The human foot is a flexible structure characterized by a pronounced medial longitudinal arch (MLA) that compresses and recoils during running. That process is actively driven by the intrinsic foot muscles and requires a proper stability of the MLA. This introduces the concept of foot core stability. Because the intrinsic foot muscles are often neglected by clinicians and researchers, the purpose of this article is to provide some guidelines for incorporating foot core training in prevention or rehabilitation programmes for runners.
The intrinsic foot muscles play a key role in postural control and maintain balance during single leg stance by controlling the height of the MLA and the foot pronation. During running, these muscles lengthen eccentrically during the absorption phase and subsequently shorten as the arch recoils during the propulsive phase, functioning in parallel to the plantar fascia.
As a consequence, the dysfunction or weakness of the MLA active support may lead to injuries (e.g. plantar fasciopathy, Achilles or Tibialis posterior tendinopathy, metatarsalgia or medial tibial stress syndrome), due to numerous biomechanical cascades and mechanisms.
In order to counteract or prevent these impairments, there are two ways for enhancing the foot core stability. Firstly in terms of volitional control of the intrinsic foot muscles, the “short foot exercise” must be practiced. Secondly strengthening sessions using neuromuscular electrical stimulation of these muscles seem to be a promising strategy in order to support the MLA and control the pronation during running.
Practically, the foot core strengthening protocol may beneficiate not only the runners affected by excessive pronation related injuries but also those who sustained a long term lower limb injury and may be affected by a detraining process. In addition we warmly recommend integrating this protocol in any lower limb injury prevention programme or strength and conditioning plan for runners.
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