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.