Effects of a therapeutic foot exercise program on injury incidence, foot functionality and biomechanics in long-distance runners: Feasibility study for a randomized controlled trial.

Many runners deal with foot and ankle injuries, and researchers wanted to know whether a structured foot-ankle strengthening program could realistically be tested in a larger trial and whether it changes foot muscle structure or movement. This was a feasibility study, comparing an 8-week foot-ankle strength training program against a stretching routine in 31 recreational long-distance runners, with the main goal of checking recruitment, adherence, and satisfaction rather than proving the program prevents injury. Recruitment was efficient, adherence was high, and participants rated the program positively. Two foot muscles grew significantly in cross-sectional area after the training program, a promising but preliminary biomechanical signal.

The main limitation is that this was a small pilot study designed to test feasibility, not to determine whether the program actually reduces running injuries, so these muscle and movement findings should be seen as groundwork for a larger trial rather than evidence of injury prevention.

If you're a runner, you may have wondered whether specific foot and ankle exercises could help prevent injuries. This study didn't test that question directly.

Instead, it checked whether a larger study on this topic would even be workable, by seeing if enough runners could be recruited, whether they'd stick with an 8-week foot-ankle strengthening program, and whether they liked it compared to a stretching routine. The good news on the practical side: people were easy to recruit, nearly everyone completed the program, and they rated it positively. The researchers also found that two foot muscles grew slightly after training, measured with imaging.

But this was a small study of 31 people, and it wasn't designed to show whether the exercises actually reduce the chance of getting injured while running. That bigger question still needs to be answered by a larger trial, which this pilot study is now helping to plan.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This paper addresses whether a randomized controlled trial testing a foot-ankle strengthening program for injury prevention in runners is practically achievable, not whether the program actually reduces running-related injuries. The authors randomized 31 recreational long-distance runners to an 8-week foot-ankle strength program or a stretching protocol and tracked recruitment metrics, adherence, satisfaction, and secondary biomechanical and strength outcomes. Feasibility indicators were favorable: recruitment success was 28% of eligible candidates, adherence reached 97%, and satisfaction scores exceeded the midpoint on all questionnaire items.

On secondary outcomes, cross-sectional area of the abductor hallucis (p=0.040) and flexor digitorum brevis (p=0.045) increased significantly in the intervention group at 8 weeks, an isolated pair of significant results among several strength and biomechanical measures, so it could reflect a chance finding rather than a robust training effect. A post hoc power analysis indicated that most strength and kinematic parameters would require smaller sample sizes than the 112 originally calculated for the injury-outcome trial. This study does not establish clinical effectiveness for injury prevention; it only supports moving forward with trial planning.

The small sample, short follow-up, and secondary nature of the biomechanical findings mean conclusions about muscle or movement change should be treated as exploratory, and the abstract does not report on adverse events or injury incidence itself.