Foot Muscle Strengthening and Lower Limb Injury Prevention

Relationships between flexion strength and dexterity of the toes and physical performance

BACKGROUND

Toe function is characterised by the strength and dexterity of toe motion. However, previous studies have mostly focused on the importance of toe strength.

OBJECTIVE

This study aimed to investigate the relationships between flexion strength and dexterity of the toes and physical performance.

METHODS

Twenty healthy participants were included in this study. The flexion force of each toe was measured using a digital force gauge, and the toe dexterity was evaluated using the marble pick-up and rock-paper-scissors tests. These parameters were statistically analysed in relation to physical performance, including repeated side step and balance ability, which was evaluated using centre of pressure (COP) data during single-leg standing, tiptoe standing, and single-leg drop-jumping.

RESULTS

A significant correlation was found between the first toe flexion force and the total trajectory length of the COP during one-leg standing and between the time required for marble pick-up and the rock-paper-scissors score and the COP during single-leg drop-jumping.

CONCLUSION

The results underscore the importance of flexion strength and dexterity of the toes in human physical performance and the necessity for the evaluation and improvement of both functions.

Adolescent exercise-related lower leg pain musculotendinous characteristics

BACKGROUND

Exercise-related lower leg pain (ERLLP) is one of the most common injuries among adolescent runners; however, there is limited information available on lower extremity musculotendinous characteristics in relationship to injury. Ultrasound imaging has previously been used to evaluate musculotendinous structures among adults with chronic lower limb injuries. Similar measurement approaches may be adopted to assess young runners with ERLLP.

OBJECTIVE

To compare ultrasound-derived lower extremity musculotendinous thickness, echogenicity, and muscle fiber pennation angles between adolescent runners with and without ERLLP.

DESIGN

Cross-sectional design.

SETTING

Hospital-affiliated sports injury prevention center.

PARTICIPANTS

Twenty-eight adolescent runners with (N = 14) and without ERLLP (N = 14).

INTERVENTIONS

Runners' patellar and Achilles tendons, and tibialis anterior, medial gastrocnemius, abductor hallicus, and flexor digitorum brevis muscles were assessed with ultrasound imaging using standardized procedures.

MAIN OUTCOME MEASURES

Separate repeated measures multivariate analyses of covariance (covariate: gender) were used to compare groups and limbs for mass-normalized musculotendinous thickness, musculotendinous echogenicity, and extrinsic ankle muscle fiber pennation angles.

RESULTS

The adolescent ERLLP group had reduced average muscle size for all structures except the tibialis anterior compared to the uninjured group (mean difference [MD] range: -0.12-0.49 mm/kg; p range: .002-.05), and reduced average medial gastrocnemius pennation angles on their case limb compared to their contralateral limb and the uninjured group (MD range: -3.7-6.4°; p < .001). The ERLLP group additionally had reduced average patellar and Achilles tendon size (MD range: -0.14--0.15 mm/kg; p range: .02-.03), and lower Achilles tendon echogenicity compared to uninjured counterparts (MD: -18; p = .02).

CONCLUSIONS

Adolescent runners with ERLLP exhibited morphological musculotendinous changes that may occur either as a result of or as a contributing factor to pain and persistent dysfunction. The findings highlight key targets for rehabilitation for young, injured runners, particularly intrinsic foot muscle strengthening.

Ankle and foot function in female athletes involved in in-water and dry-land sporting activities

BACKGROUND

The stability and mobility of the ankle and foot joints are thought to be improved by cross-training, i.e., transferring the beneficial effects acquired from performing one sporting activity to those required to perform another. This study aimed to investigate the effect of long-term participation with in-water and dry-land sports activities (IWSA, DLSA) on ankle and foot function.

METHODS

The study sample consisted of 28 healthy competitive female athletes involved in IWSA (N.=14) and DLSA (N.=14) for <8 years, as well as 15 females not involved in sporting activities (NISA). The isometric strength of the ankle dorsi flexors (ADF), plantar flexors (APF), and subtalar invertors and evertors (SIN, SEV), the ankle dorsi and plantar flexion, and subtalar/forefoot inversion and eversion passive range of motion (ROM), and the static and dynamic balance were assessed in each participant's supportive lower limb.

RESULTS

IWSA athletes demonstrated significantly greater isometric strength in ADF (P<0.01), SIN (P<0.01), and SEV (P<0.05) compared to DLSA athletes and in ADF (P<0.001), SIN (P<0.01) and SEV (P<0.05) compared to NISA individuals with differences between DLSA athletes and NISA individuals being not significant. Between-groups differences on isometric APF strength, passive ROM of the ankle and foot joints, and postural balance were not significant.

CONCLUSIONS

DLSA athletes could benefit from long-term participation with IWSA, at least in terms of increasing isometric strength of the ankle and foot stabilizers, as their function does not appear to improve after long-term participation with the sports of their choice, at least compared to NISA individuals.

Effect of intrinsic foot muscles training on foot function and dynamic postural balance: A systematic review and meta-analysis

This systematic review aimed to analyse the effects of intrinsic foot muscle (IFM) training on foot function and dynamic postural balance. Keywords related to IFM training were used to search four databases (PubMed, CINAHL, SPORTDiscus and Web of Science databases.) for relevant studies published between January 2011 and February 2021. The methodological quality of the intervention studies was assessed independently by two reviewers by using the modified Downs and Black quality index. Publication bias was also assessed on the basis of funnel plots. This study was registered in PROSPERO (CRD42021232984). Sixteen studies met the inclusion criteria (10 with high quality and 6 with moderate quality). Numerous biomechanical variables were evaluated after IFM training intervention. These variables included IFM characteristics, medial longitudinal arch morphology and dynamic postural balance. This systematic review demonstrated that IFM training can exert positive biomechanical effects on the medial longitudinal arch, improve dynamic postural balance and act as an important training method for sports enthusiasts. Future studies should optimise standardised IFM training methods in accordance with the demands of different sports.