Author: Dr. Joel Seedman

Topics: Exercise performance, foot and ankle health

All information is attributed to the author. Except in the case where we may have misunderstood a concept and summarized incorrectly. These notes are only for reference and we always suggest reading from the original source.

Other than proper posture and spinal alignment, foot and ankle function may be the single most important factor when it comes to optimizing movement quality, biomechanics, and muscle function. Foot, ankle, and toe neglect can be exhibited as the following weaknesses: (1) pain to the hips, knees, and back, (2) lack of mobility, (3) chronic and acute injuries throughout the body, and (4) poor balance, proprioception, and instability. Activation starts in the feet and ankles.

CHAPTER 1:

THE BAREFOOT AND MINIMALIST TREND

The barefoot shoe trend caused a host of injuries due to a lack of physical preparedness and improper use. The feet, ankles, and toes need to be trained first. Injury while wearing minimalist shoes is a good sign you have foot dysfunction of some sort.

THE BEST SHOCK ABSORBERS MONEY CAN’T BUY

Shoes end up taking the role of shock absorption and there is less ground reactive force being applied to the feet. Resulting in less foot proprioception and loss of innervation up the kinetic chain. Creating dysfunctional movement patterns. The activation of skeletal foot muscles helps to absorb force, reducing stress on the tendons, ligaments, joints, and connective tissue.

CHAPTER 2

THE BIG PICTURE

Squatting with weak ankles and feet contributes to faulty hip and knee mechanics, which indirectly affects the position of the spine. Associated with low back pain, neck impingement, shoulder injuries, and inhibition/weakness of the upper extremities.

FEET AND ANKLES AFFECT EVERYTHING

Intramuscular, intermuscular coordination, and motor unit recruitment are compromised (“pseudo-arthrokinematic manipulation”) without foot and ankle support. Displayed as externally rotated feet, valgus ankle collapse, and toe crowding.

SQUATS, HIP FUNCTION, AND HEAVY LIFTING

Performing heavy lifts without proper foot and ankle mechanics reinforces movement dysfunction.

STANCE MATTERS

Using excessively wide stance along with exaggerated external rotation of the feet during squats and deadlifts can contribute to dysfunction and cause damage to the hips and lower back. Assume a comfortable and minimal (10 degree toe flare) rotation.

CORE AND SPINE

With proper foot and ankle activation, greater spine stabilization and full body muscular activation is possible. The older you get, the harder it is to fix bad motor patterns and damage.

STRETCHING VS. ACTIVATION

There is greater value in addressing weakness in the anterior tibialis, posterior tibialis, peroneus longus, peroneus brevis, and extensor digitorum longus and brevis than by stretching the gastrocnemius and soleus. This can be done by various stabilization training, balance exercises, and arthrokinematic/osteokinematic manioulation (joint repositioning).

ACHILLES INJURIES

Establishing proper foot and ankle mechanics can greatly reduce the risk of these injuries.

SHIN SPLINTS

Related to the weakness and dysfunction in the aforementioned muscles.

CHAPTER 3

PERSONAL EXPERIENCE

It took him over a year to fix his flat feet, fallen arches, pronation, toe crowding, valgus ankle collapse, and external rotation. This is while learning new techniques himself.

WHAT ABOUT SHOES?

If most of your exercise is performed while in traditional shoes and you do little to train your feet and ankles, you’re probably training faulty ankle and foot mechanics.

BAREFOOT AND MINIMALIST TRAINING

Once the athlete is prepared, using minimalist footwear can build strength, create proper firing patterns, and optimal foot mechanics. Athletes should spend at least 50% of their training, practice, and skill work in barefoot or minimalist shoes.

TAKE IT SLOW

It may take weeks to months to progress.

PRACTICALITY

Use them as much as your lifestyle allows.

THE RIGHT BAREFOOT SHOE

Wide toe box to allow the toes to splay, a flexible sole so the foot can bend, zero drop heel, minimal to no cushion forcing the feet to provide shock absorption, little to no ankle support in the heel.

ORTHOTICS

Orthotics reinforce faulty foot mechanics by acting as a substitute for your muscles.

A TRUE TEST

You should warm up first, BUT, you should be able to sprint on asphalt without warming up. This means the ankles, feet, and toes are doing their job properly.

SKIN-RELATED ISSUE OF THE FEET

Blisters, corns, ingrown toe nails, bunions, general skin irritation of the feet, and many calluses can be traced to footwear and improper mechanics.

CHAPTER 4

ISN’T CALVE TRAINING ENOUGH?

No. Do eccentric isometrics (slow eccentric followed by 2-7s holds at the bottom position) to alleviate some minor ankle deficiencies. Bodybuilders should find greater lower body development with greater foot and ankle neural activation.

FOOT & ANKLE ACTIVATION: THE IMPACT ON HYPERTROPHY

Quads, glutes, hamstrings, and calves benefit. Learning to push through the outsides of the ankles, to avoid pronation, will help to build the outer quad swap.

PROPER FOOT MECHANICS DURING UPPER BODY MOVEMENTS

Straight foot position, knees pushed out slightly, weight more on the outside of the ankles, big toes pushed into the ground, and big toes spread out. Creates greater force production and neural drive to the upper musculature.

FLAT FOOT SYNDROME AND MISDIAGNOSIS

Not a permanent genetic disorder. Ankles push-outs, single-leg stand variations, single leg swaps, contralateral single leg loaded exercises, and dysfunctional offsetting single leg drills are useful.

FOOT AND ANKLE MECHANICS IN REGARDS TO SQUAT DEPTH

With greater activation, the lifter will hit a more parallel position rather than an exaggerated depth with forced external rotation of the feet.

LONG DISTANCE RUNNING

Long-term pavement punishment with faulty foot mechanics tends to contribute to pain, inflammation, injury, spasticity, and various forms of dysfunction.

CHAPTER 5

PASSIVE VS. ACTIVE FOOT ACTIVATION

Dormant and inactive feet have little innervation while running, resulting in passive recruitment. Strength coach Tony Gentilcore has discussed how critical active foot recruitment is for optimal lower body mechanics.

COMMON DEFICIENCIES IN THE ANKLES AND FEET

ANKLE AND FOOT PRONATION:

Inward collapse of the foot (valgus foot collapse) or ankle pronation/eversion is common. Often accompanied by prominent medial malleoli, over-pronation, flat feet, fallen arches, overlapping toes, genu valgum (knock-knee), prominent scaphoid/navicular bone, bunions, and hallux valgus. Duck foot or pigeon toe mechanics are associated with these issues.

A neutral position is ideal. Reducing ACL tears, low back injuries, knee pain, osteoarthritis of the lower body joints, sever ankle injuries, pulls, tears, strains, sprains, and fractures. If there is trouble driving knees out during squats, or if the feet significantly flare, pronated feet and/or ankles may be the problem.

ANKLE AND FOOT SUPINATION

Often seen in bow-legged people. Greater stress on the outer portion of the foot. Inflammation of the outer ankles, shins, and hips including the IT band, can be problems. Strengthen ankles by forcing them to assume proper alignment.

PROPER FOOT MECHANICS

3-point contact:

1. Near the proximal phalange also known as proximal phalanx, hallux or more commonly the big toe.
2. The lateral upper portion of the foot or outer ball of the foot in line with the 5th metatarsal, baby toe area.
3. Heel or calcaneus

He believes there should be greater emphasis on the base of the big toe rather than more posteriorly, so that you can maximize toe activation.

CHAPTER 6

FOOT, TOE, & ANKLE | 6 HOLISTIC EXERCISES

EXERCISE 1: STANDING FOOT MECHANICS WITH PERFECT POSTURE

Straight feet, no rotation, ankles pushed out or slightly supinated (unless already naturally supinated), more weight on the outside of the feet by pressing into the big toe, which prevents excess supination and engages toe muscles. Then focus on spreading the toes out as wide as they can while doing this exercise. Try to hold for 20-30s.

https://www.youtube.com/watch?v=oXjBmHYERlk

EXERCISE 2: STANDING ANKLE PUSH-OUTS

If you’re a pronator or have flat feet, this drill is useful. While standing, place load on the outside of the feet to drive ankles out forcefully. Keep the base of the big toe in contact with the ground. The outer hips and legs should feel tension.

Takes around 4-6 weeks to make this position natural during squats and deadlifts.

EXERCISE 3: TOE CURLS (DOUBLE OR SINGLE LEG)

While keeping weight on the outer portion of the ankles and heels, curl the toes up as high as possible, while keeping them spread, then reverse the position and curl them down. Holding each position for 2-3s and performed for 45-60s.

EXERCISE 4: UNSUPPORTED HEEL AND TOE RAISE

Great for activating muscles around the tibia while stretching areas prone to tightness around the calves. Focus on squeezing the tibialis anterior whilst doing a toe raise, then a heel raise whilst squeezing the calves. Ideally, this is performed with eyes closed for maximal stimulation and innervation. 10-12 reps of each. Single leg to increase intensity.

EXERCISE 5: ECCENTRIC ISOMETRIC CALVE RAISE

If you’re prone to tight Achilles or calves, or have trouble driving through the heels, spend plenty of time on eccentric isometric calve raises. Perform single leg variations for any imbalances.

EXERCISE 6: SHIN/TOE RAISES WITH RESISTANCE

Many individuals with flat feet, ankle pronation, tight calves, and externally rotated feet have weak shin muscles. Several sets of 10-12 reps with a several second pause at the stretched and contracted position is ideal.

CHAPTER 7

UNIFORM STABILIZATION | 8 CORRECTIONAL EXERCISES

Each exercise can be performed on hard floor, semi-soft surface (exercise mat, carpet), and unstable surface (foam pad, Bosu Ball). Also, with eyes closed, there is greater proprioceptor and stabilizer challenge. Try to perform 2-3 times per day and progress slowly.

EXERCISE 1: TOE TOUCH INLINE STRIDE HOLD

Great for weak feet and ankles. Stand with one foot staggered directly in front of the other with the front heel and back toe touching each other, keeping both feet straight. Hold for 30s and swap. Excellent for reaching proper hip alignment.

EXERCISE 2: SINGLE LEG STAND

With tall posture, lift one leg 10-12 inches in front of the other. Keep both toes straight while maintaining balance for 30-60s. Close eyes for a greater challenge.

https://www.youtube.com/watch?v=zS2rvw6l72k

EXERCISE 3: OVERHEAD SINGLE LEG STAND

Hold a bar or dowel in the overhead snatch position while doing the previous exercise for 30s.

EXERCISE 4: SINGLE LEG OVERHEAD PRESS

EXERCISE 5: SINGLE LEG RDL AND ROW

2-3 rows per RDL for 3-5 RDLs each side.

EXERCISE 6: EYES CLOSED LUNGE

Slow negatives and a pause can make it more challenging. Perfect the dumbbell and barbell versions before moving on to overhead lunges on a soft surface. Holding the bottom position for 3-7s.

EXERCISE 7: SINGLE LEG POWER HOLD

Hold a heavy barbell load on the back and do a single leg stand with perfect alignment for 10-20s. Can also be done with dumbbells or kettlebells.

EXERCISE 8: SINGLE LEG BALL SUPPORTED ISOMETRIC GLUTE BRIDGE

Single leg bridge while lying on a ball.

CHAPTER 8

DYSFUNCTIONAL OFFSETTING SINGLE LEG DRILLS (FEEDING DYSFUNCTION) | | 4 CORRECTIONAL EXERCISES

Specific foot issue exercises for pronation, flat feet, and supination.

EXERCISE 1: SINGLE LEG ANGLED HILL STAND

Stand on one leg laterally on a hill and hold your position. For pronated ankles and flat feet, the medial/portion of the planted foot should be on the decline.

https://www.youtube.com/watch?v=UT6mHflKIKM

Opposite side for the supinated.

EXERCISE 2: SINGLE ARM LOADED SINGLE LEG STAND

Hold a weight in the opposing arm to the planted leg. Good for anti-pronation. Same side for anti-supination.

EXERCISE 3: SINGLE LEG LEDGE STAND

Quite advanced. For pronated people, have the medial half portion of their foot hanging over the ledge for 20-30s while maintaining proper posture.

EXERCISE 4: SINGLE LEG PALLOF PRESS

Advanced all-in-one exercise for flat feet, ankle pronation, valgus ankle collapse, weakness, etc. Also works on core stabilization, anti-rotation, rotary stability, balance, scapular stabilization, spinal alignment, and postural control.

To perform, hold a standard Pallof press position and lift the inside leg.

https://www.youtube.com/watch?v=8ePuG_vHN5I

CHAPTER 9

REACTIVE STABILIZATION | 5 CORRECTIONAL EXERCISES

Stabilization is good for performance and joint integrity. These exercises provide unpredictable oscillations to force the joints to deal with irregular stimuli.

EXERCISE 1: SINGLE LEG STAND WITH PARTNER PERTURBATION

While standing on one foot, have a partner gently push from varying directions, angles, and positions.

EXERCISE 2: EYES CLOSED ECCENTRIC ISOMETRIC SQUAT ON BOSU BALL

Proper squat technique is paramount. Hold a 3-5s squat at the bottom. Overhead squat is incredibly challenging.

EXERCISE 3: LUNGE WITH PARTNER PERTURBATION

EXERCISE 4: HANGING BAND LUNGES

Cleans up gait mechanics, hip alignment, and flawed movement mechanics.

https://www.youtube.com/watch?v=RFKf9THte0U

EXERCISE 5: SINGLE LEG POWER HOLD WITH HANGING BAND TECHNIQUE

Similar to the power hold but with weights hanging from bands on the bar.

CHAPTER 10

RATE OF STABILIZATION DEVELOPMENT | 4 CORRECTIONAL EXERCISES

Previous exercises are good for recruiting high numbers of muscle fibers in the feet. The following do the same but with quick firing.

EXERCISE 1: MARCHING 3-STEP STOP AND HOLD

EXERCISE 2: SINGLE LEG HOP AND STABILIZE

With eyes closed, the body refuses to stabilize until it’s perfectly aligned. Hold each rep landing for 10s.

EXERCISE 3: SINGLE LEG MED BALL CHEST PASS

8-10 reps per leg. Easier with a partner.

EXERCISE 4: SINGLE LEG BOX JUMP-OVERS WITH STABILIZATION

Forces all the foot and ankle muscles to work in synchrony. Dangerous if you have bad stabilization and strength.

CHAPTER 11

SINGLE LEG SWAPS | 10 CORRECTIONAL EXERCISE VARIATIONS

EXERCISE 1: THE BASIC SINGLE LEG SWAP (WITH KB OR PLATE)

Hold a KB or plate in one arm while on one leg, swap over hands 8-12 times after a 3-5s hold.

EXERCISE 2: RAPID SINGLE LEG SWAP

Do the previous quicker.

EXERCISE 3: TOE-TOUCH STRIDE HOLD KETTLEBELL SWAP

Good for those who struggle with the previous ones. Swapping while one foot is behind the other.

https://www.youtube.com/watch?v=Y7h-_CrcNvk

EXERCISE 4: ECCENTRIC ISOMETRIC LUNGE WITH KETTLEBELL SWAP

Pass the KB under the leg from side to side.

EXERCISE 5: SINGLE LEG SWAP WITH HANGING BAND TECHNIQUE (HBT)

https://www.youtube.com/watch?v=oP7Q4h194ac

EXERCISE 6: SINGLE LEG RDL SWAP

EXERCISE 7: LANDMINE SWAP

https://www.youtube.com/watch?v=3l7sEdH0peA

EXERCISE 8: BUMPER PLATE SWAP

Good for concurrent activation potentiation (CAP), where activation of the smallest muscles in the extremities increase neural drive throughout the entire body.

https://www.youtube.com/watch?v=ApEEaPJdS08

EXERCISE 9: OVERHEAD SWAP

https://www.youtube.com/watch?v=iPXJ_3L-VVM

EXERCISE 10: BULGARIAN SQUAT WITH KETTLEBELL SWAP

Pass between the legs. Painful.

CHAPTER 12

10 ADDITIONAL BENEFITS OF THE SINGLE LEG SWAP

BENEFIT 1: WORKS FOR ALL TYPES OF FOOT, ANKLE, & HIP DEFICIENCIES

BENEFIT 2: IMPROVES ALIGNMENT FROM HEAD TO TOE

BENEFIT 3: ENHANCES FULL BODY STABILIZATION

BENEFIT 4: ELIMINATES ENERGY LEAKS

BENEFIT 5: ANT-ROTATION, ANTI-LATERAL FLEXION, & CORE STABILIZATION

BENEFIT 6: IMPROVED POSTURE AND SPINAL ALIGNMENT

BENEFIT 7: TEACHES MENTAL CONCENTRATION

BENEFIT 8: ENHANCED BODY AWARENESS AND PROPRIOCEPTION

BENEFIT 9: EASY TO COACH

BENEFIT 10: HIGHLY VERSATILE

CHAPTER 13

OTHER EXERCISES

The goal is to train stabilizers, not to overload the prime movers. Don’t substitute heavy exercises with a Bosu ball or something silly.

Standing upper body exercises like bicep curls, lateral raises, shrugs, etc. can be turned into single leg exercises. Slow eccentric squats, hinges, and lunges are also good while keeping eyes closed.

Chapter 14

PROGRAMMING

Can be done between sets of compound exercises, turning rest into active recovery. Good before heavy lifts, to turn on feet and ankles.

10 minutes a day of 1-3 different drills, with 2-3 sets.

CHAPTER 15

20 ADDITIONAL BENEFITS & KEY NOTES

• Resolved foot and ankle issues.
• Addresses weakness and physical deformities in neuromuscular system and forces you to deal with them instead of using normal shoes as a crutch.
• Don’t restrict toe movement with tight socks.
• Avoid Olympic shoes unless you’re a high level competitive Olympic weightlifter.
• Lactic acid accumulation in the feet and ankles is likely. As well as cramping. Signs you are using underdeveloped areas.
• Can be performed anywhere.
• High-quality barefoot shoes: Skora, Topo, Merrell, New Balance, Vivo Barefoot, Pedestal Footwear, Vibram, Inov8, and Nike Free 1.0.
• Bosu Balls are useful for full body stimuli.
• Most individuals have one foot or ankle with greater issues. Note which side and fix the imbalance.
• Wear toe spacers occasionally if your toes overlap.
• Walk around the house barefoot as much as possible.
• Even if you haven’t displayed any direct issues you probably have dysfunction.
• Foot and ankle mechanics are a good gauge on muscle function and health.
• If feet and ankles aren’t working properly you undoubtedly have other issues too.
• Single legs require being almost perfectly in front of the other, pointed straight, no toe flare.
• He believes half the injuries we see in athletes are due to foot and ankle dysfunction.
• Feet and ankles require progression and a variety of stimuli like other muscles.
• Sports related ACL injuries can usually be traced to pronation, flat feet, and valgus ankle collapse.
• Lower limb exercises should be used to practice foot and ankle activation. Also, in between sets you can do single leg stands, swaps, shin raises, RDLs, etc.

CHAPTER 16

FOOT AND ANKLE EXERCISE PROGRAM

FIRST STEPS FIRST: SELF-ASSESSMENT

Supinate or pronate? Stand in front of a mirror and examine the ankle. If feet and ankles cave in you pronate. Bodyweight squats amplify the issue if you’re having trouble.

PROGRAMMING OVERVIEW

• 6 intense workouts
• 3 Light workouts
• 1 General workout
• 1 Daily workout
• 1 Pronation workout
• 1 Supination workout

PROGRAMMING FOR BEGINNER TRAINEES

• Intense vs. Light workouts: For beginners, one should alternate between one intense and one light.
• Pronation vs. Supination: Every 4-5 days, one should do either pronation or supination depending on your assessment results.
• General workout: If you’re going to perform one strengthening routine for feet and ankles and don’t feel you need an in depth program this workout is ideal. Once every 3-5 days with intense and light routines. If there was a weakness exposed in the assessment, only do this exercise every 10-14 days.
• Daily workout: 1-3 times per day and good as a warm up.

PROGRAMMING FOR INTERMEDIATE & ADVANCED TRAINEES

• Intense versus Light Workouts: For intermediate to advanced trainees, one should alternate between two intense and one light workout.
• Pronation versus Supination Workouts: In addition, every 4-5 days, one should also perform either the pronation or supination workout depending on the results of your assessment.
• General Workout: If you’re only going to perform one strengthening routine for your feet and ankles and don’t feel the personal need perform an in depth program this workout is ideal. In addition this specific routine will work for all individuals regardless of the manner of foot and ankle deficiency. However it’s designed more so for those who don’t display significant levels of pronation or supination but desire general improvements in foot and ankle mechanics. Thus, if after the assessment above, neither pronation nor supination is prevalent this general workout can be performed once every 3-5 days in tandem with the intense and light workout routine described above. However, if the assessment exposes a specific weakness (i.e. pronation, eversion, supination etc.) then this workout would be performed once every 10-14 days.
• Daily Workout: This program can be performed by all individuals 1 to 3 times per day and is an excellent choice either as a warm-up or as a break from extended periods of sitting.

CHAPTER 17

***SEE BOOK FOR EXAMPLE WORKOUTS***