Foot and ankle muscle strengthening exercises are common interventions for many musculoskeletal conditions that are associated with pain and limited function in the lower limb. Science offers many strengthening exercises but has been criticized for not adhering to best practice. A systematic search of peer-review journal articles was conducted. Exercises were grouped according to primary movement and a general exercise descriptor. To compare to best practice, each program’s prescription parameters of frequency, intensity, and time were compared to the American College of Sports Medicine’s (ACSM) guidelines.
Of the included studies, most were randomized controlled trials, and the most common participants were healthy adults. Across all studies, a total of 300 foot and ankle exercises were prescribed. The most common strengthening exercise category involved ankle plantar flexion (25% of 300 exercises), followed by plantar foot intrinsics (16%). The most common prescription of strengthening exercises included 3 sets (37%) of 10 repetitions (38%) performed 3 times per week (34%), often without a prescribed load (66%). Prescribed sets per muscle group met ACSM recommendations for novice lifters in 93% of studies. Load intensity (for increasing muscle strength) was prescribed at the recommended dose of 60% of 1 repetition maximum or greater in only 2% of exercises.
Researchers found that the studies predominantly included ankle plantar flexion and plantar foot intrinsic muscle strengthening exercises, typically prescribed at 3 sets of 10 repetitions, 3 times per week. When compared to best practice recommendations, load intensity in exercise prescription is commonly less than recommended. Researchers propose using established best-practice exercise prescription guidelines like those from the ACSM.
Source: Osborne J, Menz H, Whittaker G, Cotchett M, Landorf K. Muscle strengthening exercises for the foot and ankle: a scoping review exploring adherence to best practice for optimizing musculoskeletal health. J Foot Ankle Res. 2025;18(2):e70040. doi: 10.1002/jfa2.70040.
