JEFF CUBOS
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Making seemingly random connections across disciplines

Midfoot Mobility - Toe Extension - Strength

9/16/2018

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Years ago I wrote about exercises for plantar sided foot pain. Much of what I thought back, then I still think today. However, there are two key principles I overlooked that currently find very important. That is,

  • Midfoot mobility is as important as great toe extension. 
  • We need to strengthen the foot in toe extension.

For the former, many are aware of the importance of extension of the first metatarsophalangeal joint. It is not uncommon to see many ways of improving mobility of said joint. What I have learned over the years however, is that attacking first MTP mobility is futile in the absence of medial arch mobility. That is, in order for the first metatarsal to clear room for the phalanx to extend, the joints upstream must be in doing their job well. It's not uncommon to see arthopathy and spur formation at the junction between the cuneiform and first metatarsal, so before we aggressively stretch and mobilize the first MTP joint, we need to ensure that we give respect to all joints of the foot and ankle. One isn't more important than the rest.

As for the latter, it was noted by Thomas Michaud that collectively we often strengthen the foot in neutral and/or plantar flexion. And that we often fail to do so in toe extension, if not eccentrically in toe extension. Concentric toe flexion exercises are common. So are eccentric toe extension exercises. What aren't so common are isometric and eccentric exercises, in closed kinetic chain, and in toe extension. These are key in athletics/sport and they are paramount in fall prevention in the elderly.

In the video below are some progressions of low level foot strengthening exercises. For the complete videos, simply go to my youtube page. And for those curious, I'm using Toe Spreaders from The Foot Collective. 
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I created this blog to share my thoughts with others. It is not intended to be used for medical diagnosis, medical treatment or to replace evaluation by a health practitioner. If you have an individual medical problem, you should seek medical advice from a professional in your community. Any of the images I do use in this blog I claim no ownership of.
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