cblstnwalkcropIn April of this year I attended The Fitness Summit in Kansas City, MO and heard a lady by the name of Galina Denzel give a speech regarding how to make the transition to training barefoot.

Now this wasn't the first time I had heard or read about the benefits of operating barefoot, but it was my first introduction to the idea of training the feet and cultivating proper alignment and strength of the foot. It was really eye opening and informative.

I have been experimenting with some of the techniques she talked about using with her clients on myself and I have to say that I am a bit convinced that the arch of the foot is not something that needs an orthopedic shoe to support, but rather can be strengthened and influenced directly by foot specific training.

But being an evidence based person I have been searching for studies that provide support to this idea and new belief of mine. I feel while the physiology and anatomy of the foot speaks a lot to the predicted response it will have to training I did not feel comfortable with introducing the intervention to clients without some kind of evidence ,that isn't anecdotal in nature, that this type of intervention actually does in fact elicit results.

To my excitement there are actually a couple different studies that supported a foot specific training intervention for cultivating the arch, but during my most recent pubmedding episode I found this recently published study that had a unique twist on this intervention due to the fact it focused on intrinsic foot muscles and not the more common extrinsic foot muscle focused intervention.

In addition to it being a unique study I also felt it an appropriate share this week due to the fact that I had two separate conversations with two different clients about their flat feet and how this isn't a permanent problem. I explained to them that in fact this problem can be improved and influenced by a variety of drills and an awareness of the impact our modern footwear has on our feet. I am hoping that I can convince them to set aside some time at home to work on these drills as I don't feel it is prudent to take 15 to 25 minutes out of the time they see me to spend exclusively training the foot. But I think it would rock as homework.

Now I am not at all an expert on foot specific training, but I do have in mind to attempt to create a protocol for cultivating stronger and higher arches that involves both intrinsic and extrinsic foot muscle focused exercises. I believe that taking a two pronged approach at the issue may in fact yield a better result. But for now it is just another project in the works nonetheless I think this is knowledge that many people could benefit from as it seems to be the common idea that once arches lower and flatten that they are permanently stuck in this state which could not be further from the truth.

I hope you enjoy the study and find it just as interesting as I do. Have a great saturday!

Title

Effects of Plantar Intrinsic Muscle Training on Medial Longitudinal Arch Morphology and Dynamic Function

by Mulligan and Cook

published 2013 in Manual Therapy

Introduction

ggThere is a whole supporting cast that plays a role in supporting the medial longitudinal arch of the foot. This cast includes the plantar fascia, posterior tibialis, calcanei-navicular ligament, and subtalar joint architecture. However the role of the intrinsic foot musculature is unclear. The intrinsic foot musculature refers to the muscles that originate in the foot and then insert into the foot as well. It has been proposed that these muscles also support the medial longitudinal arch and play an important role to the stability of the foot and shock absorption.

Currently the most popular therapeutic intervention for increasing the size of the arch focuses on training extrinsic foot muscles. But some have stated that it is also possible to target the intrinsic muscles through exercises that have been termed "short foot" movements.

An example of short foot exercise.

These are movements where the individual tries to draw the metatarsal heads toward the heel in an effort to shorten the foot. This heightens the arch of the foot without causing curling of the toes. But it is unclear whether or not these exercises due affect the height of the arch.

Researchers in this study wanted to assess whether or not an intrinsic foot musculature training program would lead to changes in the arch.

Method

imagesThe researchers used a 4-week training program which focused on training the intrinsic foot muscles. They recruited 18 women and 3 men, 21 subjects in total with no personal past experience with this form of training. Researchers measured the ratio known as the arch height index, which is the ratio of the dorsum foot height to the truncated length of the foot. Researchers also first measured the navicular drop,  meaning the drop in the height of the arch when changing from standing to seated position. The arch height index can also be calculated in the sitting and standing position and the ratio between these two measurements is known as the arch rigidity index. This index represents the structural mobility of the arch. Lower numbers in this index mean a stiffer arch and greater numbers mean the arch is flexible.

Following these initial measurements the subjects performed a short foot exercise composed training session for 3 minutes a day for the entire 4 weeks. A total of 30 continuous reps each held for 5 seconds were performed during each session over the 4 weeks. Once the subjects could perform these exercise without experiencing soreness the next day the subjects started performing the exercise in a sitting then double standing then single leg standing position. Researchers make note that most of the subjects were able to achieve training in the single leg stance position during the 4 weeks.

At the end of the 4 weeks the subjects stopped performing the short foot exercise measurements were taken and measurements were repeated another 4 weeks later making the total time of the study 8 weeks.

Results

Researchers reported the navicular drop to have significantly reduced from 12.7 mm to 10.9 mm from baseline to 4 weeks and remained reduced at 8 weeks at 10.5 mm.

Researchers noted that the arch height index increased from 28 to 29 after the 4 week training and remained stable at 8 weeks at 29.

Conclusion

The researchers closed by concluding that a 4 week intrinsic foot musculature focused training program that involved short food exercise assists in reducing the navicular drop and supporting the arch of the foot.

Take Away

Here is the thing while this may seem like a rather boring and uninspiring study it actually holds some great value for the large portion of the population who have been told they have flat feet, broken arches, and need to have specialized orthopedic shoes made to help their feet. Now while the study did not investigate whether this sort of intervention reduces injury risk or how it integrates with other movements it does provide advice that in an effort to cultivate a stronger and higher arch in those suffering from low arches exercises should be used that focus on both intrinsic and extrinsic foot muscles.

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