Strengthening your FEET

Physiotherapy, February 07, 2017

The better we understand our our feet work the better we can care for them. They are subjected to more impact, wear and tear than any other part of the body. As with any other body part muscle balance and flexibility is key.

If you walk a mile you will subject your feet to 60 tonnes of cumulative stress on each foot. The good news is our feet are designed to handle such stress. Most foot problems that I see can be prevented, and when problems do arise conservative treatment should be the first option.  Our feet are our structural foundation, our base for all movement. Any imbalance around the foot can lead to problems "upstream" in the kinetic chain manifesting in knee, hip, and back symptoms. The muscle function around the ankle and foot is key to health and function. Many joint issues are due to imbalances of muscle.  The feet are continuously giving feedback to the brain to get the body balanced with all movement. There are powerful sensory nerves in our souls that when compromised, can cause a negative cascading effect towards injury. Encouraging normal foot movement and posture (even briefly) can be very therapeutic. Simple barefoot walking (grounding) is the most natural position of the foot and improves foot sense.  

Human Foot developent

During the first 10 years of a kids life the foot grows at about 1 inch a year. At birth the bones are underdeveloped - only one bone and the rest soft cartilage. When we are three much of the cartilage has become bone, and at six all 28 bones have taken shape. Then growth slows between 10-20 years.  After this the foot can become wider (spreading out) due to physical and metabolic changes eg weight gain, pregnancy, training, and shoe wear. If you don't keep up with the changes then your footwear can become too tight.

Anatomy

You can split the foot up into 3 parts - the forefoot (bears 50% of the bodies weight), the mid-foot (5 irregular shaped bones that with the help of muscles form the foot arches), and the hind-foot (contains the talus bone connecting to the long bones of the leg)

The foot has 33 joints and over 100 ligaments. The bones provide a strong base for the muscles to move. Poor muscle balance causes poor joint movement leading to dysfunction and pain.

The foot relies on more than 30 muscles and tendons. The main ones are the Tibialis Posterior muscle (runs down the back of the leg around the inside of the ankle - key stabiliser for the mid and hind foot), Tibialis Anterior (runs downward from the outside upper shin crossing the ankle - if weak can cause instability and may be responsible for issues in the first meta-tarsal joint), Peroneus Muscle Group (attach on the outside of the lower leg and runs down the outside - stabilise the outside of the ankle), Gastroc and Soleus muscle (Bulk of the calf and support the back of the ankle), Plantar Muscles ( 4 layers of muscle on the bottom of the foot consisting of 12 different muscles).

Wearing shoes

The first point to get across is that nothing is more stable, and supportive for the entire body than barefeet. When shoes are worn there is a loss of mechanical efficiency and stability. The first study to demonstrate this was conducted in 1954 (Basmajian & Bentzon) which showed using EMG activity that certain muscles lost significant function when placed in a shoe. These sort of studies can be found in medical journals but not so easily in running magazines. If we wear ill fitting shoes our weight distribution can change with more weight going through a smaller area of the foot (extreme case is high heel shoes). Looking at it very simply the flatter and thinner the sole of your shoe the more the weight distribution is likely to be natural as in a barefoot state. The shoes that you wear must be comfortable - even comfortable older shoes will be better for your feet than newer uncomfortable ones. In the December 1997 issue of the British Journal of Sports Medicine (Robbins and Waked) the researches stated that "expensive athletic shoes are deceptively advertised to safeguard well through cushioning impact yet account for 123 % greater injury frequency than the cheapest ones."

Kinesthetic sense

Our feet are less able to "communicate" with the ground when we are wearing shoes decreasing the signals travelling up to the brain informing of joint, and body position. Over time the body can compensate for this poor signalling by more muscle activity and decreasing efficiency + balance. K -sense and balance is an integral part of NORMAL movement patterns - daily tasks right through to performance athletic movements.  When this "sense" of flow of movement is disturbed due to any muscle imbalance (poor fitting shoes will lead to an irregular gait pattern and then the body compensates with inefficient muscle activity contributing  to niggles). This basically means from a performance point of view more energy is required to accomplish the same movement pattern and you will not be able to hold pace deeper into an endurance run.  The irregular  - compensated git pattern leads to injuries not only in the feet but higher up the leg into the knee, hip, pelvis, lower back, and even the scapular area. Abnormal changes in gait are normal in masters athletes (due to aging, loss of feet elasticity and arch function) but if you can spend more time bare foot then these aging changes can be mitigated. 

STRENGTHENING the feet

Toe scrunching (using your toes to scrunch up a tea towel or piece of paper)  is a simple way to strengthen up the plantar muscles in your feet. Keep your heel on the floor and squeeze your toes with the rest of the muscles at the soles of your feet. If you can't accomplish this work at it for up to 1min, 2-3 x a day until you are able to pick up the tea towel easily then progress to a marble or small ball. If the foot cramps up within the minute then build up as able over a few weeks.

The next stage is lifting the tea towel or small ball, and moving it straight up (towards the shin), then inwards, and outwards to work the longer strut muscles deep in the calf, keeping your heel on the ground. Work up to 90sec on each foot daily. If you cramp up - back off and perform within capacity (eg 30sec each foot, 3 x week) and build up. Supplement this type of specific strengthening with barefoot walking.  Once you have strengthened the feet up you can stop these exercises and maintain the strength with regular barefoot walking.

STRETCHING the feet

If you have tight feet first thing in the morning and it takes time for them to loosen up ( I call this the morning marker), this can be a few seconds with 4-5 steps or 45min of hobbling then gentle stretching of the calf musculature and physio ball rolling around the sole of the foot can help with addressing this. Keep the ball rolling for the afternoon when the feet are warmed up, and don't overstretch in the morning when symptoms are worst. Ball rolling for 2-4min in the afternoon, with 2-4 x gastroc and soleus stretching should help.

 

I personally have many different shoes for different training and racing. I have my asics Kayano for training, asics flats for road running races, Hoka speed Mafate (not made anymore) for recovery runs, Hoka challenger ATR for trail racing, and then I go barefoot on the beach as much as possible to keep my feet strengthened up. Other enhancing habits that help my feet is my work standing desk (I only sit 10-15% of the day), physio ball rolling, foam rolling for my lower legs, and general stretching.  Our bodies like variety, and mixing things up. Make sure you listen to the body and find the right shoe combination for you along with daily enhancing habits that PREVENT FEET ISSUES in the first place. I'm always happy to chat if you have questions about your precious feet.