The Foot Core Paradigm: Let's Think Differently about the Foot

The foot is a complex structure with 28 bones, 33 articulations and 20+ intrinsic and extrinsic muscles.  Unfortunately, due to this complexity, the foot has been simplified, sometimes as a single unit, in biomechanical models. Clinically, treatment of the foot has been focused on passive approaches such as taping, bracing, and palliative interventions, as opposed to active strengthening. The arch of the foot alone contains 10 intrinsic muscles arranged in 4 layers.  These small muscles are critical for the stability of the foot and for normal foot function. This is very much like the role of the stabilizing muscles of the lumbo-pelvic region.  Recent studies have shown that chronic support of these foot intrinsic muscles results in their weakening, while removal of chronic support results in their strengthening.  The purpose of this presentation is to discuss the importance of the strength and function of foot core muscles and their contribution to healthy foot function.  It is hoped that this will provide a greater awareness of how we, as both scientists and clinicians, can better leverage our feet.