Foot Function and Athletic Performance
The foot is where an athlete's intention meets the ground. Every force an athlete produces has to pass through it, and every force the ground returns has to be received by it. Despite this, foot function tends to sit at the margins of performance work — assessed occasionally, trained rarely, and usually addressed only after something has gone wrong. This guide brings together what we have published on the subject: how the foot behaves during movement, what can reasonably be measured, what the evidence on structure and injury actually supports, and what can be done in training. It is a reference point rather than a protocol, and the individual articles it links to go considerably deeper than the summaries offered here.
Foot Function Within the Performance System
The argument for paying attention to the foot is not that it is the decisive factor in performance. It is that it is a discriminant among several, and one that is systematically underweighted relative to its influence. Sports performance emerges from the coordination of the whole body toward a single output, and no single element — not sleep, not eccentric hamstring work, not maximal strength — determines it alone. Treating the foot as the missing key would repeat the reductionism that the field is already prone to.
What the foot does contribute is the quality of the interface. Optimal timing of muscle actions and segmental motions can only be realised if the point of contact with the ground is able to handle the force or velocity demands of the skill being performed. When it cannot, compensatory strategies appear further up the chain, and they appear whether or not anyone is looking for them. The case for three reasons to care about foot performance rests on this: the foot underpins movement proficiency, it acts as an adaptive sensor, and it regulates neuromuscular balance by determining how the centre of mass is managed relative to the base of support (Winter, 2009).
This also frames what the foot is for in mechanical terms. Rather than a passive platform, it functions as a transmitter, and the way it transmits determines how much of what the athlete produces actually reaches the ground. That perspective is developed further in the discussion of the power carriers of performance.
The Foot as an Adaptive Structure
The foot changes its mechanical behaviour within a single step. At initial contact it must be compliant enough to absorb and distribute load; by mid-stance and propulsion it must become rigid enough to transmit force efficiently. This transition depends on the segmental organisation of the foot and on the tension developed in the plantar aponeurosis, described originally by Hicks (1954) as the windlass mechanism and later quantified as a genuine elastic energy store capable of returning a substantial proportion of the energy absorbed during stance (Ker et al., 1987).
That storage is not purely passive. The intrinsic foot muscles contribute actively to controlling arch deformation, and their contribution appears to increase as load increases (Kelly et al., 2014). Experimental work in which intrinsic muscle function was temporarily blocked found measurable changes in how the foot performed during locomotion, which supports treating these muscles as part of the propulsive system rather than as postural detail (Farris et al., 2019). The foot core framework proposed by McKeon et al. (2015) offers a useful way of organising this: passive structures, active muscular control and neural input functioning as one system, with the practical consequence that assessing any of the three in isolation gives an incomplete picture.
In sprinting the same properties are expressed under compressed timescales, where ground contact may last less than a tenth of a second and the margin for a poorly timed transition is correspondingly small. That is the subject of foot-strike dynamics in sprinting.
Force and Pressure Are not the Same Measurement
A recurring source of confusion in applied settings is the treatment of force and pressure as interchangeable. They are related but they answer different questions, and the instruments that measure them are not substitutes for one another. Force plates report the magnitude and direction of the resultant ground reaction force; pressure systems report how load is distributed across the plantar surface and how the centre of pressure travels during stance. An athlete can produce an entirely unremarkable force trace while distributing that force in a way that concentrates load on a small region of the foot, and the reverse is also possible.
The distinction matters because it determines what conclusions a given dataset can support. This is set out in force and pressure: understanding differences and purposes, and it connects to a broader question about measurement that recurs across our work on testing: the instrument constrains the inference, and the most common error is not measuring badly but asking a measurement to answer something it cannot.
An earlier conversation on how these ideas developed in practice is available in the interview on foot function and athlete monitoring.
Structure, Injury Risk and the Limits of Measurement
The relationship between foot structure and injury is one of the few questions in this area where the evidence genuinely divides, and it is more useful to set out the division than to present it as settled.
On one side, two frequently cited prospective studies found no association. Messier and colleagues (2018) followed three hundred runners over two years and reported none; Nielsen and colleagues (2014) applied the Foot Posture Index to 927 novice runners and also found none overall. An editorial in the British Journal of Sports Medicine has since argued that flat feet are better regarded as healthy anatomical variants than as deformities (Moisan, Griffiths and Chicoine, 2023) — a reasonable corrective, given how many people with low arches are pain-free and how much unnecessary intervention a century of treating flatfoot as pathology produced.
On the other, a case-control study applying the same Foot Posture Index to six hundred novice runners, of whom eleven per cent had extremely pronated foot postures, reported substantially elevated injury risk at both ends of the arch spectrum (Pérez-Morcillo et al., 2019). Earlier work had associated high-arched runners with more lateral, bony and ankle injuries, and low-arched runners with more medial, soft-tissue and knee injuries (Williams, McClay and Hamill, 2001).
The case for the second reading is made on this blog by Tom Michaud, as a guest contribution, in arch height and injury: is there really no connection?. He argues that the negative findings are largely artefacts of measurement: Messier classified arch height from footprints, which correlate poorly with radiographic measurement, and Nielsen set aside as underpowered the subgroup with extremely low arches, around two per cent of the sample, which was injured almost without exception. He also points to a variable the structural debate has largely omitted, muscle capacity, citing smaller abductor hallucis, flexor digitorum longus and peroneal muscles in painful compared with pain-free flat feet (Zhang et al., 2019) and thinner flexor digitorum longus and quadratus plantae in symptomatic flatfoot (Haelewijn et al., 2025).
Whichever reading one finds more persuasive, meta-analytic work indicates that the measurement question is real: pooled across twenty-nine studies the association between non-neutral foot types and lower extremity injury is statistically significant but weak, and it is considerably stronger when the foot is classified by the Foot Posture Index than by visual or physical examination (Tong and Kong, 2013). That alone makes the negative and positive findings difficult to read as straightforwardly contradictory.
What follows for practice is less contested than the mechanism: how a foot behaves under load and how much force it can produce are observable and trainable, while its shape at rest is neither. The contribution of the first ray to push-off is covered separately in the big toe.
Localised pathology follows different logic. First-ray injuries, and turf toe in particular, involve a specific structure under a specific loading pattern, and here mechanism and intervention are much more tightly linked, as covered in the treatment and prevention of turf toe. Plantar heel pain sits between the two cases: the tissue is identifiable but the causes rarely are, which is why it is better approached through the system than through the site of pain, the argument made in plantar fasciitis in athletes.
Training and Supporting Foot Function
The foot adapts to load as other tissue does, and both the intrinsic musculature and the plantar aponeurosis appear to respond to progressive exposure. This does not mean that a set of foot drills added to an existing programme will change much on its own. The more productive question is whether the mechanical demands the athlete already meets are being handled well, and to intervene where they are not. Practical loading of the foot–ankle complex is described in stretching and strengthening the foot–ankle complex. Treated this way, foot function is one input among several rather than a standalone service, which is also how it sits within sport science and strength and conditioning consulting.
External support works alongside training rather than in place of it. Orthotic intervention has a legitimate place, although the conventional over-the-counter device rests on the structural assumptions questioned above and offers little individualisation. More recent approaches attempt to work with an individual's loading pattern rather than correct it toward a template, which is the subject of SmartThotics as an alternative to conventional orthotics. Footwear is the larger and less examined variable, because it modifies the mechanics of every step the athlete takes rather than only those taken in treatment: footwear as a performance variable.
Where to Start
Readers new to the topic will find the most direct entry in three reasons to care about foot performance, followed by the power carriers of performance.
Those working primarily with measurement should begin with force and pressure and continue with foot-strike dynamics in sprinting.
Those working in a sports medicine or rehabilitation context will find arch height and injury, plantar fasciitis in athletes and turf toe the most immediately applicable.
Full Reading List
Three (at least) Reasons Why You Should Care About Foot Performance — why foot function belongs in athletic development, framed around movement proficiency, adaptive sensing and neuromuscular balance.
Introducing the Power Carriers of Performance — the foot as a transmitter of force rather than a passive base of support.
Foot-Strike Dynamics in Sprinting — how contact mechanics behave under the compressed timescales of maximal-velocity running.
Force and Pressure: Understanding Differences and Purposes — what each measurement can and cannot tell you, and how to choose between them.
Arch Height and Injury: Is There Really No Connection? — a guest contribution by Tom Michaud, arguing that the studies reporting no association are artefacts of measurement and that muscle capacity is the overlooked variable.
The Treatment and Prevention of Turf Toe — first-ray injury mechanism, management and return to play.
SmartThotics: The Intelligent Alternative to Conventional Over-the-Counter Orthotics — orthotic intervention that works with individual loading patterns.
The Big Toe: Mechanical and Sensory Contributions to Propulsion in Sport Performance — first-ray mechanics and plantar sensory input during push-off.
Plantar Fasciitis in Athletes: A Systems Approach to Causes and Treatment — plantar heel pain approached through the system rather than the site of pain.
Footwear as a Performance Variable: Biomechanics, Energetics and Injury Risk in Sport — how shoe construction changes the mechanics of every step.
Stretch and Strengthen Your Foot–Ankle Complex with the DorsiFlex — practical loading of the foot–ankle complex.
Foot Function and Athlete Monitoring: An Interview with Antonio Robustelli — how this body of work developed in applied practice.
Related reading
Learning to Land · Does Force Absorption Exist? · Exercise Specificity: Why Function and Demands Matter More Than Positions
Frequently Asked Questions
Does foot strengthening improve sprint performance?
Foot strengthening has been reported to improve running speed and power, with larger gains in low-arched runners than in those with neutral feet (Sulowska et al., 2019), and there is a plausible mechanical pathway from improved arch control to more efficient force transmission during stance. Direct evidence that isolated foot training improves sprint times in already-trained athletes is thinner, and the clearest trial evidence concerns injury rate rather than speed (Taddei et al., 2020). Foot work is therefore most likely to matter where foot function is currently a limitation, rather than as a general addition.
Should athletes with flat feet be treated differently?
The prospective evidence divides, and arch height alone is not a sufficient basis for a decision in either direction. Studies classifying the foot from footprints have reported no association, and an editorial in the British Journal of Sports Medicine has argued that flat feet are healthy anatomical variants (Moisan, Griffiths and Chicoine, 2023); studies using the Foot Posture Index have reported associations at both extremes of the arch spectrum (Pérez-Morcillo et al., 2019). Tom Michaud, writing here as a guest author, argues that the negative findings are measurement artefacts and that what separates painful from pain-free flat feet is muscle capacity rather than shape (Zhang et al., 2019). Whether or not that reading is accepted, the practical implication is similar: the useful questions to ask of a low-arched athlete concern how the foot behaves under load and how strong it is, both of which are observable, rather than how low the arch sits.
What is the difference between a force plate and a pressure mat, in practical terms?
A force plate measures the resultant ground reaction force and its direction, which is what you need for jump testing, asymmetry work and rate of force development. A pressure system measures how load is distributed across the plantar surface and how the centre of pressure moves, which is what you need for questions about foot behaviour itself. They answer different questions and neither substitutes for the other.
Is barefoot training necessary for developing foot function?
Removing footwear changes the sensory and mechanical conditions the foot experiences, and there is a reasonable argument for including some barefoot or minimal-footwear exposure. It is not a requirement, and abrupt increases in barefoot volume carry their own loading risk, particularly for the Achilles tendon and the metatarsals. Progression matters more than the choice itself.
How often should foot function be assessed?
There is no established interval, and assessment frequency should follow the question being asked rather than a calendar. A baseline assessment at the start of a preparation period, a reassessment after any lower-limb injury, and a targeted assessment whenever a change in movement quality is observed will cover most applied situations. Routine reassessment in the absence of a question tends to generate data that nobody acts on.
References
- Farris, D.J., Kelly, L.A., Cresswell, A.G. and Lichtwark, G.A. (2019) 'The functional importance of human foot muscles for bipedal locomotion', Proceedings of the National Academy of Sciences, 116(5), pp. 1645–1650.
- Haelewijn, N., Staes, F., Vereecke, E. and Deschamps, K. (2025) 'From structure to function: biomechanical markers of symptomatic flatfoot during running and a single leg drop and hop', Clinical Biomechanics, 106682.
- Hicks, J.H. (1954) 'The mechanics of the foot. II. The plantar aponeurosis and the arch', Journal of Anatomy, 88(1), pp. 25–30.
- Kelly, L.A., Cresswell, A.G., Racinais, S., Whiteley, R. and Lichtwark, G. (2014) 'Intrinsic foot muscles have the capacity to control deformation of the longitudinal arch', Journal of the Royal Society Interface, 11(93), 20131188.
- Ker, R.F., Bennett, M.B., Bibby, S.R., Kester, R.C. and Alexander, R.M. (1987) 'The spring in the arch of the human foot', Nature, 325(6100), pp. 147–149.
- McKeon, P.O., Hertel, J., Bramble, D. and Davis, I. (2015) 'The foot core system: a new paradigm for understanding intrinsic foot muscle function', British Journal of Sports Medicine, 49(5), 290.
- Messier, S.P., Martin, D.F., Mihalko, S.L., Ip, E., DeVita, P., Nicklas, B.J., Hunter, D.J. and Guermazi, A. (2018) 'A 2-year prospective cohort study of overuse running injuries: the Runners and Injury Longitudinal Study (TRAILS)', American Journal of Sports Medicine, 46(9), pp. 2211–2221.
- Moisan, G., Griffiths, I. and Chicoine, D. (2023) 'Flat feet: deformities or healthy anatomical variants?', British Journal of Sports Medicine, 57(24), pp. 1536–1537.
- Nielsen, R.O., Buist, I., Parner, E.T., Nohr, E.A., Sørensen, H., Lind, M. and Rasmussen, S. (2014) 'Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe: a 1-year prospective cohort study', British Journal of Sports Medicine, 48(6), pp. 440–447.
- Pérez-Morcillo, A., Gómez-Bernal, A., Gil-Guillen, V.F. and colleagues (2019) 'Association between the Foot Posture Index and running related injuries: a case-control study', Clinical Biomechanics, 61, pp. 217–221.
- Sulowska, I., Mika, A., Oleksy, Ł. and Stolarczyk, A. (2019) 'The influence of plantar short foot muscle exercises on the lower extremity muscle strength and power in proximal segments of the kinematic chain in long-distance runners', BioMed Research International, 2019, 6947273.
- Taddei, U.T., Matias, A.B., Duarte, M. and Sacco, I.C.N. (2020) 'Foot core training to prevent running-related injuries: a survival analysis of a single-blind, randomized controlled trial', American Journal of Sports Medicine, 48(14), pp. 3610–3619.
- Tong, J.W.K. and Kong, P.W. (2013) 'Association between foot type and lower extremity injuries: systematic literature review with meta-analysis', Journal of Orthopaedic & Sports Physical Therapy, 43(10), pp. 700–714.
- Williams, D.S., McClay, I.S. and Hamill, J. (2001) 'Arch structure and injury patterns in runners', Clinical Biomechanics, 16(4), pp. 341–347.
- Winter, D.A. (2009) Biomechanics and motor control of human movement. 4th edn. Hoboken: John Wiley & Sons.
- Zhang, X., Pauel, R., Deschamps, K., Jonkers, I. and Vanwanseele, B. (2019) 'Differences in foot muscle morphology and foot kinematics between symptomatic and asymptomatic pronated feet', Scandinavian Journal of Medicine & Science in Sports, 29(11), pp. 1766–1773.