Getting your ‘feet’ in the game! Can exercising your feet help you stay on them?

The Bottom Line

  • Falls are a leading cause of death among older adults but are also preventable.
  • Older adults experience changes in muscle strength that can increase the risk of falls.
  • Exercises that strengthen the intrinsic foot muscles, or small foot muscles that help with stability and movement, may improve toe strength, balance, and mobility, as well as reduce the risk of falls.
  • Speak with your health care team about how to safely execute these exercises at home. 

Many of us have heard the expression ‘stand on your own two feet’. It’s generally used to communicate that a person needs to become more independent and self-reliant. But in a very literal sense, being able to move safely on our own when up on our feet is important for preventing falls.

Globally, falls are the second leading cause of death from unintentional injury. Older adults experience the greatest number of falls that result in death. What’s more, falls that aren’t fatal can lead to injury and disability, increasing the likelihood of long-term care and institutionalization (1). However, we can actively take ‘steps’ to reduce our risk of a potentially dangerous tumble (2;3-4). Exercise is one strategy that can help prevent falls, and especially those that lead to injury. Resistance training, activities that improve flexibility, and tai chi are a few beneficial exercise types (3). Maintaining the health of our feet through visits to a podiatrist is another method we can lean on for falls prevention (4). So, if exercise and foot care are beneficial strategies, should we add exercises that target our feet to our falls prevention toolbox?

Well, research has identified intrinsic foot muscle strength as a predictor of falls (2;5-7). Intrinsic foot muscles are small muscles found in the foot. We can thank these muscles for helping us with small movements like extending or flexing our toes. They also provide stability and information that other foot muscles use to produce large movements, such as running or walking (2;8). Perhaps unsurprisingly, it appears that intrinsic foot muscles are smaller and weaker in older adults compared to their younger counterparts (2;9). Changes to muscle strength can impact one’s balance and ability to carry out essential daily activities (2;5-7). With this in mind, it doesn’t seem far-fetched to assume that exercises that strengthen our intrinsic foot muscles can hold benefits.

But before we commit to practicing these exercises, let’s get our feet wet by checking out the evidence!

What the research tells us

A recent systematic review looked at the effects that intrinsic foot muscle strengthening exercises (aka foot and ankle strengthening exercises) had on functional mobility in adults 65 years of age and older who were independent, generally healthy, and living in the community. Intrinsic foot muscle strengthening programs included exercises such as gripping small objects with the toes, wearing cushioned footwear, heel lifts, calf raises, and ankle exercises. Some studies also included other simultaneous strategies like shoe inserts and education. The review found that intrinsic foot muscle strengthening programs may improve toe strength, balance, and certain aspects of functional mobility. The good news continues on with the finding that these programs may even reduce the risk of falls. Unfortunately, fear of falling was not improved.

Intrinsic foot muscle strengthening can often be done from the comfort of your own home with minimal assistance. Speak with your health care team about whether these types of targeted foot exercises are right for you and how to execute them safely on your own or with supervision from a caregiver or professional.

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Author Details


  1. World Health Organization. Falls. [Internet] 2021[cited March 2022]. Available from
  2. Futrell EE, Roberts D, Toole E. The effects of intrinsic foot muscle strengthening on functional mobility in older adults: A systematic review. J Am Geriatr Soc. 2021; 70:531-540. doi:  10.1111/jgs.17541.   
  3. Grossman DC, Curry SJ, Owens DK, et al. Interventions to prevent falls in community-dwelling older adults: US preventive services task force recommendation statement. JAMA. 2018; 319:1696-1704. doi: 10.1001/jama.2018.3097.
  4. Wylie G, Torrens C, Campbell P, et al. Podiatry interventions to prevent falls in older people: A systematic review and meta-analysis. Age Ageing. 2019; 48(3):327–336. doi: 10.1093/ageing/afy189. 
  5. Menz HB, Morris ME, Lord SR. Foot and ankle risk factors for falls in older people: A prospective study. J Gerontol Ser A. 2006; 61(8):866-870. doi:10.1093/gerona/61.8.866. 
  6. Mickle KJ, Munro BJ, Lord SR, et coll. ISB clinical biomechanics award 2009: Toe weakness and deformity increase the risk of falls in older people. Clin Biomech. 2009; 24(10):787-791. doi: 10.1016/j.clinbiomech.2009.08.011.
  7. Spink MJ, Fotoohabadi MR, Wee E, et coll. Foot and ankle strength, range of motion, posture, and deformity are associated with balance and functional ability in older adults. Arch Phys Med Rehabil. 2011; 92(1):68-75. doi: 10.1016/j.apmr.2010.09.024.
  8. McKeon PO, Hertel J, Bramble D, et coll. The foot core system: A new paradigm for understanding intrinsic foot muscle function. Br J Sports Med. 2015; 49(5):290-290. doi:10.1136/bjsports-2013-092690.
  9. Mickle KJ, Angin S, Crofts G, et coll. Effects of age on strength and morphology of toe flexor muscles. J Orthop Sports Phys Ther. 2016; 46(12):1065-1070. doi: 10.2519/jospt.2016.6597.

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.