Intrinsic Foot Muscles Vs. Orthotics
Reference:Concept of spinal stability reference: Panjabi M. The stabilizing system of the spine. Part 1.Function, dysfunction, adaptation and enhancement. Journal of Spinal Disorders. 1992 (5):383-389
We don?t treat most low back pain patients with a permanent supportive back brace but rather with scientific evidence based muscular stabilization. Should most foot patients then be prescribed permanent orthotics?
Is it possible that Panjabi?s concept of stability for the spine can be applied to the feet? If the passive system is insufficient at providing support for stabilization / control of the foot, perhaps Physical Therapists can re-train the active system and the neural control system to compensate.
Although there is no anatomical or clinical research study to date to support this (as there is for the spine), clinically I have had good success in applying the muscular stabilization concept to the feet for various foot and ankle syndromes.
Could it be that “multifidus” exist for the feet that have just not been ?discovered? yet? Perhaps it is the abductor hallucis!
A common exercise given by Physical Therapists is the ?towel toe curls?, which may be comparable to performing phasic ?sit ups? to improve lumbar stability and dynamic control?not effective!
The following is a Yoga technique that I have found beneficial for improving tonic control of the intrinsic foot muscles and single leg standing balance.
Step #1: Stand in a “normal” relaxed pronated foot posture, with feet shoulder width apart and knees slightly flexed
Step#2: Lift all toes off the floor; this leads to the rise of the medial longitudinal arch (similar to the windlass effect via the plantar fascia)
Step #3: Drop all the toes down again WITHOUT “losing the arch”. Maintain the big toe firmly on the floor without flexing the inter-phalangeal joints Hold for 10 seconds, repeat up to 10 times
When ready, progress to single leg standing with support by holding on, then without support.
Posted on: February 12, 2002
Categories: Foot & Ankle