More Exercises for Pronated or Flat Feet

I contend that barefooting is the best and most natural way to have strong, mobile, and healthy feet. But it takes time to transition to an unshod or minimally shod lifestyle and not everyone wants that. So, I make a point to keep up with and share biomechanics- and physical therapy-informed clinical research on foot health. In the past, I’ve suggested you add the short foot exercise for arch strengthening to your foot health protocol. I use it regularly with my clients and in my FootLove Workshops.

Here is another foot exercise to consider for pronated and flat feet and hallux valgus – the condition that leads to bunions. The Toe Spreading Exercise is easy to do. I suggest you do it standing, but you could also do it seated with your hips and knees flexed to 90 degrees. I use a yoga mat under my feet for comfort.

  1. Stand with your feet pelvis width distance apart and facing forward.
  2. Spread the toes on your right foot as far apart as you can. If you are unable to spread your toes on your own, reach down with your hand and help to spread them.
  3. Raise your heel
  4. Over a slow count to 5, lower your heel to the ground.
  5. Hold in that position for 5 seconds
  6. Relax the foot
  7. Some protocols have you repeating this up to 100 times! But you might just want to start with 5 or 10 reps. Repeat with your left foot.

A recent study suggests that along with the toe spreading exercises,  you also strengthen your gluteus maximus, commonly referred to as your butt. Your big butt muscle is responsible for externally rotating your hip joint, and a strong one is thought to alter alignment of the lower extremity, thus reducing foot pronation. The authors found that the exercise most effective for a strong butt is performed in a prone position (lying face down) by slightly lifting the knee while maintaining the hip joint in external rotation and the knee joint at 90° flexion.

I bring this exercise into the yoga world as a unique modification of salabhasana aka locust pose. Or, you could think of it as a hybrid between locust and bow poses. The study protocol called for 3 sets of 20 repetitions of single leg lifts. I think you could explore fewer reps of double legs and longer holds.

Namaste, Michele

Foot Love Workshop Exercises – October 2015

You can find variations of some of these exercises in world-renowned Biomechanist Katy Bowman’s books & DVD included in her Healthy Foot Kit.

Healthy_Foot_Kit-1

Standing Exercises

All standing exercises should be done in Tadasana aka mountain pose with your feet pelvis-width distance apart, pointing forward, which means the outside edges of your feet should form a straight line (you can line up the edge of one of your feet on a yoga mat to check that it is actually straight and match the other accordingly); and your hips back so that they are stacked over your knees, ankles, and heels and not drifting or thrusting forward. Keep your weight back in your heels. I call this Smart Tadasana Alignment.

Toe Spreading

Lift your toes (this is called extension), spread them away from each other, and place them down onto the mat. Repeat several times throughout your day. You can improve your ability to actively spread your toes by passively spreading them using toe socks.

Short Foot Exercise

A full explanation is linked, but the short of it is to draw the base of your big toe towards your heel, without flexing or curling your toes. It’s OK if they grip the floor. This action lifts your arch, thereby shortening the length of your foot, and strengthening the arch-supporting muscles. Hold for 5 seconds and repeat 3 times for each foot. Try to do 5 sets of 3 repetitions per day, holding for 5 seconds each rep. You can perform the short foot exercise any time your standing in yoga postures and as you get stronger, you can do it while balancing. The Short Foot Exercise is comparable to the Strong Yoga Foot.

Balancing

Any single leg balance will strengthen your extrinsic and intrinsic foot musculature. Once you are skilled at balancing on a firm surface, you can explore a variety of unique surfaces – a folded up towel or blanket, a yoga block, a half round, a boot tray of rocks, your yard…Hold for up to one minute and repeat several times throughout your day.

Exploratory feet

Move your feet in exploratory, weird, random, bizarre, strange, silly, varied ways. This can be done sitting in Dandasana (with your legs extended in front of you) or lying down. This is a great way to mobilize your feet before you get out of bed in the morning. Repeat throughout your day.

Top of foot stretch

Extend a leg behind you, pressing the top of your foot into the mat. It is important to keep your pelvis back and stacked vertically over the knee & ankle of your front or support leg as the tendency is for it to drift forward. If balance is a challenge, please use a chair so that you can concentrate on the stretch without worrying about the balance.Hold for up to one minute. Repeat several times throughout your day.

Top of foot stretch

Top of foot stretch

Calf Elevator

Lift the heels of both feet, coming up onto your tippy toes. Try to avoid letting your ankles blow out to the sides. If they do, then only raise your heels as high as you can keep your ankles stable. Hold for several seconds. Once you are skilled at balancing on both feet, start working towards one foot at a time. You can do this either by lifting the heels of both feet, but letting the work happen mainly in one foot; or you could do this balancing on one foot! Whichever variation you choose, make sure your hips are back. Hold for up to one minute. Repeat several times throughout your day.

Calf stretch

A half round (or half moon as one of students sweetly miscalled it) is best for this stretch, but you could roll up a couple of yoga mats or blanket or use a book. Place the ball of your foot on the top of the half round with your heel on the ground. Keep your other foot even to and pelvic-width apart from the stretching calf. You can advance in this pose by slowly stepping the non-stretching foot forward. If your pelvis moves forward with you or you lose balance or get rigid, bring the forward stepping foot back and don’t progress until you can do so in a relaxed and balanced stance with your hips back. Hold for up to one minute. Repeat several times throughout your day.

I purchased a SPRI Half Round Foam Roller, 36 x 6-Inch that I cut down to one 18″ length and three 6″ lengths that I use for various purposes as yoga props.

Calf Stretch/Elevator Combination

Stand with one foot on the half-round and elevate both heels to a slow count of three. Hold for 3 counts. Lower for a slow count of three. The lowering is where you train eccentrically, generating force while you are lengthening your muscle tendon units. This is how you get stronger at greater ranges and with more control. At the place that you want to give up and drop your heel is the opportunity to exercise muscle control.

Hamstring stretch

I’ll be posting later this week on hamstring stretching, but for now, start from tadasana, place your hands on your thighs and hinge forward at your hip joints, allowing your hands to slide down your legs, keeping your spine in neutral. As soon as your spine starts to deform ie round, stop, come up a few inches and work instead on lifting your tailbone, which will move the proximal muscle attachments for your hamstrings that are located on your sitting bones away from the distal attachments that are located on your lower legs, thus stretching these muscles. Hold for up to one minute. Repeat several times throughout your day.

Ball rolling massage

Place a new, firm tennis ball on a yoga mat or carpet. Keep your heel down as you drape only your toes over the ball, weighting it as much as you can tolerate. Very, very slowly, roll the ball under your toes, from side to side, allowing your toes to spread as you go. After a while move your foot forward so that the ball of your foot drapes across the ball. Again, move very slowly side to side. Continue to move your foot forward in small sections using a side to side motion. When you are deep into the arch of your foot, you might explore some front to back motions, or invert/evert your foot to get into the lateral and medial arches. The benefit from this massage comes when you slow down, take your time, move forward in tiny increments, hang out in sore spots, and remember to breathe. This can and should be done daily as a meditation practice.

staticball3

Floor Exercises

Plantar Fascia Stretch – kneeling/squatting

In this exercise, you kneel with your knees pelvis-width apart on a mat or padded surface. Extend (curl) your toes forward. If you can, reach around and separate your toes from each other and make sure they are all extending forward. You may be able to lower your hips, shifting more of your weight onto your feet, but do this slowly and with ease as the thick band of fascia and four layers of intrinsic muscles on the soles of your feet may never have experienced this type of stretch. Images and detailed instructions are linked above.

Barbie foot

This is the exercise where you press your balls forward (of your feet, people!), all toes forward, all toes back, foot back. You know the one. In the balls forward, toes back position, your feet look like Barbie’s. You can use your arms to support you in an upright seated position, but I suggest you place your hands in your lap from time to time and hold yourself up using your own trunk musculature. Images and detailed instructions are linked above.

Bridge with marble

I know you all remember this bit of love from the workshop – a yoga bridge pose holding a marble with your toes and extending your leg. Yes, that one.  Remember, cramping is good…a good reminder, that it, that you should be moving your feet more. Again, images and detailed instructions are linked above.

Ankle circles, point/flex, invert, evert

This can be done seated with legs extended or on your back. My preference is supine with legs extended 90 degrees and soles of your feet facing the ceiling. Try to keep your legs straight and pelvis-width apart and don’t be in such a hurry. Slow, sweeping circles will assure full range of motion. If you fatigue, bend your knees, but keep moving your ankles & feet.

Exploratory feet

Exploratory feet can be done standing in Tadasana with your feet squirming around on the mat; seated in a chair with them wiggling about on a bolster; seated on the floor with them playing mischievously out in front of you; or lying supine, my favorite, with your feet in the air spazzing all over. The object is to make as many movements as you can. According to my teacher Katy Bowman, a biomechanist and math dork, if you apply a mathematical concept called a factorial, a foot with 33 joints can deform into 8,600,000,000,000, 000, 000, 000, 000, 000, 000, 000, 000 unique ways – or thereabouts. Whatever.

Toe spreaders

These exercises will help to undo the harm that shoes with small toe boxes cause to the muscles between your toes that have so little range of motion or strength that you may not even be able to generate enough of your own force to spread your toes. The third exercise, Toe Lifts, was not included in the workshop because a) I forgot; or b) We ran out of time. Whatever.

Namaste, Michele

Your Flat Feet are Exhausting

I’ve written about the purported benefits of engaging a strong yoga foot in past posts. It seems foot researchers are catching on to something yogis have been practicing for a long time. It’s called the “short-foot exercise,” but is essentially the equal of the strong yoga foot. Several recent small studies show promising benefits of the short-foot or strong yoga foot exercise for strengthening intrinsic foot architecture and improving postural stability aka balance. This is heartening as many health claims in yoga have arisen, unsubstantiated, out of various yoga lineages and proliferated through popular yoga publications and well-intentioned teachers. Proselytizing unsubstantiated health claims harms our profession.

Your feet are complex and serve many functions in stability and movement. Standing, balancing, and walking gait require the arches of your feet to deform on command as the need for stability, rigidity, flexibility, and elastic energy storage and release quickly changes depending on what you doing. Add other forms of movement you might do – run, jump, dance, hike, climb, etc. and its apparent that you need strong, flexible, mobile feet with keen ability to propriocept or sense the terrain under them. Your intrinsic foot muscles, which have all of their attachments within the foot, are considered stabilizers (as opposed to the extrinsic muscles that have attachment points both on the foot and on the lower leg and are your movers). One of the main jobs of the intrinsics is to support the four arches of your foot (medial, lateral, and two transverse) that one could envision as a half dome. It is this half dome that must deform properly in all types of movements – standing, balance, walking, running, dancing, etc.

Half dome of foot arches

Half dome of foot arches

*Image from McKeon article.

With each step you take, your intrinsic foot musculature acts to control deformation of this half dome of arches. When these muscles are not functioning properly because they are weak and uninnervated, your foundation is unstable and misaligned and thus abnormal compensatory movement occurs. I’ve written previously on how foot turnout and a forward pelvis can wreak havoc with your feet. Imagine what abnormal foot biomechanics in movement might do?? Several conditions immediately come to mind – plantar fasciitis, bunions, metatarsalgia, Morton’s neuroma, and pes planus or flat feet.  A weak medial arch (that’s the long arch on the inside of your foot) is one possible cause of flat feet, which, if you have them, negatively impact your other weight-bearing joints with friction and subsequent degeneration. Your flat feet have weak plantar muscles that fail to function optimally in their crucial roles as shock absorbers, in gait efficiency, and as postural stabilizers, making balance difficult. And, oftentimes, they just plain hurt. If your feet are flat, your medial arch is missing, which means your half dome cannot deform to provide necessary transitions from rigidity, flexibility, and energy storage and release that propel you forward when walking or running. When your arch doesn’t store and release elastic energy in gait, you are having to work exponentially harder to move forward. Your flat feet are exhausting.

The strong yoga foot or short-foot exercise is used to reinforce the arch of the foot by strengthening the plantar muscles – the four muscle layers on the bottom of your foot, predominantly your abductor hallucis, which is the most superficial and easiest to measure of the intrinsic muscles. By contracting the foot’s intrinsic muscles, the long medial arch is shortened and its angle increased. This lift of the arch lowers the mediolateral center of pressure (the pressure on the part of your flat foot that should be arched), and increases pressure of appropriate contact areas of the foot (forefoot and heel) on the floor stimulating cutaneous and muscle receptors, which help you to right yourself in the context of balance. Essentially, a strong arch is crucial to optimal gait and balance. Research shows that the short foot exercise reduces arch collapse, improves balance ability, increases big toe flexion strength,  and improves function in chronic ankle instability.

How to Perform the Short Foot Exercise

The short-foot exercise is performed by shortening the foot in a front to back direction – the first metatarsal head (aka the base of big toe; big toe mound; or ball of the foot in yoga speak) is drawn toward the heel without flexing or curling your toes. The forefoot and heel touch the floor, while the medial arch lifts.

Short foot exercise

Short foot exercise

*Image from McKeon article.

The short foot exercise can be performed either sitting or standing for improving strength, but should be practiced while standing if using this exercise to improve balance. When standing, it can be done bipedally, meaning both feet on the ground, but only one foot should be working; or unipedally – balancing on only one working foot. Placing the ankle into passive dorsiflexion by inclining the foot 30 degrees on a board or yoga wedge results in higher activation of abductor hallucis than that of the typical, neutral short foot position, possibly due to length-tension relationship in which optimal muscle length generates the greatest muscle force. The exercise is repeated 3 times for 5 seconds per rep, making one set. Sets of three reps are repeated 5 times, with two minutes of rest after every set. Alternatively, sets could be spread throughout the day.

A daily progressive program  might look like this:

  1. Week 1 – sitting,  5 sets of 3 reps with at least two min of rest between each set
  2. Week 2: – bipedal, 5 sets of 3 reps with at least two min of rest between each set
  3. Week 3: – unipedal, 5 sets of 3 reps with at least two min of rest between each set
  4. Week 4: – inclined foot, 5 sets of 3 reps with at least two min of rest between each set
  5. Maintenance – any combination of the above

For yoga practitioners, use the strong yoga foot in Tadasana and foot balancing postures. Remember, for whole body health:

  • shift your hips back when standing/balancing so that the center of your mass (your pelvis) is aligned over your knees and ankles, and heels and not over the fragile structures of your forefeet;
  • engage the lateral hip muscles on the balancing leg as this strength is crucial to optimal gait and missing in most people; and
  • lower your kneecaps by relaxing your quadriceps to minimize the amount of friction/degeneration in your knees.
The following studies informed this post and are available free, in full text on PubMed.

The foot core system: a new paradigm for understanding intrinsic foot muscle function. McKeon, PO et. al. Br J Sports Med. 49:290, March 21, 2014.

EMG Activity of the Abductor Hallucis Muscle during Foot Arch Exercises Using Different Weight Bearing Postures. Goo YM, Heo HJ, An DH. J Phys Ther Sci. 2014 Oct;26(10):1635-6.

The Effect of an Inclined Ankle on the Activation of the Abductor Hallucis Muscle during Short Foot Exercise.
Heo HJ, An DH. J Phys Ther Sci. 2014 Apr;26(4):619-20.

Immediate Effect of Short-foot Exercise on Dynamic Balance of Subjects with Excessively Pronated Feet.
Moon DC, Kim K, Lee SK. J Phys Ther Sci. 2014 Jan;26(1):117-9.

Namaste, Michele