Strengthening and Conditioning for Foot and Ankle Health

Foot and Ankle: The Foundations of Gait

The foot and ankle form the literal foundation of human movement, yet they are one of the most complex areas of the body. Each foot contains 26 bones (about a quarter of all the bones in your body), connected by 33 joints and over 100 muscles, tendons, and ligaments (1). A healthy arch and mobile ankle allow for shock absorption and power generation, while any dysfunction can disrupt the kinetic chain up through the legs and spine. Fascial connections like the superficial back line in Meyers terms or the Retro Movement in Stecco illustrate this connectivity: the plantar fascia under the foot connects through the Achilles tendon to the calf, hamstrings, and even up to the front of the head (2).

Beyond the Basics: Rethinking “Strong Feet”

Foot rehab is often reduced to the same old prescriptions—calf raises, theraband ankle eversions, toe curls, or short foot exercises. While these exercises are rooted in biomechanical principles, when applied without context, they risk reinforcing dysfunctional patterns rather than correcting them.

Take the short foot exercise. It’s designed to activate the intrinsic muscles of the arch, particularly the abductor hallucis (3). But what if your client is already clawing their toes during gait? What if they already overuse their distal flexors to stay upright? In this case, short foot or toe-grip drills strengthen a compensation, not a correction.

Similarly, toe-grip strengthening—often done with resistance bands or towels—is meant to improve stability. But in clients with inefficient gait, it can reinforce overreliance on the long toe flexors (flexor digitorum longus), which commonly dominate in the absence of proper proximal control. These individuals often present with tight feet, inefficient arches, and excessive digital clawing during stance—classic signs of a system using distal overactivation to compensate for missing central stability (4).

Short Foot, Toe Grip & Calf Raises: Reinforcing the Wrong Strategy

Let’s call it what it is: when the nervous system is doing its best to stay upright, it will grip, curl, claw, and tighten—especially at the toes. If you layer more “activation” on top of that without rewiring the motor pattern, you’re not fixing the problem—you’re strengthening it.

Short foot exercises in these cases may feel “right” to the patient, because it mimics their already-dysfunctional strategy. The same goes for toe-grip drills, which are often mistaken as stability training when they’re actually just locking down already-tight tissues.

Calf raises? Another classic. While they are excellent for vertical tasks like jumping, sprinting, and explosive plantarflexion, they do little for forward propulsion in walking gait, where the body moves horizontally, not vertically. Gait propulsion relies on tibial progression, tripod foot contact, and toe-off through dorsiflexion of the 1st MPJ—none of which are meaningfully trained by up-and-down calf raises (5).

Let’s be clear: gait is not bouncing. Efficient gait doesn’t resemble a pogo stick. If your rehab plan looks like a bouncing drill, it’s time to reassess.

What to Do Instead: Teach the System to Stabilise Naturally

So if short foot, toe gripping, and calf raises aren’t the full answer—what is? It’s about training the system, not just the muscles.

Here’s how:

• Load the tripod, not the toes. Cue heel, base of the 1st and 5th metatarsals. Train in barefoot or sensory-rich environments. Load the 1st MPJ - its supposed to take 60-75% of the bodies load during toe off. 

• Incorporate DNS-inspired positioning to activate the foot intrinsics reflexively, without forceful gripping.

• Release, then retrain. Free up the long toe flexors, plantar fascia, and even proximal hip restrictions before introducing load.

• Use functional forward movement drills. Controlled Wall Falling , single-leg stance transitions, crawling patterns—movements that mimic real-life propulsion.

• Balance and proprioception training on variable surfaces, combined with core activation, to rewire stability sequencing.

When you do this, you’re not just “strengthening the foot”—you’re reconditioning the entire sensory-motor loop from brain to sole.

Barefoot Science & Minimal Footwear

One way to naturally retrain this system is through barefoot activity or minimal footwear. Modern shoes provide too much external structure—thick soles, elevated heels, and rigid toe boxes—which outsource the foot’s job. Over time, this leads to underuse of the foot intrinsics, loss of proprioception, and weaker push-off mechanics (6).

A 2021 study found that six months in minimalist shoes increased foot muscle strength by 57% (7). Another found improved gait and balance in seniors with a history of falls when using minimal shoes compared to conventional footwear or even barefoot (8).

Footwear isn’t just about comfort. It either restores or restricts function. Encourage safe barefoot exposure or transition toward footwear that lets the foot do its job.

Train the Sequence, Not Just the Strength

Through my training  in Dynamic Neuromuscular Stabilization (DNS) it, focuses on how the body moves, not just which muscles are strong. It draws from developmental patterns—rolling, crawling, kneeling—that create reflexive core and limb coordination.

In a 2025 RCT, DNS outperformed both conventional rehab and balance training in patients with chronic ankle instability, improving movement control and reaction times (9). Importantly, it trains global motor patterns, not isolated parts.

By using DNS-informed strategies—e.g., active foot loading , or breath-driven squat patterns—you retrain timing, posture, and coordination, not just “strength.” The result is true foot control during gait—not just stronger muscles in a static environment.

Fascial Connections and Global Conditioning

The plantar fascia isn’t an island—it’s part of a tension system that extends from the toes to the brow. Restrictions here can limit ankle dorsiflexion or even cause compensations up the chain (2, 10).

Fascial manipulation, particularly the Stecco Method, targets areas of densification and loss of glide, with research showing efficacy in conditions like plantar fasciitis and Achilles tendinopathy (11).

Rolling the foot, releasing the calf, or mobilizing hip fascia isn’t just soft tissue work—it’s part of restoring whole-system resilience. In fact, plantar release alone has been shown to improve hamstring and back mobility via fascial chains (12).

Conclusion: It’s Time to Rethink “Foot Strength”

Calf raises, short foot, and toe grips are tools—not solutions. Used wisely, they’re helpful. But used in isolation or on autopilot, they may reinforce the very inefficiencies we’re trying to treat.

True conditioning of the foot and ankle means:

• Training reflexive control, not just brute strength 

• You can stregthene a muscle all you like - but if it doesn't fire when it is suppoesed to fire - it is useless.

• Moving forward, not upward for walking and running strength

• Empowering natural stability, not substituting with tension

• Treating the whole kinetic chain, not just the foot

This is exactly what we explore inside Foundation Foot & Ankle – Restoring Function. If you’re ready to stop guessing, stop repeating the same drills, and finally understand how to bring clarity to  foot and ankle presentations…

👉 Join Foundation Foot & Ankle today
https://www.thestabilisationacademy.com/FFA-Bonus

References

1. Arthritis Foundation (2024). Anatomy of the Foot.

2. Roidl, A. et al. (2022). Myofascial treatment on the plantar surface influences dorsal kinetic chain. J Sports Sci Med, 21(1): 120–127.

3. Mulligan, E. P., & Cook, P. G. (2013). Effect of foot posture and short foot exercise on arch height in subjects with flat feet. J Orthop Sports Phys Ther, 43(10), 721–729.

4. Nakai, Y. et al. (2024). Toe Tube Training and Intrinsic Foot Muscle Strength. Applied Sciences, 14(22):10514.

5. Whitting, J. W., & Smeathers, J. E. (2010). Human gait propulsion: Forward momentum, not vertical force. Gait Posture, 31(1), 71–75.

6. Stearne, S. M. et al. (2016). The foot’s strength response to barefoot vs shod conditions. J Appl Physiol, 120(4): 36–45.

7. Curtis, R. et al. (2021). Daily activity in minimal footwear increases foot strength. Scientific Reports, 11:18648.

8. Cudejko, T. et al. (2020). Minimal shoes improve mobility in persons with a history of falls. Scientific Reports, 10:21755.

9. Yesilkir, S. et al. (2025). Dynamic neuromuscular stabilization vs balance training in chronic ankle instability. J Back Musculoskelet Rehabil, in press.

10. Stecco, A. et al. (2014). Fascial manipulation in chronic pain: Theoretical basis and an updated clinical model. J Bodyw Mov Ther, 18(4), 538–546.

11. Ajimsha, M. S. et al. (2014). Effectiveness of fascial release in plantar fasciitis: a systematic review. J Bodyw Mov Ther, 18(3), 423–431.

12. Grieve, R., et al. (2015). Foam rolling the foot increases flexibility of the posterior chain. Int J Sports Phys Ther, 10(7): 1089–1096.