Current clinical guidelines for many of these foot disorders include the use of orthotic devices, but often do not consider exercises to strengthen the intrinsic muscles of the foot. It would make sense to attempt to correct the deficits in foot strength and stability rather than compensate for them with the use of passive supports such as custom orthotics. Treatment of most other musculoskeletal disorders (knees, shoulders, spinal problems, etc.) all employ strengthening exercises to correct the disorder, but somehow the foot has been excluded?
Assessment of intrinsic foot muscle weakness is lacking gold standards. Most tests employ testing toe flexion strength either manually or through dynometry or assessment of foot atrophy though imaging studies. More recently the intrinsic foot muscle test has been proposed as a functional assessment of a patient’s ability to maintain a neutral foot posture and medial longitudinal arch height during single limb stance.
Traditionally rehabilitation strategies to increase foot intrinsic muscle strength utilize towel gathering and marble pick up exercises. Currently, core foot stabilization programs involving the use of a maneuver called the “short foot exercise” are being advocated. These programs are being compared and modeled after core stabilization programs commonly used in the rehabilitation of many spinal disorders. The short foot exercise can be viewed as a foundational exercise for foot and ankle rehabilitation similar to how the abdominal drawing in maneuver or pelvic tilting maneuvers are fundamental to trunk/core stability exercise programs.
Studies have demonstrated that 4 weeks of performing the short foot exercise program increases arch height, improves balance, great toe flexion strength, and self-reported ankle/foot function.
McKeon, P. O., Hertel, J., Bramble, D., & Davis, I. (2015, March 1). The foot core system: A new paradigm for understanding intrinisic foot muscle function. Br J sports Med, 49(290), 1-9.