The importance of the intrinsic muscles of the foot in running
By Christina Valerie, Wednesday, February 2, 2016
One of Track Club’s finest attributes is its ability to bring together a wide variety of runners. From scientists (yours truly), to artists, lawyers, teachers, cooks, armed service personnel, on and on… The San Diego Track Club has it all, which provides for so many interesting and insightful interactions, and additionally, a wealth of information to draw from! Need content for an article from a physical therapist? Well, turns out SDTC has got those too!
Recently, I had the opportunity to spend some time with one of our SDTC members, Adam Iannazzo. I visited him at Feats of Strength, Adam’s physical therapy practice in Mission Valley. Adam has been a practicing PT for over 13 years now. He began running in 2010 after practicing Tae Kwon Do for many years and wanting to improve upon his cardiovascular fitness. He loves SDTC and plans to be lifer!
Through Adam’s experiences in running, he has significantly increased the focus of his practice to treating athletes and runners in particular. He has gained invaluable knowledge about the imbalances, weaknesses and injuries that impact runners the most. Adam hopes to spread his message of preventative maintenance to the running community. He believes that a strong and well balanced runner is a faster runner and most importantly, is an injury free runner!
When I first came to see Adam, he put me through a whole battery of tests to assess my needs. One of Adam’s beliefs, which he shared with me, was about just how paramount the foot is in running, and how we often neglect it when it comes to strength and mobility training.
“Almost all knee pain issues are a combination of poor foot and ankle mechanics and hip weakness… Plantar fasciitis, Achilles and calf tendonitis … mortons neurmoma… stress fractures, “shin splints” and over-pronation… These little muscles are so important but nobody works them! It’s like the little muscles in your palm for gymnasts.” -Adam Iannazzo, PT and owner of Feats of Strength (FeatsOfStrength.fit).
Interestingly enough, a recent review article was published in the British Journal of Sports Medicine (http://bjsm.bmj.com/content/49/5/290.full), describing this very topic. I guess Adam knows his stuff! According the review:
“The movement and stability of the arch is controlled by intrinsic and extrinsic muscles. However, the intrinsic muscles are largely ignored by clinicians and researchers. As such, these muscles are seldom addressed in rehabilitation programmes.” -BJSM Review Article
During our meeting, Adam talked about the importance of these intrinsic muscles and even pointed out during some of my single leg balance tests, how much my extrinsic muscles were firing, obviously compensating for weak intrinsic muscles.
But what on earth are intrinsic muscles and intrinsic movements, you ask? I have no idea… But thankfully Adam does. By his calculations, they are:
“…the small motion controlled by the muscles located inside of the foot arch and between the long bones of the toes … The intrinsic muscles of the foot (along with a few extrinsics and the plantar fascia) support and absorb the force created when walking, running or jumping. If the intrinsics are weak, we can’t fire them or have poor endurance, the force from the ground goes to the next available joint and muscle which is the ankle and Achilles tendon and then into the knee and up to the hip and then all the way out the neck and head!!!! With good intrinsic control, the amount of force that exits the head is significantly reduced and all pains get better, runners become more efficient and faster!” -Adam
The aforementioned article provides a great figure illustrating the numerous intrinsic muscles of the foot (don’t worry, I was completely oblivious about these too!):
So now that we know they’re there, how do we put them to work to keep us healthy and improve our running efficiency? Adam has a few exercises which he likes to prescribe to his fellow runners:
“At the foot and ankle I would like everybody to start working on lifting the toes while pushing down with the big toe and then reversing it as many times and as fast as they can until they almost cramp. Then trying to let the medial arch fall then squeeze it up to create the biggest arch they can.” -Adam
The last part of this exercise is also mentioned in the recent review article and is diagramed below for all of you visual learners:
Additionally, Adam suggests:
“… try a few barefoot runs in the sand at first but start slow…” -Adam
Adam does warn that this should be introduced Very slowly, starting with a quarter to a half mile per week, to allow for your body to properly acclimate as this can be strenuous on your calves and Achilles tendons at first.
Some research does in fact exist, supporting the benefits of barefoot running (another point to Adam!!). The review article summarizes a previous study:
“Robbins and Hanna reported a significant reduction in the foot length (measured radiographically from the anterior aspect of the calcaneus to the first metatarsophalangeal joint) following 4 months of barefoot walking and running. The shortened foot is an indirect measure of foot strengthening as it indicates a raising of the arch. Muscle size has been directly correlated to muscle strength.” –BJSM Review Article
The evidence for a higher arch and stronger foot is there, however, the authors do explain that:
“Further studies are needed to determine whether strength and cross-sectional area gains of the foot core muscles lead to a reduction in running-related injuries.” But that “ Clearly, a stronger foot is a healthier foot.“ –BJSM Review Article
So, in the meantime, let’s put those little piggies to work and find ourselves on the path to more efficient and injury free running!
See you all on the track!
Tina
**More questions on this topic? Feel free to contact Adam Iannazzo.
References:
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McKeon et al. The foot core system: a new paradigm for understanding intrinsic foot muscle function. British Journal of Sports Medicine (2016).
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Adam Iannazzo, BS, MPT
Owner of Feats of Strength