Helping the fallen arches

There are not many instances in the fitness industry when you are able to take off your client’s shoes due to safety and insurance reasons. Therefore, I find that anatomy of the lower limb – below the knee and feet – is not really considered or routinely strengthened.

It is a common scenario for a client to have their feet in shoes all day, maybe wearing orthotics as well, and never getting the opportunity to move and use their toes individually. Furthermore, no health professional has prescribed any corrective exercises to help strengthen the arches of the feet or the muscles which control stability at the ankle.

The arches and ankle stability are extremely important for balance in upright standing and are an integral part of the righting reflexes. If the intrinsic muscles of the feet become weak, they will load the long toe flexors and more global movement muscles of the ankle, increasing risk of overuse injuries, e.g.; shin splints – or tendonitis.

Anatomy

Feet intrinsics

Image courtesy of An Atlas of Human Anatomy by Carl Toldt, M.D

The intrinsic muscles are made up of interosseous and lumbrical muscles. They are very small muscles in the feet, and in between the toes. They help to maintain the transverse arch of the foot and keep the toes straight when the foot is pointed. Therefore they prevent scrunching of the toes.

Arches of the foot

These function to provide the following:

  • Absorb and distribute forces with walking
  • Improve walking by increasing speed and agility
  • Provide both stability and flexibility to the foot

Medial longitudinal arch

This arch is maintained by the peroneus longus, tibialis anterior, tibialis posterior, FHL, abductor hallicus and plantar aponeurosis (including ligaments, tarsals and metatarsals). The peroneus longus and the tibialis anterior both attach to the medial cuneiform and base of the 1st metatarsal, thereby acting together forming a stirrup which runs under the arch. The fact that both these tendons join to the same bones of the foot highlights the importance of maintaining control of the medial side of the foot, particularly during activity or on uneven surfaces.

Image courtesy of www.bandhayoga.com/keys_arches.html

Image courtesy of runjoerun21.wordpress.com/

 

Exercises to improve strength in the arches:

intrinsic muscles, peroneus longus and tibialis anterior muscles

Big toe lifts

  • In standing or sitting, place toes on the ground. Keep them lengthened.
  • Slowly lift the big toe upwards, keeping the other 4 toes on the ground. Then repeat lifting the 4 toes keeping the big toe on the ground.
  • No toe scrunching

Repeat x10

Piano playing

  • Try starting from the big toe and slowly lift up one toe at a time in order. When all toes are lifted off the ground, slowly return the toes from 5th to big toe in order.
  • No toe scrunching

Repeat x5

Towel picking up

  • Place foot onto a facecloth on a hard slippery floor.
  • Keeping the toes lengthened and the arch lifted, try to gather the facecloth in between the toes and lift it off the floor.

Repeat x5

Toe flaring

Start with foot relaxed, then try and abduct the big toe and little toe outwards, spreading all the toes in between. Hold for 2 seconds and repeat.

Inversion strengthening
(tib post. & tib ant)

  • Put resistance band around foot and hold the band out away from the foot. Working from the ankle only, slowly turn the sole of the foot upwards and inwards. Make sure the leg doesn’t roll.
  • Repeat x10 each

Make sure the eccentric action is smooth and controlled.

 

Eversion strengthening
(peroneals)

  • Holding band on the other side of the foot, slowly turn the sole of the foot outwards.
  • Repeat x10 each side

Make sure the eccentric action is smooth and controlled.

Calf rises with band resistance

  • Performing calf rises with a band pulling the ankle in either direction will help to recruit either the peroneals or tibialis muscles in a functional position.
  • It is important to keep the weight of the foot over the 2nd toe as you go through a full range of calf rise.
  • Each rep should be controlled and slow, and care taken on the eccentric part of the exercise.
  • Aim for 20 well performed rises in each leg, without fatigue.

Progress to wobble board balance while maintaining arches.

  

 

For more examples of hip, knee or ankle stability exercises along with their descriptions and pictures in order of progression, visit www.activeanatomy.com or call or 0414 423744 for more information about the Workshop Textbook or Corrective Exercise information CD.

 

Merrin Martin, BAppSc (Physio), BSpSc (ExScience)
Merrin is the director of Active Anatomy, a successful health professional education business. Combining her experience as a physiotherapist, Pilates instructor and exercise scientist has enabled her to become a specialist in corrective exercise programs. To contact Merrin or the Active Anatomy team call 0414 423 744 or visit www.activeanatomy.com