The muscles of the foot
The foot muscles are divided into two main groups: The external and the intrinsic (internal) muscles.
The external muscles
The external muscles start in the lower leg, cross over the ankle and attach to the foot. They dorsiflex (lift up), plantarflex (point down), invert (turn in) and evert (turn out) the foot. Examples include the tibialis posterior and tibialis anterior muscles.
The intrinsic muscles
The intrinsic foot muscles originate and end in the foot itself and are divided into two groups. The dorsal muscles are on the top and the plantar muscles are on the bottom of your foot.
The plantar muscles consist of 4 layers. They make up the majority of the intrinsic foot muscles and play a greater role than the dorsal muscles in foot function.
Intrinsic muscles help with balancing, stabilizing, and supporting the arch of your foot. They also help the external muscles produce fine movements of the toes.
Strengthening your intrinsic foot muscles: Why it matters in plantar fasciitis
Plantar fasciitis can be caused by many factors and is often a complex condition to treat. A successful treatment regime for plantar fasciitis usually consists of many different components, of which exercises is one.
Exercises to alleviate foot pain are often directed at the larger external muscles while ignoring the foot’s smaller, less obvious intrinsic muscles. The problem with this approach is it misses a crucial element in plantar fascia rehab: The core of your foot!
The "foot core"
Some researchers suggest your foot has a core system similar to your abdominal core.
Your abdominal “core” stabilizes and helps your spine, pelvis, and upper limbs move safely and efficiently – keeping you injury-free. This core stability relies on adequate muscle control and coordination (dynamic control) and enough strength and endurance to bear different loads during your activities (tissue capacity).
If we relate the abdominal core stability concept to your foot, strengthening your intrinsic foot muscles would be like strengthening the core of your foot. As a result, your foot and ankle will be more stable and robust, which can help prevent injuries like plantar fasciitis.
The importance of the "foot core"
Injury prevention and treatment benefits of strengthening your intrinsic foot muscles
One crucial aspect to understand about your plantar fascia is that it is not structurally equipped nor meant to be the only structure supporting your foot.
Instead, it works with your intrinsic muscles, joints, ligaments, and nerves to stabilize your foot and transfer loads through it as you stand, walk, and run.
Strengthening your core foot muscles can improve your:
- Foot stability
- Shock absorption
- Proprioception (joint position sense)
- Reaction time to changes in your environment
Even though a flat foot arch is often associated with plantar fasciitis, treatment is not simply about changing the shape of your foot arch. Some people have flat foot arches and have absolutely no issues with plantar fasciitis.
Foot strengthening exercises should aim to make your whole foot more agile, strong, and stable (regardless of its shape) while you’re moving. As a result, your foot absorbs and transfers loads more evenly.
In addition, your plantar fascia isn’t left to manage all the pressure passing through the foot alone.
The best foot strengthening exercises for plantar fasciitis
Many simple yet effective foot exercises can be integrated into your broader plantar fasciitis rehab program, depending on your stage of healing.
Low-load exercises that teach you to correctly activate and use your foot muscles are an excellent place to start. Examples of these are the Toe Yoga or Towel Grab exercises mentioned lower down.
A progressive program
Once those are easy for you, it’s essential to progress to higher-load activities so that your foot and plantar fascia can adapt to more load.
Keep building your strength slowly and challenging your foot stability in a way that suits your specific needs and activities.
For instance, activities that challenge your balance on one leg and on different surfaces are a great way to introduce more load to your foot muscles. In this way, they’re forced to work against your entire body weight. Which you need to be able to do to run!
Any exercise progressions you make along the way should be adapted to your injury as your symptoms allow, and as they improve.
It’s crucial to know that the initial rehab exercises are not enough to prepare your foot and plantar fascia for the type of loading that running demands from you.
You’ll have to include jumping-type activities during the later stages of your rehab. These exercises train your foot to take and transfer loads quickly and efficiently, which helps prevent re-injury.
We’ve designed the Plantar Fasciitis rehab plan in the Exakt Health app with all of this in mind. The app uses specific exercise and movement tests to determine when your foot is ready to progress. The app is free to download from the app store.
Some of the intrinsic muscle exercises we recommend for treating and preventing plantar fasciitis include:
Why: This is a great place to start if you are new to foot exercises or lack movement awareness and coordination in your feet. It helps to teach you how to use the individual muscles in the foot in a neutral position and can be done anywhere, anytime.
- Sit on a chair so that you can easily see your feet
- Slowly lift ONLY your big toe off the floor. All your other toes should remain relaxed on the floor and not be scrunched up
- Then place your big toe back on the floor and lift your other toes off the floor
- Do 20 times
- Your foot should not roll in or out as you move your toes; it should remain still in the middle
Top tip: It helps to guide the movement with your hands if you find it hard to do.
Towel grab exercise
Why: This exercise helps build the muscles that give the arch of your foot its healthy curved shape. It also keeps it stable while you move and the strain off your plantar fascia!
- Sit on a chair – it works best if the floor is slippery or smooth
- Place your foot on a towel and use your toes to gather the towel
- Do 20 “towel grabs”
- Then rest 30 seconds
- Do 5 sets
Progression: You can progress this one by placing a small weight on the towel. For instance, a book or small hand weight. Then build it up as you’re able.
Why: Balance exercises are a way of bringing in a functional element to your intrinsic foot strengthening. For example, it helps your foot muscles learn how to switch on correctly when you’re standing and builds their endurance in preparation for walking and running.
- Tense your core muscles gently and shift your weight over to one side
- Make sure that your pelvis stays level as you lift your leg off the floor
- Balance on one leg
- Try to keep your foot as still as possible and don’t allow it to roll in or out
- Your weight should be evenly distributed between the ball of your big toe, the ball of your little toe, and your heel
- Work on it until you can easily balance for 30 seconds
- Switch legs and do the other side
- Repeat 3 times on each leg
Progression: You can make this exercise harder by turning your head or closing your eyes while balancing.
One piece of the puzzle
There are many ways to treat plantar fasciitis. On their own, foot strengthening exercises cannot heal your pain nor make your plantar fasciitis disappear. However, they can help develop your foot’s core and provide you with a powerful and more dynamic base of support to move from.
A comprehensive rehab plan should also include exercises that strengthen the plantar fascia specifically as well as exercises for the hips and legs in general. Research has also shown that a stretching regime that targets the plantar fascia and muscles in the posterior chain of your leg may be beneficial.
The treatment plan in the Exakt Health app is designed to take all of these areas into consideration and provide you with a mix of exercises that are tailored to your stage of healing. You can download it from the app store.