Foot Strengthening & Running Mechanics

Foot Strengthening & Effect on Running Mechanics: Study Review


With our clients, we emphasize foot control and endurance as a foundation for healthy running. The way your foot impacts the ground and propels you forwards is indisputably key to your overall form and efficiency. In this post, we dive into a recent study about foot strengthening and its effect on gait mechanics in long distance runners. We cover the study methods, results, our takeaways, and what it means for you below.


Published in March 2020, this single-blind randomized controlled trial involved 28 healthy recreational runners. In order to be eligible for this study, participants were required to run between 20-110 km per week (12-60 miles per week), age of 18-55 years old, and had no history of pain or injury in the previous 3 months. Exclusion criteria were current physical therapy course of care, experience with minimalist shoes or barefoot running, any orthopedic or neurological impairment, previous lower extremity surgery, or diabetes mellitus. Obviously, these are detailed and restrictive criteria that may not apply specifically to you as a runner. However, we can cautiously look at the results with respect to an individual who does not meet these exact qualifiers – more on that later.


The intervention group underwent eight weeks of a foot strengthening program (one session with a physical therapist and three solo home sessions per week). Outcomes that researchers measured include: hallux (big toe) strength, cross sectional area and volume of foot intrinsic muscles, medial longitudinal arch range of motion and stiffness, and vertical propulsive impulses while running. These measures essentially dive into the details of foot strength and range of motion, specifically while running.


What were the key findings? The intervention group experienced an overall 22.3% increase in foot intrinsic muscle volume, which positively affected participant gait mechanics . Running vertical propulsive forces also increased, improving overall drive per step. Foot arch motion and stiffness did not change as a result of the foot strengthening program. This is all to say that the small muscles that make up the foot grew in size and strength, as well as the propulsive forces while running as a result of the strengthening program. However, the arch itself did not lengthen or mobilize secondary to the treatment.


The most notable limiting factor of this study was the small sample size. There is a limit to what we can extrapolate from this study to a broader runner population. However, the results are promising and suggest that implementing consistent foot strengthening exercises may improve overall  running performance.


So, what does this mean for you? The feet are an area of concern when it comes to running-related injuries, including plantar fasciitis, stress fractures, bunions, neuromas, and bursitis. Having adequate foot strength is key to absorbing the ground reaction force every time you hit the ground – which can be as much as 90 times on one foot per minute! 


Where should you start? Unfortunately, the study did not specify in detail what the foot strengthening program implemented for the intervention group consisted of, only that the control group received a 5 minute full-body stretching routine designed for a pre-run warm-up. However, they did explain that there was a tiered progression in place for exercise difficulty as the intervention group noted ease in performing the initial exercises. This aligns with most strengthening programs – as you become more skilled, it makes sense to increase the challenge level and consequently reap further physiological benefits. 


There are several exercises we tend to prescribe that directly address the arch and foot intrinsic muscles to better promote endurance and proprioceptive awareness (i.e. understanding where your body is in space). See below for a few exercises we recommend as an introduction to foot strengthening:


  1. Big toe lifts: try to keep all other toes down and lift only the big toe up towards the ceiling. This trains foot proprioceptive awareness and is an introduction to further toe control work.
  2. Lacrosse ball ramping: stand near a wall for balance support and place the ball underneath your arch. Practice squeezing your foot around the ball for holds of 5-10 seconds initially. Then relax into the ball for 10-20 seconds. Aside from promoting arch strength, this also serves as an active technique to release tension in sore feet.
  3. Single leg balance: stand near a wall just in case you need to catch yourself. Practice standing on one foot, keeping the ball of your big toe on the ground the entire time (i.e. the “knuckle” of the big toe). Time your first rep until you need to step down – plan to progress this over time as it becomes easier.


Our main takeaway from this study is that a consistent, targeted foot strengthening program with appropriate progressions in difficulty can optimize and positively impact running gait mechanics. Further research is merited in truly applying these results to a broader population of runners, however. 


Interested in implementing more foot strengthening or control work into your exercise routine? We have dozens on our Instagram account – search #psptfeet and give us a follow. 


If you found this post interesting, we also created a Strength Training for Runners E-Book designed to help you prehab any running-related injury and maximize performance. It contains a detailed 3-month strength training program with videos – designed by a runner, for runners. Information about common running injuries, factors that contribute to healthy running, and why strength training is essential to your program is also included.

Take a look here: 


Are you currently dealing with foot pain or stiff ankles? Interested in a more holistic training program to supplement your running? Reach out today to learn more about our physical therapy services, run coaching, strength training, and recovery services:


For the article: 

Ulisses T. Taddei, Alessandra B. Matias, Fernanda I.A. Ribeiro, et al. Effects of a foot strengthening program on foot muscle morphology and running mechanics: A proof-of-concept, single-blind randomized controlled trial. Physical Therapy in Sport. (42) 107-115. 2020.


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