It looks pretty certain that the intrinsic foot muscles play an important role in static and dynamic balance and we also know that these muscles are weak in the average individual and even weaker in older people.
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But does strengthening these muscles help to prevent falls? Well, we don't really know. Some large scale trials have been carried out to see if podiatry based interventions can help to prevent falls, but the results were not encouraging . However, the foot exercises used in these large scale trials would do little if anything to strengthen the intrinsic since the only "toe exercises" used where grabbing/curling activities.
Recent research has shown that if you want to target the intrinsics then you need to create torque around the MTPJs whist the joints between the bones of the toes remain straight. This has previously been demonstrated for the abductor hallucis and now very recently for the flexor digitorum brevis, and likely applies to all the plantar intrinsics other than the quadratus plantae, a curling muscle.
So where does that leave us in terms of exercises to strengthen the intrinsic foot muscles.
Calf raises -no ,shown to be ineffective.
Toe curls - no an extrinsic foot muscle exercise ( towel curls ,marble pickups).
Strict short foot exercise - no, if the toes are not being pressed down then the plantar intrinsics are not firing.
Doming exercise or less strict short foot exercise where the toes press down - will activate the intrinsics but low dosage
Functional exercises -this is where we started ,targeted exercises is required.
Banded toe flexion - will work to a degree . Karen Mickle used this exercise to strengthen the toe flexors of older people and was successful. I remember heaping praise on her a bit but I did this because she got it right when practically everyone else was getting it wrong.
Novabow toe press - In my opinion, a game changing exercise option that is planned to be launched later this month (my company holds patents in a number of countries). It allows the toe press action that targets the intrinsics in particular and resistance levels are easy to control. Also, people report enjoying using the device.
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