Why Foot and Ankle Strength Matters

What if one of the biggest predictors of falls, balance issues, and even athletic decline wasn't the hips, core, or knees, but the toes? And what if strengthening them could dramatically change outcomes as we age?

In this episode, I sit down with Dr. Tom Michaud, a chiropractor, researcher, and internationally recognized expert in foot biomechanics, to explore how weak toes and poor foot function significantly increase fall risk in older adults and limit performance in master athletes. We discuss why foot and ankle health is often overlooked and how it serves as the foundation for balance, speed, and long-term vitality.

Dr. Michaud breaks down findings from pivotal studies, including work by researchers like Karen Mickle and Max Piquet, highlighting the role of intrinsic foot muscles such as the flexor hallucis longus and peroneus longus in stability and dynamic movement. We also cover simple at-home tests to assess fall risk and practical exercises that actually improve foot strength. This episode is essential listening for clinicians, athletes, and anyone who wants to stay mobile, resilient, and active as they age.

Key takeaways:

• Weak toes are a primary predictor of falls in older adults, leading to serious injuries and complications.

• Enhancing toe strength through targeted exercises can significantly reduce fall risk while boosting athletic performance.

• Not all traditional foot exercises are effective - exercising the foot muscles in a lengthened position yields better strength gains.

• Proper assessment of foot architecture and the application of custom strengthening exercises can prevent injuries and improve dynamic performance.

• Diagnostic tests like the anterior fall envelope and paper grip tests offer valuable insights into an individual's fall risk and foot strength.

More About Dr. Tom Michaud: In the early nineties, Williams and Wilkins published Dr. Michaud's first textbook, Foot Orthoses and Other Forms of Conservative Foot Care, which was eventually translated into four languages. His next book, Human Locomotion: The Conservative Management of Gait-Related Disorders, which was published in 2012, is used in physical therapy, chiropractic, pedorthic, and podiatry schools around the world. In addition to technical books, Tom also published a book for recreational runners: Injury-Free Running: How to Build Strength, Improve Form, and Treat/Prevent Injuries, now in its second edition.

During his 40 years of clinical practice, Dr. Michaud designed and patented numerous diagnostic tools and exercise products to help with the evaluation and treatment of a wide range of sports injuries. Since his recent retirement from clinical practice, Tom is devoting his time to researching, writing, and designing new products in order to develop evidence-based evaluation and treatment protocols that can assist in not just the prevention of sports injuries, but also in ways to stay fit as we age.

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