Have you ever returned home from a long day at work, feet aching, and all you can think about is kicking off your shoes and letting the dogs breathe? After changing to those house clothes, you begin rubbing the bottom of your feet and thinking, why do they hurt so much? Maybe you’re an athlete who has spent their entire life in cleats and have experienced multiple recurring injuries over the years to your knees, hips, and back. Have you ever considered that the strength and mobility of your feet might be a contributing factor to these injuries?
The foot is the foundation of our kinetic chain. Your feet are the starting point for energy absorption and transmission throughout the entire body during any type of movement pattern. Specifically, the source of its power lies is in the arch, which is controlled by a team of muscles, tendons, and ligaments working together in perfect harmony. This team consists of 4 layers of tiny muscles called your instrinsics, strong tendons of the posterior tibialis and peroneal muscles, and your plantar fascia. These structures, in conjunction with the 33 joints in your foot, are dynamic in nature. They are designed to absorb load and convert it into the powerful energy needed for running, jumping, and changing direction.
Sport is Played on the Feet and the Toes
The foot and ankle girdle really is a masterful work of art and engineering. The complexity and configuration of the joints are meant to move in all 3 planes of motion, allowing the foot to mold and grip the ground. The toes can splay and display dexterity closely resembling that of our hands. At the same time, it’s a class 2 lever designed to handle heavy loads, similar to how a wheel barrow functions. The fulcrum point of this lever is your transverse arch running from the ball of your first toe to the fifth toe. This locks in to allow the shin, when loaded, to translate over the arch, putting the powerful calf and Achilles tendon in a position to produce a tremendous amount of force, propelling us forward in a sprint or vertically in a jump.
Have you ever been told to never squat with your knees over your toes? This ridiculous thought was perpetuated throughout the medical community for decades in fear that, somehow, squatting this low would cause your knees to explode. This ultimately gave birth to the cue given by many coaches and PT’s to squat with all your weight on your heels, effectively eliminating your ability to generate torque and stability through the arch of the foot, causing undue stress upstream on the knee, hip, and low back.
The Spiral Pathway
There is a powerful interconnection between the foot stabilizers mentioned above, and the deep core stabilizers of the pelvic floor hip rotators. This is like a local stabilization pathway; the communication between these two regions dictates how the body moves through space, attenuating force and transferring it through the kinetic chain for energy production. When it comes to quickly and efficiently transferring these impact forces during walking – the faster our feet and core can “talk” to each other the better our walk – the decreased risk of injury and the more efficient our gait (less energy).
Every exercise in the gym or injury rehab program, regardless of region of the body, will benefit from foot to core sequencing. Whether the focus is shoulder stability or training following an ACL surgery, all joints in the body require fast pre-activation of the deep core stabilizers. This is the foundation behind the Power Athlete Dynamic Movement Prep Series, and is validated by PA alum Stuart McGill’s statement of proximal stability (trunk) leading to distal mobility (arms and legs). Since our feet are the only contact with the ground, the feet actually play a critical role in how quickly we can stabilize the core when standing or moving in a closed kinetic chain. This is achieved through a spiraling effect that begins with the foot, creating stability via joint centration upstream.
Let’s take a look at the squat. Creating equal pressure over our big toe, fifth toe, and heel allows the foot to supinate and the ankle to externally rotate (eversion). As you begin to lower down, the knee flexes producing tibial internal rotation. Keeping pressure over the big toe allows the glutes to fire appropriately, creating external rotation of the femur at the hip. You can see how each joint is rotating in an equal and opposite manner, creating tension like wringing out a towel. Losing contact with that big toe will cause the arch to collapse into pronation and internally rotate the ankle. We will then see tibial external rotation, femoral internal rotation, and over extension at the low back and pelvis as a compensation pattern to create a sense of mechanical stability – essentially resting on the passive structures of your joint capsules and ligaments.
This is what we see when an athlete tries to squat through their heels; they’ve taken away the solid foundation of the feet, and replace them with two pegs. Pushing through the heels may get some glutes to fire, but these are definitely not the fibers needed to push you forward during a sprint. We also observe much more activation through the tensor fascia latae (ITB), low back, and not much else. We don’t see the co-contraction between the adductors, glutes, hamstrings, and hip flexors to create a solid trunk, like when the foot is active.
Is Pronation Bad?
Hell no! It is not the evil boogeyman at the source of all your bodily ailments. Pronation, where the middle of the foot flattens towards the ground, is actually essential for effective supination. We train the dead bug to strengthen our hip flexors, in order to use them to pull our glutes and hamstrings into the best position to contract and produce force. The same application occurs at the foot and ankle. We need to train your anterior tibialis to pull your shin over your toes to put the calf into the best position. The foot also needs to flatten and pronate in order to wake up the tissues of the posterior tibialis, foot intriniscs, and peroneals into position to supinate. This excursion is vital to attenuate force, absorb load, and produce power. As long as you maintain three points of contact on the ground, the knee will begin to translate out over the instep of the foot, putting you into the perfect position to load and explode. This is why training your foot to always supinate and driving your knee outside your toe box is so detrimental to performance; it engrains a pattern of producing force off your fifth toe (much smaller lever than your big toe). Then, you go to jump and it looks like you are moving on wet cement or quicksand. Mechanics are altered, force output is decreased, and athleticism is impaired.
The Foot and Sprinting
We now know that foot engagement leads to trunk activation. However, sprinting mechanics occur differently than the squat we just discussed. Upon contact of the foot to the ground, we will see pronation in the midfoot of a dorsiflexed ankle in order to absorb the weight of the body and ground reaction forces of gravity. The foot should then re-supinate into a rigid lever to propel the body forward. Pronation needs to occur…. we just need to strengthen and control it. You may still have a dorsiflexed ankle, but if the foot remains in pronation it will be like trying to push off an unlocked foot as you roll to the inside of the big toe. This is like running in low gear and could potentially set you up for a nasty case of shin splints. Pushing off a “locked foot” is like running in high gear. Instead of rolling through, we get contact directly under the big toe leading to engagement of the Windlass Mechanism (creation of your strong arch). From here we see another spiral effect. This time we achieve internal rotation (inversion) of the ankle and external rotation of the tibia with knee extension and hip extension and internal rotation to drive that leg behind your body.
Master Your Movement: Strengthen Your Feet
A weak, dysfunctional foot complex for walking…repeated 10,000 + times per day is a recipe for disaster, long before we approach the squat rack or start the stopwatch on a run. Most of us have jacked up our feet, and don’t even realize it.Thanks to outlandish marketing claims on shoe wear and orthotics, along with neglecting our feet in training, we have created a terrible situation that detracts from the performance of our athletes and sets them up for potential increased risk for injury to joint systems up the kinetic chain.
PT, DPT, FAAOMPT, OCS, ATC, CSCS Former baseball catcher and an avid outdoorsman. Worked with Division 1 basketball, football, and track and field at the University of Pittsburgh, along with the Pittsburgh Pirates and Arizona Cardinals organizations. Received a Bachelors in Athletic Training from the University of Pittsburgh in 2011 and a Doctorate in Physical Therapy from Duke University in 2014. Is board certified in Orthopedics and a Fellow through the American Academy of Orthopedic Manual Physical Therapists. Is a PT with the United States Olympic Committee and USA Shooting. Currently operates his performance therapy practice in Scottsdale, AZ with Dr. Tom Incledon of Causenta Wellness, and became a Power Athlete Block One Coach in September of 2017.
Dr. Zanis utilizes the Power Athlete Methodology to optimize performance, reduce injury risk, and rehab his clients and athletes through movement assessment, coaching, and individualized program design.
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