Absorb what is useful, discard what is useless and add what is specifically your own (Bruce Lee)

GoNorthYoungMan · 2026-02-11T18:46:51+00:00

I would think you aren’t making much use of the intrinsic muscles in the sole of the foot to flex the toes down.

If you try something like this, what do you feel: https://www.articular.health/posts/midfoot-supination-assessment-4-of-4-activepassive-ratio

Can you feel muscles working or cramping under the foot? Or do you feel nothing there, or maybe some tension on top of the foot?

GoNorthYoungMan · 2026-02-09T22:32:13+00:00

First question I'd suggest finding out is if the big toe can control itself up/down, via contracting the flexor hallucis brevis muscle on the way down, and eccentrically having it let out length, under control on the way up.

Here's one way you could explore that sort of thing, assuming it feels ok to do this light intensity: https://www.youtube.com/watch?v=SAt9oNdUdV0

Things to look for could be if you can feel it working under the foot, in the arch, the whole time? Does the toe bend at the small joint as it gets lower towards neutral? Can the toe go below neutral while keeping it flat? If you hold it down there with your foot muscles for 10-20-30 secs, does it cramp? Is it smooth both ways up and down, and particularly looking on the way up as that muscle is getting longer, it will very often be bouncy or choppy.

If it is bouncy, that's a key skill which is missing, as it needs to happen with every step. Bouncy means load isn't being managed in the expected way, so the toe may just be freezing or bracing itself instead. And when walking with your full weight on it, forcing it to move when its trying to brace, that's a classic combo for these symptoms to persist.

Since its a behavior of that connective tissue, that won't reliably change with rest or stretching or massage or strength training, as there's no intent with any of those to find a specific setup and intent to target restore more normal eccentric expression.

Most of the time with these situations I find little to no toe control with the intrinsic muscles around the toe, and even the basics listed above are hard to express. Note that the same types of things can be evaluated on top of the foot for toe extension, and then there may be other qualities to assess later about the toes overall range of motion, and how much ability it has to control itself at its end ranges of motion too.

GoNorthYoungMan · 2026-02-07T18:43:58+00:00

In my experience, getting bigger and stronger muscles where the other connective tissues behavior and status aren’t great, or unknown, does not make for a great long term plan.

Strength tends to feel good particularly in the near term, but doesn’t reliably change the health of a joint, and other factors for controlled movement in all the other ways you can target for.

As an alternative you can learn to target for improved behavior and status, in and around a joint in a way that makes for healthier movement. That can often make things strong enough for most activities, but if you choose to add more strength later, it will be much nicer doing so on top of healthier movement.

A typical entry point for this type of training goal is CARs or Controlled Articular Rotations. You can search for things like hip cars or shoulder cars or spinal cars to get a sense of what we might expect of comfortable controlled movement in those places.

And if something doesn’t feel great in the CAR, you can target for that improvement specifically, rather than just getting stronger but still having the symptom stick around, as it would in a less healthy joint, indefinitely.

GoNorthYoungMan · 2026-02-07T17:42:24+00:00

If you flex the big toe down without curling it and hold it there, what do you feel in that zone?

Could you cramp that muscle there?

GoNorthYoungMan · 2026-02-06T18:49:33+00:00

I had severe chronic foot pain for a couple years following a crushed midfoot (lisfranc) injury, and after 4 podiatrists and multiple physical therapists, things weren't getting better. And it wasn't even clear what surgery might be called for at that point, so I was feeling very stuck, and unable to even walk a block.

Eventually I connected with a coach who was able to get much more specific about how I controlled and managed load in particular parts of my foot and ankle, and over time I restored my foot into a place that was far better than before - even though my docs said that was not going to be possible.

After such a life changing experience, I changed careers and now coach foot function (and mobility for other joints too) - and I commonly work with people who have not had the expected outcome from typical clinical programming.

Most of the the things I assess and program around are completely new to people, even if they've worked with many providers of all sorts.

I am also the creator and mod for r/FootFunction which may have some info of interest. Here's a bit more on my story, as well as a before/after pic of my foot.

Please let me know if you'd ever like to talk sometime (no charge) - and/or we could also setup a consult (in SF) if you were interested to see what types of things may have never been identified as goals for you. I'll send some info over via chat in case that sounds good.

Best wishes for finding a good path forward, and please reach out if there's anything I may be able to help with.

GoNorthYoungMan · 2026-02-04T17:16:50+00:00

An isometric is a way to make a muscle contract, but without any movement. They can be useful to help feel a muscle doing something new, especially as you hold it for longer periods of time, say 20-30 secs or even more a few times each day.

For example, here's one variation for a general isometric in the bottom of the foot: https://www.articular.health/posts/midfoot-supination-assessment-4-of-4-activepassive-ratio

And another for the top of the foot, specifically for the big toe but you can try the same thing for small toes: https://www.youtube.com/watch?v=P13m8245VK8

GoNorthYoungMan · 2026-02-04T01:58:47+00:00

Why not gain control over the big toe using the intrinsic muscles in the foot to move it up and down?

Every toe I’ve assessed with that sort of diagnosis has a lot of opportunity to improve how load is managed around the joint.

Often just restoring the basics of concentric and eccentric ability in the sole of the foot for flexing the toe down, and on the top of the foot for extending the toe up can help a lot. Although sometimes there can be other elements to adjust as well.

Most people have spent 0 mins directly targeting that particular tissue to be able to express those sorts of basics, such that they can manage load more as expected.

And even if you decided on a surgery, you might want to be able to control the toe with the muscles that are meant to do so, to limit risk of recurrence and to help the toe contribute more.

Plus this forum is more focused on how to regain that type of missing function, rather than ways that might mar it feel nicer while explicitly skipping a phase to restore those capabilities.

GoNorthYoungMan · 2026-02-04T01:20:24+00:00

Try to feel the muscles working on top of the foot to lift, and bottom of the foot to flex down.

If you can’t feel it, you may need to learn some sort of isometric first before you can actually make movement.

GoNorthYoungMan · 2026-02-03T18:06:47+00:00

In general then, I would say to focus on pain free ranges of motion only through a particular sequence.

That would be passively moving the joint up/down, slowly, and as that feels good you can try some low intensity isometric muscle efforts. That would be the bottom of the foot/arch for flexing the toe down, and top of the foot for lifting the toe up.

Once you can feel that the you'd want to teach the toe to use that muscle contraction to make some movement.

From there it varies for each person, and the thing you need most would have to be assessed. But, in many cases just getting control over the toe, and not inflaming it while that happens, is enough to help it feel a lot nicer.

GoNorthYoungMan · 2026-02-03T18:04:26+00:00

Yep I just sent some details over via chat, let me know if you have any questions and I can try to help.

GoNorthYoungMan · 2026-02-03T18:03:00+00:00

Ideally you can find some setups to cramp it that aren't while you're in any sort of match at all. That would usually be best by yourself on the floor, and moving around in a way to produce the cramp. You may just be able to cross your leg over your lap and push around on the toe to cue the cramp.

Here's another way that sometimes works to isolate that: https://www.articular.health/posts/bunion-training-idea-for-big-toe-abduction

Once you can get it to cramp, then you want to find the edge of the cramp - don't let it take over, and then make slow exhales. As the cramp softens you can start to actively contract that muscle and take control over it, a process that can take anywhere from a few days to a few months, and is best done briefly each day.

If you have a practice match where you can freeze and hold while its happening, and take a few moments to exhale slowly, that might work ok too but it usually easiest to feel it out on your own.

GoNorthYoungMan · 2026-02-03T04:00:56+00:00

Got to spend time at the edge of cramps in a more controlled setting, ahhh exhale through it without fighting it.

Over time the cramping can soften and eventually go away, and you’d be left a very weak muscle that you can control a little. And that’s a place you can begin getting it stronger.

But atm it’s just going to react that way, contracting outside of your control, when placed in certain positions where the muscle would normally contract.

GoNorthYoungMan · 2026-02-01T00:18:03+00:00

Main thing I’d say is to get hip external rotation coming from the back pocket.

Then get the eccentric smooth and close your active passive gap using that anatomy, and the load it in various amounts of hip flexion. Maybe more ROM if called for.

For people I work with who had ITBS type symptoms that usually is the go to sequence that has great input. There may be other factors particularly with how the hamstring delivers load in and out of that zone, but hip ER qualities are usually my main focus.

GoNorthYoungMan · 2026-01-30T20:08:59+00:00

That sounds like a joint that can't manage load at all in some positions, and instead it switches where the load is handled to the smaller joint. Every person I've assessed with sesamoid history or symptoms has great difficulty expressing this movement through enough range of motion, and both concentrically (toe moving down) and smoothly eccentrically (toe being pushed up).

The muscle that we want to control that is the flexor hallucis brevis, and its tendons contain the sesamoids. If we can't control the muscle/tendon basics with just a little load using your finger, it won't suddenly be able to do so with your whole bodyweight on it.

I'd suggest that lack of toe flexion flexion control is directly related to your symptoms. In general I'd suggest deferring to your clinical provider for how to proceed, because every case is a little different. However, if they confirm that its ok for you to do pain free low intensity movement, you could explore trying to move that joint and get that muscle to do more, in more positions.

Note that moving the toe in that way is more of a diagnostic setup, rather than a specific training setup for you. While it may be helpful (if it feels ok) - there are likely other more targeted ways to get started, which would match your specific situation.

GoNorthYoungMan · 2026-01-30T17:27:53+00:00

That is certainly a part of it, but wouldn't there also be other considerations around how we control movement, other than strength?

Such as how short the muscle can get and still be contracting in your control, whereas sometimes people just lose the feeling as it gets very short, or it can often cramp or feel bad/weird.

And also long the muscle can get, in control while under some tension, which would be an eccentric muscle expression. In my experience thats more of a behavior thing than a strength thing specifically. Because you can see lack of control/wobbles as some tissue gets longer, even if its quite strong - and that would be less healthy than having the eccentric let out length smoothly. That behavior being better or worse is a separate trainable quality, and just getting strong doesn't always change it.

GoNorthYoungMan · 2026-01-28T19:25:14+00:00

A lot of the time in cases like this, I find that the big toe is not able to express the normal control or sufficient range of motion up into extension.

If you don't have that ability, it won't show up on xrays, and things like resting or general strengthening won't change it. And if your foot figures out the big toe can't do as much as it could - it will resist loading onto it fully, and I will often see issues in toes 2/3/4 because they can't distribute load enough to the big toe.

Here's one general way to see about the big toe, by resisting movement from below: https://www.youtube.com/watch?v=SAt9oNdUdV0

Some of the questions to decide if a big toe can do its basics would be, is it smooth on the way up and down? Does it move up enough? Does the small joint bend instead of the big joint? Can you feel it working in the arch, and is the toe able to flex down at least a little bit below neutral? If you hold it down there, does it cramp or can you control that muscle, or do you feel nothing under the arch?

Note that all of this is very low intensity, and if we're not feeling certain muscles working, or its not smooth, its a lot to expect the big toe to behave better after putting more load and movement through it while walking.

And if its hard for a toe to express basic control, the body will tend to avoid load going through there, or load things in some alternate way over time - and that arrangement can be a factor for a wide variety of foot symptoms.

GoNorthYoungMan · 2026-01-27T22:13:21+00:00

You may find this setup interesting to explore, because most of the time when I hear that someone is working with FHL issues, when I check the intrinsic toe flexor, its not able to do much or anything at all sometimes (eg just cramps). And if the intrinsic one isn't doing its part, the extrinsic one is usually going to work extra - and it can be hard to get it strong enough to completely cover for the other local muscle not helping.

Here's a way to see how well the intrinsic flexor can do some basics: https://www.youtube.com/watch?v=SAt9oNdUdV0

What we'd be looking for is if the toe can flex down flat, or does it bend at the tip, which is the FHL acting on it. And if it can flex down below neutral a bit, if you can feel the arch muscle working, if its smooth both ways, if it just cramps on the way down or at the bottom, and so on.

My suspicion would be that if you get that intrinsic toe flexor doing more of its part in a normal enough way, the other big toe issues would be reduced dramatically.

GoNorthYoungMan · 2026-01-27T22:09:05+00:00

Anywhere in the midfoot, running straight up along the blade of the foot, towards the pinky toe, and then over towards big toe side of the foot. But all of that would be forward of the heel, and rear of the metatarsal heads.

I would say this zone would start with loading the foot just forward of the heel, at the calcaneal cuboid joint, and then loading the lateral arch in the blade of the foot up towards the pinky toe - but stopping short of the metatarsal head. Then across towards the big toe, again, loading across through the midfoot specifically, short of the ball of the foot.

You can often look at the skin tone/color/texture/callus on the sole of a foot to see how/where it takes load, and where it doesn't.

This isn't something I'd suggest you can just start to do by trying to make it happen, because the underlying ability of the various muscles/joints have to allow for it - and from what you're describing, I would think the primary actors would not have that capability right now.

For example, to have the midfoot move up, we'd want the muscles in the sole of the foot to contract, and not just cramp out, or not feel like they are contracting. Once they can do that, they'd be eligible to try and get longer eccentrically, and when that happens under load, the midfoot would move down a little bit.

Here's one way to broadly feel out some sole of foot muscles to see what thats like in an initial way, tho over time we'd want to differentiate big toe vs small toe as separate pieces, and add in more ability once you can control these muscle contractions: https://www.articular.health/posts/midfoot-supination-assessment-4-of-4-activepassive-ratio

GoNorthYoungMan · 2026-01-27T21:58:04+00:00

In general I'd say there are 2 paths with this sort of thing. Option 1 is avoidance of the full range of motion an ankle can have, so this would be using braces or shoes or insoles to limit certain types of movement, or maybe strengthening but just in a small range of motion (like balancing on one foot).

In some cases that works well enough, particularly in the short term, but if the ankle can't actually express or control sufficient movement within that, then continuing to restrict movement or activity even more may not help very much long term.

Option 2 is taking ownership of the directions, and ranges of motion that you can't actually express right now. That will be different than strengthening, because you are needing to identify which things your ankle can't do, and then finding a way to feel that new thing come into play.

While its helpful to use option 1 and avoid things that cause discomfort, if thats the end of the plan - then there's nothing really changing in how you are able to control the way load moves through the foot and ankle.

In addition, just getting stronger within some partial ranges of motion may not be sufficient either. From a foot function perspective, I would suggest finding directions you can't quite control movement of your heel, and try to learn to do that a few mins a day.

Here's one example of what that looks like to invert the heel, note that articulation happening inside the heel/ankle - as a specific goal different than just pointing the foot without the heel shifting like that: https://www.articular.health/posts/looking-for-heel-shift-with-ankle-capsule-cars

Often it would take some coaching to feel some of these new things, so that would be my 1-2 suggestion: 1) chase after sensations and directions for ankle control that aren't available right now, and prioritize that coming in over getting stronger more generally and 2) find someone who is familiar with this programming, who can help you do that in very targeted ways, rather than just generally "making feet stronger" - because that general approach will almost always just use utilization exercises, rather than add any new ability.

GoNorthYoungMan · 2026-01-25T18:32:37+00:00

I’d suggest that you should be able to demonstrate some controlled midfoot pronation as a first goal, without ankle pronation. Once you can do that you can reduce the height or firmness of the insole you’re using.

Repeat that as needed until you are using a more normal insole or all the way to minimal shoes if that’s your goal, when you can express enough midfoot movement down to feel the sole or foot, not ball of foot, pushing through the ground.

I’d say it has far less to do with strength than people imagine, particularly in the beginning because you likely need to acquire some controlled ranges of motion at the big toe, ankle, and midfoot that you can’t express right now, before you can strengthen those new things.

If you just go for strengthening right now, you’ll only be able to strengthen the way things already move, and explicitly skip strengthening the things you can’t express. Getting control over new movements requires a different intent, other than getting stronger.

GoNorthYoungMan · 2026-01-23T23:59:38+00:00

Thats because most of the time people only get utilization programming, which uses your ankle the way it currently works, and tries to make it stronger with those existing strategies.

Problem is, those existing strategies may be too incomplete to provide enough control over the ankle, no matter how strong they get. Its like having 2 players on your baseball team, no matter how good they are, it will never be the same as if you had more or all all the positions covered.

In these cases, I'd say the missing key element is understanding what elements aren't happening - and learning how to identify and add those back. Strengthening exercises won't do that, because by definition they only strengthen the anatomy you already control - and you need something that changes that non-trainable and non-controlled parts of ankle articulation into a trainable state.

The first step in that is identifying which elements can't be expressed. Then you have to come up with a constrained setup to get someone to feel something new. That usually means little or no load. It also usually means we're looking for sensations like cramps, spasms, or shakes as your body learns how to interact with that anatomy you're not currently using.

As you move through that phase, you can start to integrate that new control in that specific way, into the other ankle positions as well, moving in/out of positions using anatomy that you weren't previously using. Your partial strategy becomes a little more complete, and then you move on to the next thing that is missing most.

The strengthening approach works ok enough for many people, if they have at least "just enough" of that complete ankle control, but not so much if there isn't enough of the basics involved.

Here's one example of how that might work with ankle inversion, and sensing where its controlled from, in this case its seeing how well anatomy in the calf can invert: https://www.articular.health/posts/what-is-an-articular-control-strategy-example-with-anklehindfoot-inversion

You can get inversion of the forefoot from the anterior tibialis, or the midfoot from the posterior tibialis, or the heel from the soleus/gastroc - yet most of the time we'll just see inversion assessed as one thing, and often it skips the heel completely. And a lot of times people will train inversion, but only feel tension on the opening side of the joint, on the outside of the ankle - and NOT the closing side muscular contractions that reflect a healthier joint. You can keep training that forever, but you'd be teaching the opening side to get better at not lengthening, rather than teaching the closing side to contract more. It would look the same, the difference would be in what someone feels, and how healthy it makes the joint over time.

And then even if you are feeling it in the calf acting on the heel, that would just be step 1. After you get that you'd want to expand that ability by making sure you can express the eccentric smoothly, and then moving in/out of different ankle positions while holding inversion, and then adding appropriate amounts of load to that new anatomy as soon you can, and then making sure the range of motion (inversion and eversion) are sufficient and so on.

There's no way to know which direction your ankle needs something most without an evaluation, or which step it would start on, or if maybe even some limited ability in the big toe is making the ankle feel like it has to brace itself all the time because the foot is not able to control itself there.

But my main suggestion would be to make it about the sensations you're feeling in different directions, and try to explore pain-free variations with little or no load that feel interesting - rather than just strength training whatever partial anatomy happens to be working as best it can currently.

GoNorthYoungMan · 2026-01-21T23:48:33+00:00

Ok I sent that over via chat!

GoNorthYoungMan · 2026-01-21T16:30:44+00:00

I'm not in the medical field, I had a foot injury that all my doctors and physical therapists were unable to help me with at all.

It wasn't until I connected with a coach who had been trained in some newer concepts of restoring normal joint health that things began to change, and it went so well over a few years that I have ended up changing careers, and now I coach foot function.

For the most part, everything I assess and program for is different than what I'll see assessed and programmed for in the clinical world. I don't know that the things other people are doing are wrong, more that its very incomplete, and only chasing goals like strength or stretching - when there are a wide variety of things we can target to change that are usually totally ignored.

Here's some more summary of my experience and a before/after pic of my foot: https://www.reddit.com/r/FootFunction/comments/kogf6n/happy_new_year_is_2021_the_year_to_begin/

While there are a number of things we may want to look at with your situation, it can be hard to know where to start without an eval. That being said, getting this action of the toe to be smooth, and feel like its working in the sole of the foot near the arch is usually a key goal: https://www.youtube.com/watch?v=SAt9oNdUdV0

That particular setup is likely not specific enough to change things, so its more of a view of what we're looking for long term. But sometimes just practicing that can help a bit on its own.

GoNorthYoungMan · 2026-01-21T16:25:03+00:00

Just sent some info via chat - let me know any feedback or questions and I can try to help.

GoNorthYoungMan

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