This is a follow up to the last newsletter concerning building strength in the foot muscles. Yes, on its surface, this sounds like a very tedious, boring and insignificant topic. However, 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.
Below, you will find what I find is the best exercise for the intrinsic foot muscles (muscles that start and end in the foot). There are different methods of accomplishing the same task: For example, here is the way the guys at The Running Clinic do it, while here is the way the Speed Clinic at UVA does it(#3 on the page). Personally, I prefer the way I show in this newsletter. In any case, it underscores the importance of being able to control and activate the muscles of the foot if you want to prevent injury.
The Short Foot Exercise
There are researchers, innovators and pioneers that are held in high esteem in every field. In the world of rehabilitation, Vladamir Janda is one such individual. A Czechoslovakian (yes, I had to spell check that) physiotherapist who pioneered and developed many ideas that are the foundation for rehab principles used today. One of his principles is the development of stability in the lower leg through the “Short Foot Exercise” (SFE). (what do they say about people with short feet?)
By training the foot with the SFE and gradually progressing though more difficult stages, we can improve the control of the foot muscles and in turn, create a more stable base of support for the leg, hips and the rest of the body. The ability to make a “short foot” really isn’t about strength of the foot muscles, rather it’s about the ability to use and control the intrinsic foot muscles. In other words, the ability to have these muscles “turn on”.
For those more detail oriented, here’s a study showing how the SFE can significantly improve ankle stability in patients with chronic ankle instability. Here is a video of a simple squat. Note the left ankle deviating inward due to the foot arch collapsing, but then this is corrected using the “short foot”, which stabilizes the ankle and foot:
OK, enough with the preamble. I have made a video below showing the progression on how to, and how not to do the SFE. The idea is that you want to make the foot shorter with a bigger arch, but do so without curling the toes and without rolling the ankle in or outward. You must keep the metatarsal heads pressed down. Most people have difficulty doing this at first, but once you get it, you can practice this while you’re barefoot in the shower, brushing your teeth or whatever. We usually have to start people with “passive modeling”, meaning we make their foot do what it should, so they get the feel of it.
It’s surprising how many people cannot do this action on their own. After we let their feet “get a feel” for how it’s supposed to be done, we move on to “active modeling”, where the patient tries to mimic the movement with our gentle assistance, then without any assistance. After that, they do the SFE while weight bearing, and finally doing the SFE while weight bearing during activities such as one legged balance, single arm rows and finally medicine ball catches and throws for example.