Sporcularda Foot Core Sistemi: İntrinsik Ayak Kaslarının Antrenmanı ve Atletik Performansa Etkileri

Öz

Amaç: Bu derleme çalışmasının amacı, ayak intrinsik kaslarının sporcularda performansın artırılması ve alt ekstremite yaralanmalarının önlenmesindeki etkinliğini değerlendirmektir. Biyomekanik, anatomik ve antrenman bilimlerine dayandırılmış güncel kanıtlar ışığında ayak intrinsik kas antrenmanlarının sporcu antrenman programlarına entegrasyonu incelenmiştir. Yöntem: Bu çalışmada, 2010–2025 yılları arasında yayımlanmış bilimsel makaleler, sistematik derlemeler, meta-analizler, deneysel araştırmalar ve vaka çalışmaları incelenerek foot core antrenmanlarının atletik performans, postüral kontrol ve yaralanma önleme üzerindeki etkileri değerlendirilmiştir. Literatür taraması; Web of Science, PubMed, Scopus, SportDiscus, Google Scholar ve Academic Search Ultimate veri tabanlarında gerçekleştirilmiştir. Tarama sırasında "foot core training", "intrinsic foot muscles", "short foot exercise", "plantar arch stability", "foot muscle activation", "postural control", "balance and foot biomechanics", "neuromuscular foot function" ve "injury prevention in athletes” anahtar kelimeleri kullanılmıştır. Anahtar kelimeler, Boolean operatörleri ile birleştirilmiş ve yalnızca tam metin erişimi olan İngilizce çalışmalar dahil edilmiştir. Literatür seçimi, başlık, özet ve tam metin taraması ile yapılmış; çalışmalarda kullanılan ölçüm yöntemleri, örneklem grubu, müdahale süresi ve sonuç değişkenleri dikkate alınarak analiz gerçekleştirilmiştir. Sonuç: Ayak intrinsik kas antrenmanının, medial ark desteğini artırdığı, denge ve postüral kontrolü iyileştirdiği, verimli yürüyüş ve itiş mekanikleri sağladığı ve atletik popülasyonda yaralanma riskini azalttığı tespit edilmiştir. Spor özgü programlara entegre edilen izometrik ve dinamik egzersizler, kuvvet ve propriyosepsiyon gelişimiyle birlikte fonksiyonel hareket kalitesini artırmıştır. Ancak metodolojik çeşitlilik ve uzun dönem takip eksikliği, standartlaştırılmış protokollerin önemini vurgulamaktadır.

Anahtar Kelimeler

• Atletik Performans
• Ayak İntrinsik Kasları
• Foot Core Antrenmanı
• Yaralanma Önleme

Foot Core System in Athletes: Training of Intrinsic Foot Muscles and Its Effects on Athletic Performance

Öz

Objective: The purpose of this narrative review is to assess the function of the intrinsic foot muscles in optimizing sporting performance, improving the mechanics of movement, and preventing injury to the lower limb. The review aggregates biomechanical, anatomical, and sport science literature justifying the incorporation of intrinsic foot muscles training into sporting conditioning. Methods: In this study, scientific articles, systematic reviews, meta-analyses, experimental researches and case studies published between 2010 and 2025 were examined to evaluate the effects of foot core training on athletic performance, postural control and injury prevention. The literature search was conducted in Web of Science, PubMed, Scopus, SportDiscus, Google Scholar and Academic Search Ultimate databases. The keywords "foot core training", "intrinsic foot muscles", "short foot exercise", "plantar arch stability", "foot muscle activation", "postural control", "balance and foot biomechanics", "neuromuscular foot function" and "injury prevention in athletes"were used during the search. Keywords were combined with Boolean operators and only English studies with full-text access were included. Literature selection was made by title, abstract and full-text scanning; analysis was performed considering the measurement methods used in the studies, sample group, intervention period and outcome variables. Results: Evidence substantiates that intrinsic foot muscles training augments medial arch support, enhances balance and posture control, assists in optimal gait and propulsion mechanics, and minimizes risk of injury in sport populations. Isometric and dynamic protocols, when implemented as part of sport-specific conditioning, produced quantifiable gains in strength, proprioception, and functional movement quality. Although promising, heterogeneity of methods and absence of long-term data underscore the necessity for controlled, longitudinal studies.

Anahtar Kelimeler

• Athletic Performance
• Foot Core Training
• Injury Prevention
• Intrinsic Foot Muscles

Kaynakça

1. Abe, T., Tayashiki, K., Nakatani, M., & Watanabe, H. (2016). Relationships of ultrasound measures of intrinsic foot muscle cross-sectional area and muscle volume with maximum toe flexor muscle strength and physical performance in young adults. Journal of Physical Therapy Science, 28(1), 14-19. https://doi.org/10.1589/jpts.28.14
2. Chen, Z., Li, Y., Zhang, Y., Zhang, Z., Wang, J., Deng, X., … & Song, B. (2022). Analysis of Visual Risk Factors of Anterior Cruciate Ligament Injury of Knee Joint. Journal of Clinical Medicine. https://doi.org/10.3390/jcm11195602
3. Chouhan, R., Misra, A., Soni, R., Joseph, A., Umate, R., Chouhan, R., … & Umate, R. (2022). Effectiveness of Plyometrics Along With Pilates Exercises in Increasing Vertical Jump Performance Among Basketball Players. Cureus, 14(12). https://doi.org/10.7759/CUREUS.32957
4. Dewir, I. M., & El Laithy, M. H. (2024). Effect of Short-Foot Exercise on Dynamic Balance of Subject With Acquired Flat Foot: Telerehabilitation Single Case Study. Fiz Pol. https://doi.org/10.56984/8zg5608hq5
5. Dygut, J., & Piwowar, M. (2022). Muscular Systems and Their Influence on Foot Arches and Toes Alignment—Towards the Proper Diagnosis and Treatment of Hallux Valgus. Diagnostics. https://doi.org/10.3390/diagnostics12122945
6. Edwards, C. M., Puranda, J. L., Miller, I., Aboudlal, M., O’Rourke, N., MacDonald, M. L., & Adamo, K. B. (2024). Musculoskeletal Injuries, Exercise Behaviors, and Reproductive Health Are Related to Physical Fitness of Female First-Responders and Health Care Providers. Women’s Health Reports, 5(1), 393-403.
7. Ellenbecker, T. S., & Aoki, R. (2020). Step by Step Guide to Understanding the Kinetic Chain Concept in the Overhead Athlete. Current Reviews in Musculoskeletal Medicine, 13(2), 155. https://doi.org/10.1007/S12178-020-09615-1
8. Fourchet, F., & McKeon, P. O. (2015). 15 Foot Core Strengthening: An Update About the Intrinsic Foot Muscles Recruitment. https://doi.org/10.1136/bjsports-2015-095573.15

9. Heindel, M., & Buchanan, K. (2018). Barefoot Rehabilitation Of Type II Posterior Tibialis Tendon Dysfunction In A Veteran: A Case Report. Case Report Posters. https://doi.org/10.1016/j.phsyio.2015.03.273
10. Hirota, K., Watanabe, K., Miyamoto, H., Negishi, K., Watase, M., & Teramoto, A. (2024). Comparison by ultrasound shear wave elastography of toe flexor muscle contraction during MTP flexion exercise and short-foot exercise. Journal of Back and Musculoskeletal Rehabilitation, 37(4), 1041-1047. https://doi.org/10.3233/BMR-230282
11. Ichikawa, S., Kumai, T., Akiyama, Y., Okunuki, T., Maemichi, T., Matsumoto, M., … & Niki, H. (2024a). Relationship Between Dynamic Balance and Physical Characteristics of Elite Lifesaving Athletes. https://doi.org/10.20944/preprints202406.1866.v1
12. Ichikawa, S., Kumai, T., Akiyama, Y., Okunuki, T., Maemichi, T., Matsumoto, M., … & Niki, H. (2024b). Relationship Between Dynamic Balance and Physical Characteristics and Functions in Elite Lifesaving Athletes. Journal of Functional Morphology and Kinesiology. https://doi.org/10.3390/jfmk9030134
13. Jaffri, A. H., Koldenhoven, R., Saliba, S., & Hertel, J. (2023). Evidence for Intrinsic Foot Muscle Training in Improving Foot Function: A Systematic Review and Meta-Analysis. Journal of Athletic Training, 58(11-12), 941-951. https://doi.org/10.4085/1062-6050-0162.22
14. James, D. C., Solan, M. C., & Mileva, K. N. (2018). Wide-pulse, high-frequency, low-intensity neuromuscular electrical stimulation has potential for targeted strengthening of an intrinsic foot muscle: A feasibility study. Journal of Foot and Ankle Research, 11(1). https://doi.org/10.1186/s13047-018-0258-1
15. Jastifer, J. R. (2023). Intrinsic muscles of the foot: Anatomy, function, rehabilitation. Physical Therapy in Sport, 61, 27-36. https://doi.org/10.1016/j.ptsp.2023.02.005
16. Kanayama, T., Takata, Y., Asai, K., Kimura, M., Yoshimizu, R., Kinuya, S., … & Nakase, J. (2024). Quantifying lower limb skeletal muscle activity changes after 3 months of intrinsic foot muscle training: A randomized controlled trial. Journal of Sports Medicine And Physical Fitness. https://doi.org/10.23736/S0022-4707.24.16425-0
17. Kao, S.-L., Hsiao, M.-L., Wang, J.-H., Chen, C.-S., Chen, S.-Y., Shiau, Y.-J., & Yang, C.-H. (2024). Effects of integrated intrinsic foot muscle exercise with foot core training device on balance and body composition among community-dwelling adults aged 60 and above. BMC Geriatrics, 24(1). https://doi.org/10.1186/s12877-024-04945-y
18. Kavya, K., & Kutty, N. N. (2022). Effect of Foot Intrinsic and Tibialis Posterior Muscle Training on Dynamic Balance in Bharatanatyam Dancers a Comparative Study. Indian Journal of Physiotherapy and Occupational Therapy - An International Journal. https://doi.org/10.37506/ijpot.v16i3.18393
19. Kelly, L. A. (2015). In-vivo function of human plantar intrinsic foot muscles. https://doi.org/10.14264/UQL.2015.341
20. Lai, Z., Pang, H., Hu, X., Dong, K., & Wang, L. (2021). Effects of intrinsic-foot-muscle exercise combined with the lower extremity resistance training on postural stability in older adults with fall risk: study protocol for a randomised controlled trial. Trials, 22(1). https://doi.org/10.1186/s13063-021-05554-5
21. Latey, P. J., Eisenhuth, J., McKay, M. J., Hiller, C. E., Sureshkumar, P., Nightingale, E. J., & Burns, J. (2020). Feasibility of the Archercise biofeedback device to strengthen foot musculature. Journal of Foot and Ankle Research, 13(1). https://doi.org/10.1186/s13047-020-00394-z
22. Lee, D.-R., & Choi, Y.-E. (2019). Effects of a 6-week intrinsic foot muscle exercise program on the functions of intrinsic foot muscle and dynamic balance in patients with chronic ankle instability. Journal of Exercise Rehabilitation, 15(5), 709-714. https://doi.org/10.12965/jer.1938488.244
23. Longo, U. G., Papalia, R., Salvatore, S. De, Greco, A., Marino, M., Bravi, M., … & Denaro, V. (2022). Lower Limb Risk Prevention in Athletes: Evaluation and Strategies. International Journal of Bone Fragility. https://doi.org/10.57582/ijbf.220201.033
24. Matsumoto, Y., & Ogihara, N. (2024). Direct visualization and measurement of the plantar aponeurosis behavior in foot arch deformation via the windlass mechanism. Clinical Anatomy, 38(2), 116-126. https://doi.org/10.1002/CA.24171;CTYPE:STRING:JOURNAL
25. McKeon, P. O., & Fourchet, F. (2015). Freeing the foot. Integrating the foot core system into rehabilitation for lower extremity injuries. Clinics in Sports Medicine, 34(2), 347-361. https://doi.org/10.1016/j.csm.2014.12.002
26. McKeon, P. O., Hertel, J., Bramble, D., & Davis, I. (2015). The foot core system: A new paradigm for understanding intrinsic foot muscle function. British Journal of Sports Medicine, 49(5), 290. https://doi.org/10.1136/bjsports-2013-092690
27. Morikawa, M., Maeda, N., Komiya, M., Hirota, A., Mizuta, R., Kobayashi, T., … & Urabe, Y. (2021). Contribution of plantar fascia and intrinsic foot muscles in a single-leg drop landing and repetitive rebound jumps: An ultrasound-based study. International Journal of Environmental Research and Public Health, 18(9). https://doi.org/10.3390/ijerph18094511
28. Muthupandikumar R., & Premkumar M. (2024). Effectiveness of Intrinsic Foot Muscle Training on Balance, Physical Activity and Quality of Life in Down’s Syndrome (DS) Children and Adult Population-A. researchgate.net. https://doi.org/10.53555/kuey.v30i10.8490
29. Oishi, M., Ogihara, N., Shimizu, D., Kikuchi, Y., Endo, H., Une, Y., … & Ichihara, N. (2018). Multivariate Analysis of Variations in Intrinsic Foot Musculature Among Hominoids. Journal of Anatomy. https://doi.org/10.1111/joa.12780
30. Poomsalood, S., Hanphitakphong, P., Chombanphaeo, T., Phanuphab, M., & Yancuhra, A. (2023). Effects of short foot exercise on Q-angle in individuals with flatfoot. Journal of Associated Medical Sciences, 56(3), 162-168. https://doi.org/10.12982/JAMS.2023.067
31. Ramírez-delaCruz, M., Bravo-Sánchez, A., Esteban-García, P., Jiménez, F., & Abián-Vicén, J. (2022). Effects of Plyometric Training on Lower Body Muscle Architecture, Tendon Structure, Stiffness and Physical Performance: A Systematic Review and Meta-analysis. Sports Medicine - Open 2022 8:1, 8(1), 1-29. https://doi.org/10.1186/S40798-022-00431-0
32. Ridge, S. T., Rowley, K. M., Kurihara, T., McClung, M., Tang, J., Reischl, S., & Kulig, K. (2022). Contributions of Intrinsic and Extrinsic Foot Muscles during Functional Standing Postures. BioMed Research International, null(null), 1-9. https://research.ebsco.com/linkprocessor/plink?id=f1fc45e8-da60-342e-9072-0d6926eca1f1
33. Rodrigues, M. M., Borges, D. C., de Oliveira, L. V., Cabreira, M. T., da Silveira, M. F., & Hentschke, V. S. (2023). Intrinsic Foot Strengthening and Electrostimulation in Older Adults - Randomized Clinical Trial. Fisioterapia Em Movimento. https://doi.org/10.1590/fm.2023.36127
34. Shinohara, H. (2025). Reconsideration of the Load-Bearing Functions of the Plantar Fascia and Intrinsic Foot Muscles in the Windlass Mechanism. Scientific Reports. https://doi.org/10.1038/s41598-025-97477-3
35. Sichting, F., & Ebrecht, F. (2021). The Rise of the Longitudinal Arch When Sitting, Standing, and Walking: Contributions of the Windlass Mechanism. Plos One. https://doi.org/10.1371/journal.pone.0249965
36. Słomka, K. J., Pawłowski, M., Michalska, J., Kamieniarz, A., Brachman, A., & Juras, G. (2018). Effects of 8-Week Complex Balance Training in Young Alpine Skiers: A Pilot Study. BioMed Research International, 2018. https://doi.org/10.1155/2018/6804534,
37. Smith, R. E., Lichtwark, G. A., & Kelly, L. A. (2022). Flexor digitorum brevis utilizes elastic strain energy to contribute to both work generation and energy absorption at the foot. Journal of Experimental Biology, 225(8). https://doi.org/10.1242/jeb.243792
38. Smith, R., Lichtwark, G., Farris, D., & Kelly, L. (2023). Examining the intrinsic foot muscles’ capacity to modulate plantar flexor gearing and ankle joint contributions to propulsion in vertical jumping. Journal of Sport and Health Science, 12(5), 639-647. https://doi.org/10.1016/j.jshs.2022.07.002
39. Song, S., LaMontagna, C., Collins, S. H., & Geyer, H. (2013). The Effect of Foot Compliance Encoded in the Windlass Mechanism on the Energetics of Human Walking. https://doi.org/10.1109/embc.2013.6610216
40. Soysa, A., Hiller, C., Refshauge, K., & Burns, J. (2012). Importance and challenges of measuring intrinsic foot muscle strength. Journal of Foot and Ankle Research, 5(1). https://doi.org/10.1186/1757-1146-5-29
41. Sulowska, I., Oleksy, L., Mika, A., Bylina, D., & Soltan, J. (2016). The Influence of Plantar Short Foot Muscle Exercises on Foot Posture and Fundamental Movement Patterns in Long-Distance Runners, a Non-Randomized, Non-Blinded Clinical Trial. PLOS ONE, 11(6). https://doi.org/10.1371/journal.pone.0157917
42. Sulowska-Daszyk, I., Mika, A., & Oleksy, Ł. (2017). The Influence of Plantar Short Foot Muscle Exercises on Foot Posture and Gait Parameters in Long-Distance Runners. Journal of Kinesiology and Exercise Sciences. https://doi.org/10.5604/01.3001.0011.6820
43. Sulowska-Daszyk, I., Mika, A., & Oleksy, Ł. (2020). Impact of Short Foot Muscle Exercises on Quality of Movement and Flexibility in Amateur Runners. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph17186534
44. Sulowska-Daszyk, I., Oleksy, Ł., Mika, A., Bylina, D., & Sołtan, J. (2016). The Influence of Plantar Short Foot Muscle Exercises on Foot Posture and Fundamental Movement Patterns in Long-Distance Runners, a Non-Randomized, Non-Blinded Clinical Trial. Plos One. https://doi.org/10.1371/journal.pone.0157917
45. Suzuki, K., Kumai, T., Ichikawa, S., Maemichi, T., Okunuki, T., Shimpo, T., Akiyama, Y., Mitsui, H., & Niki, H. (2024). Dynamic Balance and Muscle Activity in Lifesavers: A Study on Intrinsic and Extrinsic Foot Muscles. Cureus Journal of Medical Science, 16(8). https://doi.org/10.7759/cureus.67756
46. Suzuki, M., Kuruma, H., Kato, K., Gota, Y., Kase, H., Fujimoto, H., & Nagashima, R. (2024). Effect of short foot exercise on lower-limb motor control function during single-leg standing in university students with flatfoot: A randomized controlled trial. Journal of Bodywork and Movement Therapies, 39, 293-298. https://doi.org/10.1016/j.jbmt.2024.02.023
47. Tourillon, R., Fourchet, F., Édouard, P., & Morin, J. (2024). Effects of a Forefoot Strengthening Protocol on Explosive Tasks Performance and Propulsion Kinetics in Athletes: A Single-Blind Randomized Controlled Trial. https://doi.org/10.1101/2024.11.06.24316826
48. Tourillon, R., Gojanovic, B., & Fourchet, F. (2019a). How to Evaluate and Improve Foot Strength in Athletes: An Update. FRONTIERS IN SPORTS AND ACTIVE LIVING, 1. https://doi.org/10.3389/fspor.2019.00046
49. Tourillon, R., Gojanovic, B., & Fourchet, F. (2019b). How to Evaluate and Improve Foot Strength in Athletes: An Update. https://doi.org/10.3389/FSPOR.2019.00046
50. Ünver, B., Taşkıran, H., & AKGÖL, A. C. (2022). Foot Muscle Strength, Muscle Shortness, Balance, and Shoe Preferences in Different Foot Postures. Clinical and Experimental Health Sciences. https://doi.org/10.33808/clinexphealthsci.714950
51. Veltrie, R. E. (2020). The Effects of Intrinsic Foot Muscle Strengthening on Foot Posture, Balance, and Agility in Ice Hockey Players. https://doi.org/10.33915/ETD.7602
52. Vincent, K. R., & Vincent, H. K. (2018). Use of Foot Doming for Increasing Dynamic Stability and Injury Prevention in Runners and Athletes. Current Sports Medicine Reports. https://doi.org/10.1249/JSR.0000000000000522
53. Wang, J., Wang, Y., Zhou, B., Wang, L., & Lai, Z. (2024). Age-Related Reduction of Foot Intrinsic Muscle Function and the Relationship with Postural Stability in Old Adults. Clinical Interventions in Aging, 19, 1005-1015. https://doi.org/10.2147/CIA.S454068
54. Wegener, C., Greene, A., Burns, J., Hunt, A. E., Vanwanseele, B., & Smith, R. M. (2015). In-Shoe Multi-Segment Foot Kinematics of Children During the Propulsive Phase of Walking and Running. Human Movement Science. https://doi.org/10.1016/j.humov.2014.11.002
55. Welte, L., Kelly, L. A., Lichtwark, G. A., & Rainbow, M. J. (2018). Influence of the Windlass Mechanism on Arch-Spring Mechanics During Dynamic Foot Arch Deformation. Journal of the Royal Society Interface. https://doi.org/10.1098/rsif.2018.0270
56. Willemse, L., Wouters, E., Bronts, H., Pisters, M. F., & Vanwanseele, B. (2022). The Effect of Interventions Anticipated to Improve Plantar Intrinsic Foot Muscle Strength on Fall‐related Dynamic Function in Adults: A Systematic Review. Journal of Foot and Ankle Research. https://doi.org/10.1186/s13047-021-00509-0
57. Willemse, L., Wouters, E. J. M., Pisters, M. F., & Vanwanseele, B. (2024a). Plantar intrinsic foot muscle activation during functional exercises compared to isolated foot exercises in younger adults. Physiotherapy Theory and Practice, 40(8), 1656-1668. https://doi.org/10.1080/09593985.2023.2204947
58. Willemse, L., Wouters, E., Pisters, M. F., & Vanwanseele, B. (2024b). Effects of a 12-Week Intrinsic Foot Muscle Strengthening Training (STIFF) on Gait in Older Adults: A Parallel Randomized Controlled Trial Protocol. BMC Sports Science Medicine and Rehabilitation. https://doi.org/10.1186/s13102-024-00944-z
59. Wilmot, S., Alfonso, A., Velez, J., Research, A. E.-A. in A., & 2019, undefined. (t.y.). The Effect of Sensory Stimulation versus Motor Control Cueing of the Foot on Balance in Elderly Females: Single Group Pretest-Posttest Study. scirp.org. Geliş tarihi 04 Mayıs 2025, gönderen https://www.scirp.org/journal/paperinformation?paperid=96119
60. Yamaguchi, T., & Nishimoto, H. (2024). 719 EP026 – The effects of Shiko, a traditional Japanese training exercise: towards the prevention of running injuries. British Journal of Sports Medicine, 58(Suppl 2), A88-A88. https://doi.org/10.1136/BJSPORTS-2024-IOC.151