Sunday, November 15, 2020

Towel Scrunching Exercises For Your Feet?


Have you ever been asked to do foot strengthening exercises? A patient who saw me this week was asked to do foot strengthening exercises by another health professional who saw him recently. This included some towel scrunching exercises for his "collapsed arches" so as to strengthen the muscles supporting his arches

My patient was quickly bored and I told him just walking in minimalist footwear would be just as effective as doing strengthening exercises for the foot.

We know from published evidence that weakness in our intrinsic foot muscles can lead to a variety of load related injuries. And supportive footwear can contribute to intrinsic foot muscle weakness since these muscles tend to switch off (since they aren't absorbing forces and controlling foot movement) while walking and running.

Researches randomly assigned runners into three different groups. One group wore minimialist shoes (Vivo Barefoot), another group did foot strengthening exercises and the third was a control group. All groups maintained their running mileage throughout the study.

The minimialist footwear group increased their walking step count weekly while the foot exercise group did progressive resistance exercises at least 5 days per week.

Foot muscle strength and size were measured via ultrasound at the start of the study, week 4 and at the end of  the study (week 8). Researchers found all foot muscle sizes and strength had increased significantly in both the minimalist footwear and foot strengthening exercise group. There were no changes in the control group.

The researchers concluded that walking in minimialist shoes is just as effective as doing strengthening exercises for your feet. It is definitely way more convenient changing footwear rather than doing specific foot exercises. This may result in better compliance with patients.

So definitely don't throw away your Vibrams or barefoot styleminimialist type shoes. They are definitely still useful. Vibram ended up with a bad reputation after they were sued. 

However, I feel minimalist type shoes were unfairly criticized as the evidence for barefoot or minimalist type shoes are actually sound provided your running technique is correct. 

*Much less impact if technique is correct-see below

If you walk with barefoot style/ minimalist type shoes instead or running (to strengthen your intrinsic foot muscles) there will be a much lower risk of injury.

Definitely still useful. And much less boring than doing towel scrunches.


Reference

Ridge S, Olsen M et al (2019). Walking In Minimalist Shoes Is Effective For Strengthening Foot Muscles. 51(1): 104-113. DOI: 10.1249/MSS.0000000000001751.

Liberman DE, Venkadesan M et al (2010). Foot Strike Patterns And Collision Forces In Habitually Barefoot Versus Shod Runners. Nature. Jan 463(7280): 531-535.

*Using results of Daniel Liberman's study, runners who land correctly in their running technique will have benefits as impact is a LOT less (even less than heel striking with cushioned running shoes). If you land wrongly (with barefoot style shoes), the impact is 7 times greater thus greatly increasing the chance of injury. See picture above.

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