For the majority of my patients, I would prefer to skip this stage of rehab if possible. Many people have weak feet because they aren’t using them correctly. But when I show them, they are able to maintain a nice arch when standing. If you can do that, I prefer to strengthen the feet with more engaging and functional exercises (i.e. PADDLEBOARDING!)
1. Step 1: Can you reform your arch while standing?
Tip 1: You can start by pulling your big toe up. If your plantar fascia is intact, it should pull your foot in and raise the arch. Then relax the toe back to the floor while you try to keep the arch
Tip 2: Slightly bend your knee and then rotate it outwards. As the tibia (shin bone) rotates out, it should help the middle of your foot roll outwards and raise your arch. Make sure to keep the forefoot flat on the floor and try not to stand on the outer edge of your foot.
If you still can’t maintain an arch when standing and balancing, then I do recommend these exercises to help you strengthen the foot.
STEP 2: STRENGTHENING THE MUSCLES:
Posterior Tibialis – this muscle connects to your navicular
Contraction of this muscle will help pull your arch up while also helping you to push down with your forefoot. This is a key difference as we do not need to strength the anterior tibilias (which pulls your whole foot up)
Strengthen by having a band pull your foot out and up, which will require you to sweep inwards as you maintain pressure against the floor.
Perform ~3 x 20. Hopefully, you’ll get tired by about 20 reps. If not, get a stronger resistance band. If you don’t have a band, you can use a towel on the floor and put a weight on it. Drag the towel to the middle with each sweeping motion, and then reset like a typewriter once you get all the way.
On the opposite side, this muscle is great at helping to prevent the common inversion ankle sprain. This muscle also pushes down on your 1st ray, the bone right behind the big toe. Simply perform the same exercise as above, but with the band pulling IN and UP. In this case, the picture shows the band just pulling inwards. Just make sure to keep the foot flat on the floor. (You can substitute a towel with a weight on it as before as well)
Peroneal strengthening (Advanced)
Perform heel raises with a band pulling the ankle out. This will force you to put more weight on the inner forefoot. Try to keep your foot/ankle straight as you go up and down.
Intrinsic foot strengthening
Often after surgery, many of the small foot muscles have atrophied and become weak. This will give you a good start by strengthening them and increasing the bloodflow in the foot. Perform these execises until your foot is tired or about ~1-2 minutes. Then repeat throughout the day for at least 2 more sets.
Performing these exercises will help you get the proper strength to just stand with a good arch and will help you with your balance. Once you can do this, you can progress to the other more advanced exercises.