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The influence of body posture and added mass on intrinsic and extrinsic foot muscle activation and force output during common foot strengthening exercises

Review written by Dr Melinda Smith info

Key Points

  1. Activation of intrinsic and extrinsic muscles and metatarsophalangeal joint torque differed markedly across commonly used foot exercises.
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BACKGROUND & OBJECTIVE

The intrinsic foot muscles are critical contributors to lower limb function - supporting balance, walking, running, and jumping - and have become an increasingly prominent focus in both rehabilitation and performance settings (1). A wide variety of foot strengthening exercises have been described, but our understanding of which exercises best load these muscles has been limited. Existing investigations have relied on electromyography (EMG) to evaluate exercise effectiveness, measuring muscle activation but not force production (2-5).

While activation reflects muscle recruitment, it is not the same as load, and sufficient mechanical load drives strength adaptation (6). For clinicians prescribing exercises with a strengthening intent, understanding which exercises generate meaningful mechanical load through the foot is essential.

This study examined muscle activation and force output across a range of commonly prescribed foot strengthening exercises, and the effect of two modifications - a forward lean and added mass - on these outcomes.

The intrinsic foot muscles are critical contributors to lower limb function and have become an increasingly prominent focus in both rehabilitation and performance settings.
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Single leg heel raises with a forward lean closely replicated push-off demands during walking, making them well suited when progressive loading is the therapeutic goal.

METHODS

  • 15 individuals (9 males; mean ± standard deviation age = 36.58 ± 8 years, height = 175 ± 12cm, weight = 72 ± 17kg) with no history of lower limb injury or surgery in the previous six months and no
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