Things often work better in pairs… Especially with Exercise

You have heard us always talk about how the lower kinetic chain is connected, how ankle rocker effects hip extension and how important hallux (great toe) extension is.

What can we conclude form this study?

  • toe spreading exercises are important for reducing navicular drop (and thus mid foot pronation, at least statically)
  • In addition to increased abductor hallucis recruitment in ascending and descending stairs, when hip external rotation exercises were added along with toe spreading exercises folks had more recruitment of the vastus medialis (a closed chain external rotator of the leg and thigh)

Keep in mind:

  • the exercises given were all non weight bearing and open chain for the external rotators. Imagine what might have happened if they were both closed chain AND weight bearing!
  • They concentrated on the effects of toe spreading (AKAlift/spread/reach) on the abductor hallucis. It also has far reaching effects on the dorsal interossei, long and short extensors of the toes.


Goo YM, Kim DY, Kim TH. The effects of hip external rotator exercises and toe-spread exercises on lower extremity muscle activities during stair-walking in subjects with pronated foot. J Phys Ther Sci. 2016 Mar;28(3):816-9. doi: 10.1589/jpts.28.816. Epub 2016 Mar 31.