This article will talk about the need for a stable foot as well as how to strengthen and maintain it. There is a rehab concept called regional interdependence that states that your primary complaint can be caused by a seemingly unimportant impairment elsewhere in the body. We can explain how that happens by the joint-by-joint rule developed by Gray Cook and Mike Boyle. It states, “The body works in an alternating pattern of stable segments connected by mobile joints. If this pattern is altered – dysfunction and compensation will occur.” All joints have three planes of motion. If it moves freely in all three planes it’s a mobile joint. If primarily moves in one plane, then it’s considered a stable joint. As you can see in the diagram, the foot is the first segment and should be stable. The ankle right above it should be mobile, moving in many different directions; The knee primarily bends and straightens so it’s a stable joint; the hip is a ball and socket so it should be very mobile, and the lumbopelvic region should be stable as it primarily bends forward and backward and on up the chain.
The foot is the foundation for the entire kinetic chain as it is the only contact with the ground when we are upright. It is critical for good posture, balance and movement quality. Loss of stability in the foot leads to overpronation, collapsing the arch inward and pulling the knee, hip, pelvis, and spine with it. This can lead to injuries in any of those joints. A stable foot is like standing on the ground compared to an unstable foot which would be like trying to balance on a waterbed.
So what are the causes of fallen arches? The most common are weak feet, improper footwear, tight ankles and weak glute muscles. The average American sits 14 hours a day. We sit during meals, driving, working on the computer, watching television, etc. Add 6-8 hours of sleep and there’s barely any time to workout or even be on our feet. Since our feet are weak, we have to wear shoes with arch supports and cushioned heels so they don’t hurt when we walk barefoot. Well now our feet don’t have to do any work and become even more feeble. A lot of my patients have switched to a minimalist shoe with no arch support and zero cushion, but guess what? Now their feet and ankles hurt because they don’t know how and don’t have the strength to maintain their arch. Don’t throw those shoes away yet. I’ll show you how to bulletproof your feet so you can wear them again.
Stiff ankles and weak glutes will also force the arch to drop. If you can’t move through the ankle the body will sacrifice the stability of the foot and will lengthen out the foot and/or collapse the arch straining the plantar fascia. Lastly, let’s talk about the glutes. They should be some of the strongest muscles in your body. Most of the muscles in the hip are external rotators but since we sit on them all day long they become weak. If the glute muscles can’t keep the hip neutral everything will collapse inward. It would take some very strong feet to hold the body up on their own. We will talk about the ankles and hips in the next articles. Let’s talk about how we can fix the foot.
There are 26 bones in the foot connected by 32 joints which are controlled by 29 muscles. With all these joints and muscles, that makes the foot an inherently mobile segment of the body. I know I said it’s supposed to be stable, but our feet are designed to adapt to uneven surfaces/terrain like rocks, sand and bumpy grass. Think of it like a jeep with independent suspension going over boulders. All the tires are moving independently in order to maintain contact with the ground. If you don’t use it, you lose it and most of us have lost it. So let’s talk about how we can get it back and about the “foot tripod”.
The “foot tripod” forms a stable triangular base of support, promoting proper foot alignment and weight distribution. It is crucial for maintaining balance, stability, and efficient biomechanics during weight-bearing exercise. The three points of contact are the heel and the first and the fifth metatarsal joints at the ball of the foot. Practice the foot tripod while seated and then move to standing. Every exercise from standing on one leg, to squatting, to jumping will require you to maintain this foot tripod.
Make sure all 3 points of contact are touching the floor with equal pressure. Push the toes down and then try to pull the toes back toward the heel, creating an arch. Don’t curl your toes. We don’t stand and walk on the tips of our toes. Practice this as many times as you can until you don’t have to think about doing it anymore.
The concept of the “foot tripod” is also relevant in sports, especially those that involve running, jumping, and dynamic movements. Proper foot posture and alignment can significantly impact an athlete’s performance and reduce the risk of injuries. Here’s how the foot tripod applies to sports:
- Running: When running, maintaining the foot tripod is crucial for distributing the forces generated during each stride. The heel, base of the big toe, and base of the little toe should all make contact with the ground and be distributed evenly. This helps absorb shock and provides a stable platform for propulsion. Proper foot placement and alignment can improve running efficiency and reduce the risk of overuse injuries. I had a patient complaining of pain on the inside of his knee when he ran. As I watched him jog, he landed on the outside of his foot causing his foot to roll and collapse inward as he went into the stance phase of the run. His knees also collapsed inward but it was a violent stop when it got to the end of its range. I was shocked he wasn’t in more pain. We worked on foot stability, proper landing on the entire ball of the foot, and glute strength and his knee pain was gone.
- Jumping: In sports that involve jumping, such as basketball or volleyball, the foot tripod is essential for generating power and landing safely. A strong push-off from the heel and the balls of the feet is necessary for vertical leap and horizontal movement. If you want to generate vertical force, you want all the joints to stack up vertically. But with collapsed arches the force starts spilling out laterally and rotationally. When landing, maintaining the tripod can help distribute landing forces evenly, reducing the risk of ankle sprains or ACL and meniscus tears.
- Agility and Cutting: Sports like soccer, football, and tennis require quick changes in direction. The foot tripod plays a role in stability during lateral movements and rapid shifts in weight. Maintaining proper foot posture can aid in balance and reduce the risk of ankle sprains or other injuries when making sharp cuts or pivots.
- Balance and Stability: Many sports, including gymnastics and yoga, emphasize balance and stability. The foot tripod is essential for maintaining a strong foundation while performing various balance-related activities. It helps ensure that weight is evenly distributed across the foot, aiding in balance and preventing falls.
- Injury Prevention: Proper foot posture, including the foot tripod, can help prevent common sports injuries, such as shin splints, plantar fasciitis, and stress fractures. It supports the natural arch of the foot and promotes optimal biomechanics, reducing the strain on joints and soft tissues.
Soft Tissue/Joint Mobilization: If the joints of the foot have become immobilized and the muscles on the bottom of your feet hard and stiff it’s important to work on them before attempting these exercises. I used to use a lax ball/golf ball on the bottom of my foot to remove any trigger points. They are great if you are sitting down and not putting a lot of weight on them. I prefer a racquetball or tennis ball so I can really put some pressure without a lot of pain. You can even practice stepping forward and backward with the ball under your foot to simulate uneven surfaces.
Coordination Exercises: Once you’ve softened up the muscles, removed any trigger points, and got the joints moving, you need to get to know your feet again. Let’s work on coordination of the intrinsic muscles of the foot. These all may take a day or two to figure out, but don’t give up.
- Yoga Toes: While sitting down, try to push your big toe down and lift your other toes up. Then switch lifting your big toe while keeping your other toes down. Keep your knees in one position, don’t just roll your foot in and out. Practice for 1 minute.
- Toe Spreaders: Try to spread all your toes out as far as you can. This is difficult because shoes have pressed your toes together for many years. You’ve had no need to spread them out. Having wider toes creates a more stable base and prevents pronation. Be patient and if you need to spread them out with your fingers and then try to maintain that position. Practice for 1 minute.
- Toe Reaches: Seated, put your feet on a book with the balls of your feet right on the edge. Don’t do a toe crunch, instead try to reach long with your toes and touch the tips of them to the ground. You should feel a deep muscle activation and even cramp in the middle of your foot. Perform for 1 minute.
Strength and Balance Exercises:
- Line of Gravity: Stand with your feet together and create the tripods. Lean forward and feel the bottom of your feet engage to prevent the arch from collapsing. Then shift your weight backwards and instead of puling your toes up, grab the ground with your toes. Perform 20 forward and backward leans.
- Single Leg Stand: Create the foot tripod, stand up tall and bring the other knee to hip height. Try to stand for 30 seconds without letting the arch collapse inward. Switch legs. Progress to Single Leg RDLs. The dynamic movement will put more demand on the foot. You can progress even more by using a kettlebell or weights while doing the SL RDL to challenge the foot even more.
- Calf raises: Stand next to a wall for balance, and go up on the balls of your feet. Make sure you have equal weight across your big toe and little toe. Most people flare out at the top and end up putting all their weight on the outside toes. Don’t do that! When you come back down, do it slowly under control and don’t let the arch collapse when the heel touches. Perform 20 of these. Progress to Single Leg Calf Raises.
You can see the accompanying video with all the exercises on my YouTube channel.