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Toe curls are not an affective way of strengthening the ntrinsic foot muscles

Discussion in 'Biomechanics, Sports and Foot orthoses' started by scotfoot, Dec 18, 2019.

  1. scotfoot

    scotfoot Well-Known Member


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    Researchers at Brigham Young University have just published a paper (see below ) which demonstrates why toe curls are not an effective exercise for strengthening the abductor halluces in the foot . The exercise produces only relatively low level of activity in this muscle and in my opinion relies instead on the extrinsic toe flexors .

    Doming exercise against resistance produced near maximum activity in the abductor halluces according to the information in the paper .

    Note ; I own Jomarg Innovation a company with interests in this area .

    Paper
    Functional assessments of foot strength: a comparative and ...


    https://bmcmusculoskeletdisord.biomedcentral.com › articles

    1. Cached
    3 days ago - In particular, the intrinsic foot muscles contribute to many of the same actions as larger extrinsic lower limb muscles, making it difficult to isolate their effects
     
    Last edited: Dec 18, 2019
  2. scotfoot

    scotfoot Well-Known Member

    Dear Admin
    I have added the content of this thread to another " Toe curls .What do they achieve " so this one can be deleted if you like .
     
  3. Dr Rich Blake

    Dr Rich Blake Active Member

    I have discouraged my patients from doing toe curls in favor of metatarsal doming or arcing for years. Rich
     
  4. scotfoot

    scotfoot Well-Known Member

    Hi Rich ,
    I believe you are perfectly correct to go with metatarsal doming rather than toe curls and the study just produced by Brigham Young University backs that up .

    To summarise the study , a group of researchers looked at the amount of electrical activity (EMG) produced in a number of muscles during toe strength measurements using 3 basic measuring methods . The electrical activity was used as a surrogate for muscle engagement during the exercises .

    Methods one and two were respectively (1) toe curls using a special piece of equipment , and (2) the very simple approach of standing on a pressure mat and pushing the toes of one foot downwards . The second method produced a peak EMG in the abductor hallucis of about twice that found in toe curls indicating that it would probably be a far more effective method of strengthening the foot intrinsics .

    In fact ,although the researchers went out of their way to get a toe curl device that would produce as high an amount of activity in the abductor hallucis as possible , it remained only at about 30% of the maximum 100% value used by the researchers . So toe curls , flat out and in the optimal conditions , are probably of very little use , if any , in strengthening the abductor hallucis or other intrinsics .

    I realise that some influential academics have , in the past , advocated the use of all sorts of toe curl activities and devices , but this study indicates just how inappropriate these are for foot strengthening . In my opinion you might as well be trying to improve bicep strength by simply swing your arms backwards and forwards .

    And so to the third measurement method the researchers used . This method was in a different category altogether than (1) and (2) .

    Method (3) used metatarsal doming but with an inelastic plastic cuff placed over the dorsal surface of the foot to resists the doming action . The EMG in the abductor hallucis produced by this method was near 100 % of the experiment maximum value .
    Actually , a better way of isolating the abductor hallucis during this "isometric hold "measurement method , is to have the toes raised in a dorsiflexed postion . This method has already be used by other research groups to build foot strength by up to 60-70% in only 8 weeks .

    It is also worth noting that method (3) used by the researchers also produced EMGs in the tibialis anterior and peroneus longus that would indicate muscle strengthening would occur in these muscles if the protocol was switched from measuring to strengthening . So potentially one simple exercise , lots of muscles around the foot and ankle strengthened .

    Gerry
     
    Last edited: Dec 22, 2019
  5. Dr Rich Blake

    Dr Rich Blake Active Member

    Gerry, thank you so very much for the explanation! Toe curls have especially bothered me with the pes cavus people as it encourages hammertoes. Have you heard of Toe Pro device for intrinsic muscle strength? Just heard of it at a lecture in New York. Rich
     
  6. scotfoot

    scotfoot Well-Known Member

    Rich
    I realise of course , that you are perfectly capable of reading and understanding the paper for yourself , but I thought I would summarise it for any other readers who might be disinclined to visit the paper via the link.

    Re the Toe Pro , yes I am aware of it and I think it is soon to be tested on patients in the USA .

    One other thing that might be of interest to you is a conference abstract (see below ) that looks into intrinsic and extrinsic foot muscle involvement in posture .If you look at figure 1 , you can see that in a double squat position , the most active foot muscle by far is the tibialis anterior (35% of MVC ) .

    You can see then why older people , with age induced muscle atrophy , might have trouble getting into and out of chairs , since this involves the double leg squat position ,which might be difficult with weakened tibialis anterior muscles .



    [PDF]
    Intrinsic and extrinsic foot muscles have unique roles in ...


    www.asbweb.org › conferences › abstracts › 313AE--Intrinsic And Extrins...


    by T Kurihara - ‎Related articlesOur results indicate the intrinsic and extrinsic foot muscles activate as unique groups. The activity of intrinsic and extrinsic foot muscles increases with postures of increasing balance difficulty in a similar manner.
     
  7. Dr Rich Blake

    Dr Rich Blake Active Member

    Plus as they age the Achilles tightens making it harder for the AT to work. Rich
     
  8. richardbaker

    richardbaker Welcome New Poster

    Toe curls have especially bothered me with the pes cavus people as it encourages hammertoes. Have you heard of Toe Pro device for intrinsic muscle strength? Just heard of it at a lecture in New York. Rich
     
  9. scotfoot

    scotfoot Well-Known Member

    Generally speaking , until now , just about every site on the internet offering advice on exercises for the foot has included toe curling activities , such as the towel curl , as part of its information package . This includes sites run by national and respected professional bodies .

    I , and many others , think it is a bad exercise since it targets the extrinsic toe flexors , not the intrinsic toe flexors , and may have the capacity to cause or exacerbate muscle imbalance .

    Yesterday , for the first time , I came across a Scottish NHS site which gives advice on foot exercises but which does not include any reference to toe gripping exercises . I have no idea who was advising them (the site organisers ) but it appears to have been a person or persons who know their onions .

    www.nhsinform.scot › muscle-bone-and-joints › exercises-for-foot-pr...
    Exercises for foot muscle or joint problems | NHS inform

    26 Aug 2019 - Exercises for foot problems. Introduction. Seated foot and heel raise. Toebend. Big toe lift and hold. Standing calf stretch. Ankle stretch.
     
  10. scotfoot

    scotfoot Well-Known Member

    Adapted from ; Bruening, D.A., Ridge, S.T., Jacobs, J.L. et al. Functional assessments of foot strength: a comparative and repeatability study. BMC Musculoskelet Disord 20,608 (2019). https://doi.org/10.1186/s12891-019-2981-6

    In my opinion these pictures and graphs , taken from the paper referenced above , demonstrate why toe curls are a near useless exercise for strengthening the intrinsic foot muscles .
    Fig A shows a max toe pull or curl , and you can see in muscle activation graph linked to by the red arrow , that the abductor hallucis is not that active in the exercise .
    Now look at the activation levels linked to exercise C , where the toes and muscles of the lower leg arch the top of the foot up against a fixed nonelastic leather strap . Far higher activation levels .
    upload_2020-2-8_13-45-8.png

    upload_2020-2-8_13-45-9.png
     
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