The feet never get any love. Nobody likes feet. Some people see a bare foot in the room, and they run! No other structure in the body seems to inspire such powerful, albeit negative, sentiment. But, given the foot’s importance, the script should be flipped! The feet should be praised, worshipped, even placed on a pedestal. In this article, we are going to explore why.
The Ultimate Effect of Shoes on Posture & Neurology
The body maintains three interdependent receptor systems that are responsible for gathering information to help us better navigate our environment. These receptor systems are the proprioceptors (within the joints to give feedback about body position); interoceptors (relating information about our internal environment, organs for example); and exteroceptors (relating to us information about our external environment). The soles of the feet are stock-full of these exteroceptors.
As human beings when we explore the world in which we live our feet are the only part of us in constant contact with our external environment. This being the case, it is no surprise that the sole of the foot has more exteroceptors than almost any other body part. As mentioned above, as we place our foot onto the ground these exteroceptors are used by the brain to gather information about several things: our postural position; the need to make adjustments as it relates to absorbing/utilizing ground reaction forces; the need to create more stability, etc. This information enables the brain to make immediate changes to levels of stiffness and tension in muscles all the way up the kinetic chain.
These adjustments to tonicity are made in order to protect our joints and connective tissue from harm or perceived potential threats. We must always think, whether in sport or in the weight room, that it is the skeleton and its connective tissues that we are primarily loading. The skeleton is the important player in movement. The brain uses muscle to move, protect, and to maintain the positional or postural integrity of the skeleton, it is not the other way around. Therefore, whether biomechanically sound or not, the firing patterns executed in administration of this ongoing task eventually become engrained in the central nervous system, and can begin to govern the way we move.
Long Term Effects of Using Shoes as a Crutch
This genius system of checks and balances could, among other things, help us to be much more aware of our position relative to the gravity line (posture/joint alignment), essentially eliminating many postural problems. However, with the wearing of shoes and the amount of time we spend with the feet on hard surfaces (concrete, shoe soles, orthotics, etc.) our brain receives less and less information from the important receptors of the foot, and they become “dulled” and essentially “inexperienced.” As the saying goes, if you don’t use it, you lose it. Eventually, the feet lose their ability to “see” where we are, causing lag in our movement and affecting the brain’s ability to make the correct neurological adjustments at the correct time (eg. On-field performance; a quick, necessary positional correction during a split squat pattern, etc).
In the above situation, when trainees go barefoot (especially when outside or when performing SMR) they find the soles of the feet to be particularly tender. The exteroceptors, never having opportunity to sense things, are suddenly overloaded with a million intimate pieces of information that they are no longer accustomed to receiving. They find themselves unable to recognize or identify the new sensations, and the confusion and abrupt overstimulation is perceived as threatening. Naturally, the brain records this perceived threat as “pain.” It is no different than wearing shades or being in the dark for an entire day (wearing shoes), and then suddenly removing them or stepping outside and exposing the retina to full-on sunlight. At first, the eyes are uncomfortable and it takes time for them to get their bearings.
Pain makes us unsure of movement, and so it may take some time for your trainees or athletes to acclimatize to the sensations of being barefoot while wandering about. But I have seen with many trainees that once they have been exposed to their new “world,” for a long enough time, they will afterward often look forward to training barefoot. In my experience, this is because of the noticeable increase in the stability and neural drive that they receive in their lower body training. I had noticed this happening with some individuals, but at the time did not understand enough about the foot’s physiological structure to describe this phenomenon with the aforementioned detail. Still, I am oversimplifying things when talking about going barefoot. There may be other functional or structural/anthropometric issues that make it unwise to throw an individual shoeless into the lion’s den (a lower body exercise), but for the vast majority of trainees, they need more of it. Much more.
Of course, being in bare feet more often is only the first step to revitalizing what may be the missing link in our training programs. It will not solve postural problems and realign you for better movement overnight. There’s more.
The Effects of Shoes on Gait
Not only can shoes inhibit our ability to maintain a healthy line of communication between our body and the brain as mentioned above, but they can also mess with the performance of one of our most primal and essential functions: gait. This happens when shoes contribute to a lesser of mobility of the big toe (first Metatarsal Phalange/MTP).
As was mentioned in a recent and fantastic guest post by Dr. James Spencer on Eric Cressey’s blog, it appears that healthy movement and performance all begins with the big toe (can the body be anymore imperfectly perfect?). And of course it does! Given its location on the body, why wouldn’t our first joint of concern be the big toe? It’s the King-ding-a-ling of the Foot, and according to Spencer, perhaps even the true first joint of Boyle and Cook’s Joint-by-Joint approach. A big toe which is immobile and lacks the ability to dorsiflex/extend can significantly hinder all forms of gait by a weakness or an inability to activate what is known as the Windlass Mechanism.
The plantar fascia comes rides down from the Achilles tendon to the calcaneous, where it then wraps itself around and over the ankle joint. Once it has done so it breaks off into five paths and attaches to each of the toes (with the MTP being of particular importance). When we walk or run, raising the heel/plantar flexion of the ankle (aka dorsiflexion of the MTP) results in an activation or “tautening” of this fascia and the “stacking” of the MTP and ankle joint closer toward one another. This plyometric/stretch activation of the plantar fascia is what is responsible for turning the foot into a stiff, powerful lever which then propels us forward into the next phase of gait.
“Okay, so the Windlass Mechanism is important, but how do shoes inhibit big toe mobility? I can wiggle my own within a shoe just fine, thank you.” That is because shoes raise the foot from the ground and greatly shorten the required ROM of the big toe, preventing the adequate amount of extension/dorsiflexion required to activate the plantar fascia.
The First Missing Link: Mobility South of the Ankle
Rolling on a lacrosse ball is the first thing that comes to mind when you hear “foot mobility” isn’t it? Mobility isn’t only about passive measures and self-myofascial release, but rather the ability to actively move a joint through full range of motion.
So, what does all of this mean, finally? It means that maintaining or re-attaining mobility of the MTP may be just as important for our movement health as the ability to do a solid glute bridge. And so we should probably begin addressing the foot a little bit more in our strength and conditioning programs. And because they are, literally, what grounds us, we should probably be addressing them first.
If the big toe does not allow the activation of the Windlass Mechanism which assists propulsion, you can imagine the gross, chronic compensations and equally frustrating consequences that may then take place. Tight hip flexors will result as the iliacus, quads, and tfl must fire earlier and more frequently to get the foot/leg off of the floor. The foot itself will over-pronate to get as much big toe “propulsion” as possible by rolling off the inside of the foot. Pronated feet lead to valgus knees, to bunions, and to the worst of them all- an awkwardly loaded Achilles.
Issues with ankle mobility can also arise because, with the foot on the ground, a stiff big toe will deny the ankle saggital plane movement in its full range. Then the hips will go, as their ability to extend or hyperextend (during gait) will be hindered by early hip flexion (as said above) and the absence of full ankle extension. Once the hips go, the back will. This time it will be a training tweak or bulge during an Olympic or dead lift. If big toe mobility is not brought back online, these problems will not be remedied by simply performing hip or ankle-based correctives- no matter how well they are coached.
The Power of the Kinetic Chain
The list goes on and on. I know it may seem that I am unnecessarily stretching this out. But ask any sports performance PT or Chiro who studies functional anatomy and they will tell you that catastrophic domino effects such as this are what they are often forced to unravel like the stinking layers of rotting, tear-inducing onions. To make things worse, if you don’t’ address the foot, you could be chasing ghosts every time a symptom manifests that puts your athlete on the bench.
All sports coaches will tell you that although it is offense that sells tickets, it is defense that wins games. Therefore, strength training programs that are defensive in nature and are geared toward injury prevention should be our immediate priority. Improved athletic performance (although they are really two sides of the same coin), should probably come second. This being the case, as unsexy as it may sound, assessing, correcting, and training the foot first could save us from the need for a time machine down the road.
This small consideration and addition to programming has the potential to improve our athlete’s overall health and performance, even if it is by only 1%. Logic and many functional anatomy circles would suggest that it will improve health and performance by a hell of a lot more than 1%, of course, but if you are an Olympic athlete; professional athlete; or amateur athlete trying to make it, even that 1% is huge. Your chance of being scouted or drafted increases by 1%. Your chance of provoking a soft or connective tissue strain or injury decreases by 1%. If you are a coach, you will also be making the job of your medical team (PT’s, Chiro’s, etc.) much easier by speaking and understanding their language; getting athletes to buy in to what they are being told; and speeding potential diagnosis and rehabilitation periods.
I wish that was all there was to talk about in regards to the foot, or that the MTP was the only joint that is totally underappreciated. But nope, there’s a little bit more. Hold on!
The Second Missing Link: Stability South of the Knee
The next place to look at with lots of overlap and interdependence between cause and effect (starting to see the joint-by-joint relationship, yet?), would be the intrinsic foot muscles (IFM) which support the medial arch of the foot. This arch is composed of four layers, listed here from the superficial to the deep muscle fibers. Some of them bigger than muscles in the leg.
Muscle Layer #1
Abductor Hallicus*: Contributes to stabilization and supination of the midtarsal joint against the pronating force of ground reaction during propulsion.
Flexor Digitorum Brevis
Abductor Digiti Minimi
Muscle Layer #2
Quadratus Plantae*: Flexor digitorum longus tendon enters the foot from the medial side and pulls the toes medially Quadratus plantae allows the toes to flex in the sagittal plane by redirecting the pull of the flexordigitorum longus
Muscle Layer #3
Adductor Hallicus Transverse
Adductor Hallicus Oblique
Flexor Hallicus Brevis
Flexor Digiti Minimi
Muscle Layer #4
Plantar and Dorsal Interossei
All of these muscles begin and end in the foot and stabilize it by supporting the medial arch in some form or another. Although the Windlass Mechanism is also crucial for stabilizing the arches of the foot, strengthening of the IFM is a must for foot stability while at rest, for landing and absorbing ground reaction forces, for weightlifting, and for propulsion (gait and jumping). As Dr. Spencer has mentioned, the arch of the foot is perhaps the first joint of the body which specifically requires stability work. Although we see exercises for flat feet involving creating arches through the scrunching of towels or other low-friction items, such exercises substitute IFM activation with toe flexion, effectively facilitating the toe flexors (which attach deep to the medial gastroc) to do the job of the IFM. In other words, these toe-flexion based exercises could predispose the kinetic chain to a potential shit storm, as the facilitation of toe flexion often interferes with a properly functioning back-line (calves, glutes, etc.)
Just like big toe immobility, weakness of the IFM will result in flat feet, over pronation and bunion formation, valgus knees in gait and landing (we know that dysfunction in a joint system is typically the result of dysfunction in the joint above or the joint below, and we focus on hips when valgus knee activity is an issue, but what about the feet?), abducted/everted feet/hips, energy leaks in gait and performance as a result of poor postural alignment, and other significant movement dysfunction(s) upward through the kinetic chain because the body is a regionally interdependent entity. All of these patterns can then become slowly engrained into the CNS where it will not be long before they adversely affect performance and/or result in soft or connective tissue injury.
What Does All of This Mean for Strength Coaches?
The world of Strength & Conditioning has been influenced by different philosophies in different eras. There was the era where it was highly influenced by bodybuilding, then by Olympic and powerlifting, then by methodologies out of the Eastern Block, etc. In this era, the medical industry has revolutionized our practice through its recognition of the body as a system of systems, and not simply a bag of meat to hammer into the ground. This has both simplified and complicated S&C. There is now more to learn, but there is also more insight on how to grant our athletes healthier, longer, and more lucrative careers.
Therefore, mobilizing the big toe and strengthening of the IFM should be incorporated into the assessment and or early phases of strength and conditioning programs (particularly in the off-season) as a method for both prehabilitation (potential injury prevention) and performance enhancement. With a greater understanding of the importance of the above mentioned joints (MTP and the Medial Arch), we can apply our own unique methods of progressions/regressions to improve foot function and attain the desired result: more stable lifting, landing, and propulsion mechanics.
Strength Training For The Foot
Here are some suggestions and progressions for training the MTP and the IFM.
Big Toe Mobility: Re-mastery of Toe Mobility & Control
Foot and Calf SMR: prepare the toes and IFM/Fascia for movement by promoting blood flow and restoring optimal muscle tonicity, just like we foam roll our legs before training the lower body.
Toe Wave Progression: Try Toe Waves to begin re-discovering the neural pathways to using the feet
4 to 1 Toe Lifts: Extend the big toe and small toes separately from one another. Notice how the arch of the foot changes and stiffens as the toe(s) is extended. If somebody cannot “find” the muscles which move the big toe or little toes individual, perturbate the toes to help the individual identify what muscle needs to be accessed
Regression: Perturbate the big toe
Regression: Perturbate the small toes
Gait Drill: This exercise will help to cement your newfound toe mobility into your gait pattern
Medial Arch Stability: Progressing the Janda Short Foot Exercise for Athletes
Janda SFEà Janda SFE with Toe Extension: Contract the IFM without having to flex/curl the toes
Janda SFE Bilateralà Unilateral Squat/Hinge: Maintain the contracted IFM during a squat or deadlift
Janda SFE Bilateralà Unilateral Palof Press SFE: Maintain the contracted IFM during the palof press
Janda SFE Bilateralà Unilateral Box Drop SFE: Contract the IFM upon stepping off and landing from a low box
Janda SFE Reactive/Medball: Maintain the IFM while performing a reactive drill
Prioritizing Strength Training For The Feet
Just like many correctives/regressions in S&C, it doesn’t take much. Include one exercise for both the big toe and the IFM during your warm-up, progressing until you reach the most challenging exercise for each. Once that has been done, simply maintain it with a little bit of attention at the start of every workout (toe wiggling, for example). According to the evidence pertaining to the need for foot mobility and stability referenced within the article and here below; a definite case can be made for foot training for athletes so that basic function is re-achieved. It may be the best-bang-for-our-buck piece of insurance coverage that we can give our athletes.
Let’s stop running from the feet!
About The Author
Alex Nurse is a Toronto strength, speed, and agility coach. With knowledge in both Neurokinetic Therapy and Soft Tissue Release, he helps his athletes and clients improve their athletic performance while avoiding the potentially debilitating domino-effect of movement dysfunction. He divides his time between Body + Soul Fitness and GameWithoutPain- an organization dedicated to the health and performance of E-sports athletes. He co-writes the Toronto Health and Performance Newsletter with his colleague, Joel White.