone with feet.

One major tool in the development of stability in the lower leg is the “Short Foot Exercise (SFE). (what do they say about people with short feet?)

Why is the SFE important? Very briefly, when you run your ground contact time is somewhere around 1/5th of a second. In that brief period of time, your foot has to provide a stable base of support for balance and propulsion while also being mobile enough to be a major shock absorber for the body. A fault in strength, timing or coordination of the muscles will quickly result in poor performance and/or injury.


Last year, I wrote an article on the SFE, but more recently, a study was just published in the Journal of Sports Rehabilitation and looked at the ability of the SFE to improve balance in both static and dynamic situations.
The study wanted to find out: when it comes to foot conditioning to increase arch height as well as improve balance in static and dynamic tests, which is better – the SFE or the traditional “towel-curl” exercise (TCE). Personally, I’ve never given the TCE to any patients because I don’t feel it’s very functional. As it turns out, in this new study, I was right…sort of.

The study was 4 weeks long and had the subjects perform either the TCE or SFE 100 times per day. Then they measured
1) the height of the navicular bone during weight bearing (basically, the height of the medial longitudinal foot arch),
2) the total range of movement of the center of pressure (COP) in the mediolateral (ML) direction for a static-balance test and
3) the amount of COP movement in a dynamic-balance test
(Y-balance test).
The center of pressure was measured via forceplate.

In the end, there were no differences in the height of the navicular bone or differences in the static balance test. All groups showed an improvement in reducing the movement of the COP in the ML direction (improved stability) for the dominant leg, but the SFE group showed a much greater improvement in the non-dominant leg – an average decrease of 9.3 mm in the movement of the COP in the ML direction.

So here’s the gist:
• Foot stability and mobility are important aspects of performance and injury prevention for everyone
• Studies suggest (like this one, this one and this one) that wearing shoes can reduce the strength of the muscles that control foot stability (no, I’m not suggesting we all go barefoot)
• So, it would seem important to do some conditioning on the foot muscles
• The “short-foot” exercise seems like an important tool in that foot conditioning

“So, is that it? All I have to do is the SFE to have good foot health?” No, obviously not. However, I’d suggest it’s a good place to start. After you’ve mastered the ability to perform the SFE (practice it while sitting at your computer, eating, watching TV or whatever) you should progress. Here’s a standard progression we use in the clinic:
Learn the SFE while seated -> Progress to doing the SFE while standing -> then when doing Vele’s Forward Lean, -> then standing on one leg, -> then one one leg doing a sideways medball toss, one arm cable rows etc.


By now, you should have developed new motor control programs that are relatively unconscious.
Patients usually take a while to gradually develop proper stability during this progression.  I think for many people, this is an important tool for injury prevention and I use it frequently for patients with a history of injury and poor stability.

- Kevin Maggs, ,

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