Years of neglect can prevent the 28 bones, 30 joints, and more than 100 muscles, tendons and ligaments in feet from doing their job, which is essentially to provide support, balance and mobility. Big, stiff shoes, or those with pointy toes and skinny heels, constrict the way our feet move. Combine that with little time spent walking without shoes to keep our feet moving naturally, and no time focused on foot-specific strength and mobility, and you can get a cascade of problems.
That can mean everything from decreased performance for athletes to increased injury risk on the playing field or off, Dicharry says.
Yet the standard approach when someone has an injury of any type, or lacks balance and stability, is often quite narrow: rest or ice (although the effectiveness of icing is now being challenged), orthotics, more supportive shoes, rehab for the injured body part. Instead, the key lies in helping return the foot to its natural, functional state, Dicharry and others say.
Such were the conclusions of a 2013 review in the British Journal of Sports Medicine. The researchers suggest that an increased awareness and training of the “foot core” is essential to keeping feet stable and strong and protecting the lower extremities, reducing injuries in the process.
Stephen Pribut, a Washington-area podiatrist who runs a sports medicine practice, says that people usually choose their footwear based on what is acceptable and expected — as opposed to what is most comfortable and best for foot health.
“In addition, most jobs are rather sedentary, so having a chance to use our feet during the bulk of the day isn’t there,” he says. “I tell patients to wear something comfortable that doesn’t make them suffer.”
On the playing field
Kate Galliett, a coach in Salt Lake City, says she began incorporating foot training in her clients’ routines 15 years ago after seeing a lot of endurance athletes with such issues as plantar fasciitis, in which a thick band of tissue that runs across the bottom of the foot connecting toes to heel gets inflamed, causing heel pain.
“After doing some research and practicing exercises for the foot, I started training clients with foot strength and functionality in mind,” she says. This has made a huge difference.
She says that “if your foot can’t function as intended, up and down, side to side, it will compensate in other ways. This is what leads to injury.” And not just to the feet, but to legs, hip and back, she adds.
Galliett is a fan of one of Dicharry’s favorite exercises, which he calls toe yoga. “I have my athletes lift the big toe without lifting the little ones, and then do the opposite,” she says. “I also have them perform calf raises with a yoga block or small ball gently squeezed between the ankles to keep the lifting load over the great toe and the center of the foot.”
Other exercises she and other trainers use include single-leg stances, using wobble or slant boards, and even simple walking without shoes on to put your feet through their natural range of motion.
Benjamin Morgan, a 38-year-old ICU nurse with the Air Force, is a trail runner and obstacle course racer. Fifteen years ago, he sprained his ankle badly and the pain never completely went away.
Looking for ways to eliminate the pain and improve his odds against recurring injuries, Morgan a few years ago turned to specifically training his feet, including by going barefoot as, he says, ancient humans had.
“I will find a field or a park and do sprints in my bare feet to strengthen them and my lower extremities,” he says. “I also wear minimalist shoes in the gym [which are close to a barefoot experience], where I’ll jump rope and work on mobility with sandbags or a weighted vest” to help him develop better stability in his feet.
In addition, Morgan uses a toe-spreading device developed by a podiatrist several years ago, which keep toes in a splayed position in an effort to improve foot alignment and stability, and spends time in minimalist shoes with little cushioning or support in his day-to-day routine. With these efforts Morgan says his ankle pain has now gone away, and he thinks his running has improved.
“When I’m running on trails, I feel much more stable and less likely to get injured,” he says.
Pribut agrees that toe spreaders can be helpful for some patients, and he supports exercises that helps foot strength, balance and proprioception (awareness of the body and its movement). As to shoes, he points out that none are natural: “They are all compromises.”
It’s not just endurance athletes who can benefit from foot strengthening. Sam Robinson, 26, senior director of product testing for MyGolfSpy, is an avid golfer. To enhance his game, he became more dedicated to overall fitness, including footwork to improve his strength and balance.
“I started working on my single-leg stability and doing all my heavy strength training out of shoes,” he says. “I also practice grounding work — being in nature in my bare feet, and make sure I roll out my feet with a ball every night” to keep his feet limber.
After two years of this regimen, Robinson says he can hit the ball 50 yards farther than just a few years ago. “It’s the foundational principle of building from the ground up,” he says.
Dicharry says that many exercises people use to strengthen their feet end up strengthening shin muscles rather than feet. Instead, people should focus on the muscles used to move the foot up and down or in and out, and also on the big toe, which helps stabilize, steer and improve propulsion of the foot and body. For that reason, he says, the toe yoga move is particularly helpful.
“The idea is to move your big toe independent of the others, and vice versa,” he explains. “With your foot planted, lift your big toe and hold it for a few seconds, while the other toes stay grounded. Then reverse it, driving your big toe into the ground and lifting your other toes. Alternate back and forth, keeping your foot neutral, not caving in as you move.”
Other easy-to-execute moves include the “pass around,” which involves standing on one foot at a time, holding a light weight in the opposite hand. “Pass the weight around your body in one direction about five times, and then switch hands and legs and reverse,” Dicharry says. “This trains [all the tiny muscles in] your foot to make corrections in order to maintain balance and stability.”
Galliett also recommends simply spending more time in your bare feet, whether walking around outside or on varied surfaces within your home. And then at the end of the day, take about 30 seconds to rub your feet with some lotion, which will remind your brain of all those nerve endings.
Foot training, Dicharry says, is all about muscle memory. “Small doses — five to 10 minutes — throughout the week is all it takes,” he says.
This will be well worth it, Galliett says. “Think about it: sooner or later most of us are going to step off a curb wrong or trip over something. If you’re stable and strong, you’re more likely to come out of it unscathed.”
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