Foot Core Training to Prevent Running-Related Injuries

Members do not see these Ads. Sign Up.

Foot Core Training to Prevent Running-Related Injuries: A Survival Analysis of a Single-Blind, Randomized Controlled Trial
Ulisses T. Taddei, PhD, PT, Alessandra B. Matias, MSc, PT, Marcos Duarte, PhD, ...
The American Journal of Sports Medicine November 6, 2020

 

Related Thread:
'Core stability' of the foot

 

A very interesting paper from Taddei et al particularly in light of the work done over the last 20 years or so by Sue Mayers with Australian Ballet . Here is part of the Taddei conclusion :

Conclusion:
Recreational runners randomized to the new foot core strengthening protocol had a 2.42-fold lower rate of RRIs compared with the control group.

So what has Sue Mayers go to do with the present study ? Well ,using intrinsic foot muscle strengthening exercises and calf raises ,she has greatly reduced injury rates among members of the Australian Ballet .
You could say that the Taddei paper has given emphatic , empirical backing to Mayers long held subjective observations .

 

Here is some information on Sue Mayer which might be of use if you are interested in injury prevention ;

Susan Mayes is a physiotherapist who heads up a medical team which has drastically cut the number of injuries among the members of the Australia Ballet group . Their methods have been have been noted by the global ballet community and in one instance ,a prominent dancer from the US was given his career back by their treatment .
Among a number of other measures , Mayes focuses on the strength of the calf musculature and the strength of the intrinsic foot muscles , and dancers do supplementary exercises in these areas . That's worth noting ; athletes who are dancing for many hours a day , often explosively and in minimal shoes ,benefit from targeted intrinsic muscles training which seems to help prevent injury .

This is one factor that puts Mayes years ahead of researchers who believe that training in minimal shoes will strengthen the intrinsics and lead to injury reduction . She found that even among dancers trained from an early age ,insufficiently strong intrinsics and minimal shoes can lead to injury . Specific strengthening seems to be required through exercises such as doming .

.From a recent article in The Australian from an article titled "Is this Elite sports top physio " by Emma Sandall , around Dr Sue Mayers and her work with the Australian Ballet .

Quote
"Mayes also emphasises the importance of strengthening the calf and intrinsic muscles in the foot for all athletes. One study has shown that the foot can generate 17 per cent of power through the body.
“If you don’t pay attention to strengthening it, you can waste all that potential power,” says Mayes. “Not to mention its potential for injury prevention and management.”
End quote

Put simply Mayes seems to be better at prehab and rehab than anyone else when it comes to the foot and ankle .The results looked at over about 20 years ,with 180 professional athletes/dancers , bear that out .

It's all in the feet: Intrinsic foot strength in dancers | Dance ...
www.dancewriter.com.au › health › its-all-in-the-feet-in...
4 Sep 2019 - Grouped together, they are called the 'Intrinsic muscles', named because their origin and insertion is within the foot. They work specifically across ...

 

So what sort of exercise protocol did Taddei et al use ?

Well ,it's an extensive set of exercises , probably because of the difficulty that strengthening the foot intrinsics presents.
The authors will no doubt be aware of the possibility of targeting all of the relevant muscles with a single exercise (see Bruening et all 2019 ,figure c ) and this might cut any exercise program down to 10 mins x2 a week .

Going back to Mayes and Australian Ballet it should be noted that specific targeted foot exercises are likely to be carried out more diligently by professional dancers than by recreational runners .

Also worth considering is the following .
Mayes's methods over the last 20 years will have been very much judged on results .
It doesn't matter if she has great patter , a string of letters after her name or even if she is married to the company director or the Australian Prime Minister .If what she does doesn't work ,out she goes . Injuries cost money and the bean counters see only the figures .

Clearly ,to have lasted so long in one place in what could be called professional athletics ,she must be doing things better than possible replacements .

If you are involved in prehab/rehab with athletes , why are you not doing what Mayes does ?

Bruening et al link
https://www.researchgate.net/public...trength_a_comparative_and_repeatability_study

 

Re the Taddei paper ,an injury reduction rate of 50% just by strengthening the feet sounds unlikely . However , the paper linked to below by Farris et al 2019 ,demonstrates that without properly functioning intrinsic foot muscles, push-off is impaired in both walking and running , necessitating altered gait strategy with obvious and significant knock-on effects throughout the lower body .
Over time it seems quite possible that the biomechanical changes in gait caused by intrinsic weakness /early fatigue might lead to RRI .

The functional importance of human foot muscles for bipedal ...

www.pnas.org › content

17 Jan 2019 — The Nerve Block. Measurement of the peak-to-peak M-wave response of the flexor digitorum brevis (FDB; Fig. ... Foot power was calculated as per Takahashi et al. (28) and ... Kelly LA,; Farris DJ,; Lichtwark GA,; Cresswell AG.
by DJ Farris · ‎2019 · ‎Cited by 52 · ‎Related articles

 

Subgroups of Foot-Ankle Movement Patterns Can Influence the Responsiveness to a Foot-Core Exercise Program: A Hierarchical Cluster Analysis
Ricky Watari et al
Front Bioeng Biotechnol. 2021 Jun 8

 

Another paper suggesting that for some, foot strengthening can help reduce knee pain and even lead to strengthening of the hip musculature .
Short foot exercises have additional effects on knee pain, foot biomechanics, and lower extremity muscle strength in patients with patellofemoral pain

• DOI: 10.3233/BMR-200255

Abstract

Background: Patellofemoral pain (PFP) is a common knee problem. The foot posture in a relaxed stance is reported as a distal factor of PFP. However, the effects of short foot exercise (SFE) on the knee and functional factors have not yet been investigated in patients with PFP.
Objective: This study aimed to investigate the additional effects of SFE on knee pain, foot biomechanics, and lower extremity muscle strength in patients with PFP following a standard exercise program.
Methods: Thirty patients with a 'weak and pronated' foot subgroup of PFP were randomized into a control group (ConG, n= 15) and a short foot exercise group (SFEG, n= 15) with concealed allocation and blinded to the group assignment. The program of ConG consisted of hip and knee strengthening and stretching exercises. SFEG program consisted of additional SFE. Both groups performed the supervised training protocol two times per week for 6 weeks. Assessment measures were pain visual analog scale (pVAS), Kujala Patellofemoral Score (KPS), navicular drop test (NDT), rearfoot angle (RA), foot posture index (FPI), and strength tests of the lower extremity muscles.
Results: Both groups displayed decreases in pVAS scores, but it was only significant in favor of SFEG. NDT, RA, and FPI scores decreased in SFEG whereas they increased in ConG. There was a significant group-by-time interaction effect in hip extensor strength and between-group difference was found to be significantly in favor of SFEG.

Conclusions: An intervention program consisting of additional SFE had positive effects on knee pain, navicular position, and rearfoot posture. An increase in the strength of the hip extensors may also be associated with improved stabilization by SFE.

Keywords: Patellofemoral pain; foot core; foot posture; short foot exercises.

 

Predictive Effect of Well-Known Risk Factors and Foot-Core Training in Lower Limb Running-Related Injuries in Recreational Runners: A Secondary Analysis of a Randomized Controlled Trial
Eneida Yuri Suda et al
Am J Sports Med. 2021 Nov 17

 

Effects of Foot-Core Training on Foot-Ankle Kinematics and Running Kinetics in Runners: Secondary Outcomes From a Randomized Controlled Trial
Alessandra B. Matias et al
Front. Bioeng. Biotechnol., 14 April 2022