The Short foot exercise (SFE) was first made popular by Janda and is claimed to strengthen the intrinsic foot muscles (mostly the abductor hallucis) and enhance motor control of the intrinsic foot muscles, especially for those with flat or pronated feet and to make the feet stronger. There is a lot of rhetoric and misunderstandings about the use of the short foot exercise and a lot of unsubstantiated claims made for it. There is either no relationship or a weak relation between arch height and muscle strength (see: Foot Arches and Muscle Strength).
The short foot exercise is carried out by shortening the distance between the heel and the base of the hallux by sliding the forefoot posteriorly along the ground. The clinician can use their hands to physically move the forefoot into the "short" position to demonstrate the exercise. It is probably better to start off the exercise seated and later progress to standing and then single limb stance position. As the arch is raised to slide the hallux backwards, it is important to not curl the toes while doing this. The position is held for 6-8 seconds and then repeated an increasing number of times as progress is made. As an option or variation, the foot can be alternated in abducted and adducted positions while doing the exercise.
No outcome studies have assessed the efficacy of the short foot exercise to do what gets claimed for it.
Research on or using the Short Foot Exercise:
|Moon et al (2014)||18 asymptomatic subjects; navicular drop >10mm; assessed body sway; "short foot exercise immediately improved the dynamic balance of subjects with excessively pronated feet".||Made a leap of faith to linking improvements in body sway to cutaneous stimulation.|
|Heo et al (2014)||14 asymptomatic subjects with normal navicular drop; used EMG of abductor hallucis muscle with foot at 30 degrees and 0 degrees; "These results suggest that passive ankle dorsiflexion during short foot exercise for strengthening the abductor hallucis is a more effective clinical treatment exercise."||Not an intervention study; results speculative.|
|Goo et al (2014)||11 asymptomatic subjects; short foot exercise standing and sitting; EMG showed no diffferences in activation of abductor hallucis when standing vs sitting|
|Jung et al (2011)||28 subjects with pes planus; 8 weeks intervention; 2 groups: foot orthotics or foot orthotics and short foot exercise; found "that foot orthoses combined with short-foot exercise is more effective in increasing the CSA of the AbdH muscle and the strength of FH compared with foot orthoses alone"||Foot orthotic group only also gained muscle strength. (Foot orthotics and muscle strength)|
|Jung et al (2011)||20 normal subjects; found that the short foot exercise is a more useful strengthening exercise than the toe curl exercise in activating the abductor hallucis muscle.||Corss-sectional EMG study; not an intervention|
|Bridges(2015)||Intervention group did show an increase in static arch height (0.33mm). Control group showed a bigger decrease in arch height (1.33mm)||Unpublished masters thesis; subjects did other exercises in additions to the short foot exercise; the increase reported was only 0.33mm, most likely due to reliability and accuracy of the measurement system used which was not reported on.|
|Lee et al (2016)||"The activity of the abductor hallucis muscle was significantly lower (p < 0.001)...in the pes planus group than in the neutral foot group during the exercise."|
|Sulowska et al (2016)||Reported improvement in 2/6 parameters in the Foot Posture Index in group doing short foot exercise.||Did multiple comparisons and did not do a Bonferroni adjustment|
|Sulowska et al, 2017||Reported improvements in all components of the Foot Posture Index in a group of runners after 6 weeks of the short foot exercise||No control group; no blinding of assessors; multiple comparisons|
|Andhare et al 2018||Improvement in Foot Posture Index after using short foot exercise||Questionable randomization and blinding process|
- some clinicians and 'non-experts' 'hang their hat' on using the short foot exercise to "cure" flat or pronated feet. This will only work if a weakness of the abductor hallucis muscle is the cause of the flat or pronated foot. It is a rare cause. See Dunning–Kruger effect and also Foot Arches and Muscle Strength.
- the exercise would be useful for dealing with deficits in intrinsic muscle strength (see: plantar fasciitis and muscle strength)
- the exercise has been suggested as being used for claw toes, but no effectiveness data is available and this remains speculative
- some will have difficulty doing this exercise due to the orientation of joint axes and relevant lever arms. This will erroneously interpreted as a weakness and an indication that they need to do more of the exercise by those unfamiliar with this
Short Foot Exercise (Podiatry Arena)
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