Foot-strength work lowers injury risk

Eight weeks of simple foot exercises led to far fewer running injuries over the next year. The drills work the foot core, the small muscles inside the arch, through toe and arch moves and single-leg balance. So far this rests on one strong trial and still needs replication.

Why it works

Stronger foot muscles support the arch and keep the foot from rolling inward too far as it lands. They also sharpen proprioception, your body's sense of where the foot is, through each step you take.

What it means in practice

A little foot-strength work, 5-10 minutes done 2-3 times a week, is a cheap add-on to an injury-prevention routine. It fits naturally alongside general strength and balance training.

The evidence

• Taddei, U.T., Matias, A.B., Duarte, M. et al. (2020). Foot Core Training to Prevent Running-Related Injuries: A Survival Analysis of a Single-Blind, Randomized Controlled Trial. American Journal of Sports Medicine.

  Over the 12-month trial, control-group runners were 2.42 times more likely to sustain a running-related injury than runners who trained their foot and ankle muscles (95% CI 1.98-3.62, p=0.035). Time to injury tracked with both Foot Posture Index (r=0.41, p=0.031) and the strength a runner actually gained in the foot (r=0.45, p=0.044). The protective effect only surfaced at 4 to 8 months, so it rewards sustained adherence rather than a short block. This is a single single-blind RCT of 118 recreational runners, so the finding still awaits replication.

  n=118

Why we call confidence medium

In a 2020 randomized trial (RCT), Taddei found an 87 percentage-point reduction in injury rate, 2.42x lower in the group that did the exercises. It is a single high-quality trial, so replication is still needed.

Where it applies

Adult recreational runners.

Does not apply to: runners already on a comprehensive strength program targeting the lower extremity.