Foot Core Training for
Strength, Mobility and

About the Foot Core

Your feet provide a foundation for whole-body movement and dictate your body alignment from the ground up. Strong and mobile feet are able to adapt to changes in terrain, mediate force loads, propel you forward, and send messages to your brain about your position in space. Healthy feet provide a stable base of support and play a key role in pelvic health, and in functional movement along the lower kinetic chain.

Each foot has a complex architecture made up of 26 bones, 33 joints, and a vast network of muscles, tendons, ligaments, and fascia. The feet are generously embedded with proprioceptors — sensory neurons in muscles, tendons and fascia that inform your brain about your body’s position relative to gravity.

Your foot core is formed by four arches — lateral longitudinal, medial longitudinal, and two transverse arches — shaped by the metatarsal and tarsal bones. The foot core is supported by the foot intrinsic muscles, along with tendons, ligaments and fascia. Extrinsic muscles originating in the lower leg also come into play as they cross the ankle and insert into the foot.

The foot core helps to absorb force loads of 2-3 times your body weight, and stores elastic energy to propel you forward when walking and running. In addition to the stabilizing mechanisms of your foot arch itself, the ability to control your big toe is responsible for up to 85% of foot stability.

Foot core training enhances the strength and stability of your arches, metatarsals, and toes when standing, walking and running. It improves foot mobility, to optimize movement and prevent injury during physical activity, and enhances proprioception for improved balance.

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Dr. Lev Kalika
Dr. Lev Kalika

Clinical director & DC RMSK

About Foot and Ankle Strengthening Specialist Dr. Lev Kalika

The concept of foot core training was first conceived by Professor Vladimir Janda, MD, one of the world’s leading physiatrists, and a revolutionary in the field of physical therapy. Dr. Janda called his intrinsic foot training approach “Short Foot“ training. Dr.Kalika learned this method directly from Professor Janda when he was studying at Charles University Hospital in Prague.

Today, some 20 years later, Dr. Kalika has helped hundreds of patients to overcome foot pain, combining the Janda approach with regenerative technologies, gait retraining and barefoot therapeutics. His expertise in diagnostic ultrasonography and his unique methodology have helped to improve ankle and foot strength and mobility in elite athletes, runners and ballet dancers in NYC and beyond.


Why Physical Therapy Alone May Not Resolve Your Condition

Physical therapy is a valuable and effective approach to resolving musculoskeletal pain and dysfunction, but in many cases, physical therapy does not provide a stand-alone solution. Prior to beginning physical therapy, patients often need to address underlying issues that contribute to their pain and disability.

Unfortunately, mainstream physical therapy clinics are often not adequately equipped or experienced to identify and treat complications that undermine the effectiveness of physical therapy. They often rely on one-size-fits-all treatment protocols that overlook the unique characteristics of the individual condition, opting to treat the symptoms and not the patient.

Issues that should be addressed prior to beginning physical therapy include:

  • Scar tissue and fascia adhesions
  • Neurogenic inflammation
  • Joint edema
  • Inflamed soft tissues
  • Myofascial trigger points
  • Compressed or entrapped nerves
  • Tendons that have degenerated and lost their elastic properties
  • Compensation patterns developed post-injury

Holistic Non-Invasive Diagnosis and Regenerative Therapy

Identifying and treating underlying issues prior to beginning physical therapy is key to getting fast and effective results. Failure to do so can completely undermine your treatment protocol, and in some cases, your condition may even worsen.

At NYDNRehab, we use a broad range of advanced technologies and innovative therapeutic approaches to resolve issues that can potentially undermine the success of physical therapy.

Our talented staff is certified in a diverse array of treatment methodologies, rarely found in run-of-the-mill physical therapy clinics. Our one-on-one sessions are personalized, based on the patient’s unique diagnostic profile.

Obstacles to physical therapy success include:

  • Scar tissue and fascia adhesions
  • Neurogenic inflammation
  • Joint edema
  • Inflamed soft tissues
  • Myofascial trigger points
  • Compressed or entrapped nerves
  • Tendons that have degenerated and lost their elastic properties
  • Compensation patterns developed post-injury

Why Foot and Ankle Care at NYDNRehab
is Superior to Mainstream Podiatry

Many people turn to podiatrists to resolve their foot and ankle pain, only to find that conventional diagnostic and treatment approaches render suboptimal results.

XRay imaging falls short of revealing nerve entrapments, fascia adhesions, trigger points and other issues that contribute to foot pain. Standard treatment protocols involve braces, expensive orthotics and steroid injections, to target pain without regard for foot function.

Patients often suffer for years, resigning themselves to a lifetime of foot pain, or eventually seeking a surgical solution as a last resort that leaves them with lasting damage to the structures of the foot.

At NYDNRehab, we take a holistic approach to foot diagnosis and treatment. We understand that foot pain often arises from functional issues farther up the lower kinetic chain, and that treating pain without restoring function is an exercise in futility. At the same time, we recognize that when your feet are tight and immobile, it can translate along the fascia of your lower kinetic chain, affecting structures all the way up to your pelvis.

Our high resolution diagnostic ultrasound equipment gives us crystal clear dynamic images of the structures of the foot in real time that are far superior to XRay or MRI. Our gait analysis and biomechanical lab uses advanced technologies that are second to none, giving us quantitative data to measure your progress.

Our personalized one-on-one approach to patient care ensures that our treatment protocol aligns with the unique characteristics of the patient and their diagnostic results. Our end goal is to restore and enhance pain-free functional movement, so you can get back to the activities you enjoy.


Symptoms and Causes of Intrinsic
Foot Weakness


  • Pain in the feet, toes and ankles
  • Heel pain
  • Flat foot arches
  • Foot over-pronation (rolling inward) when standing, walking or running
  • Toes that bend or “claw” when the arch is relaxed
  • Chronic foot conditions like plantar fasciitis, metatarsalgia, and others


  • Sedentary lifestyle
  • Being overweight
  • Poor gait mechanics
  • Non-supportive footwear
  • Standing on concrete for extended periods
  • Overuse from sports and exercise

How We Diagnose Foot and Ankle Conditions

To get a comprehensive and accurate overview of your condition, Dr. Kalika uses his own carefully researched methodology, using dynamic ultrasonography, sonoelastography and M-Mode technology to quantify intrinsic foot function.

This innovative diagnostic approach is particularly useful in the diagnosis and treatment of foot conditions such as:

  • Tibial stress syndrome
  • Heel pain
  • Plantar fasciitis
  • Tibialis posterior tendinosis
  • Peroneal tendinosis
  • Arch pain
  • Toe conditions like hallux valgus and hallux limitus
  • Ankle pain
  • Achilles tendinosis
  • Plantar plate tears
  • Metatarsalgia
  • Tibial stress syndrome
  • Morton’s neuroma

Ultrasound gives us the capacity to compare the injured foot with its uninjured counterpart, and to traverse the length of long structures like muscles, bones and neural bodies, to see how they interact with other structures.

Additional advanced diagnostic tools for foot pain include:

  • 3-D gait analysis
  • Foot pressure analysis using force plate technology
  • Postural, structural and biomechanical assessment
  • Force plate jumping analysis

Our thorough and accurate diagnostic methodology ensures that we address every factor that contributes to your foot pain and dysfunction.


Our Pretreatment Strategies
Accelerate Results

To make the most of foot core physical therapy, we first pre-treat the affected tissues to eliminate factors that inhibit movement. Pre-treatment helps to reduce pain and inflammation and restore functional range of motion, to prepare you for physical therapy success.


Pre-treatment therapies may include:

  • Regenerative technologies like extracorporeal shockwave therapy (ESWT), to eliminate inflammation, reduce pain and stimulate tissue healing. ESWT is particularly effective for plantar fasciitis and tendinopathies.
  • Ultrasound-guided dry needling, to eliminate myofascial trigger points that cause pain and inhibit movement.
  • Nerve hydrodissection, to free up nerves entrapped by adhesions and scar tissue, and restore smooth gliding among other structures.
  • PRP injections, to trigger and accelerate tissue healing at the cellular level.

Our Unique Approach to Foot Strengthening Physical Therapy

To optimize the results of your foot core physical therapy, we focus on three key areas:
  • Foot core strength and stability, to enhance arch support and optimize foot function.
  • Foot mobility, to improve the foot’s ability to navigate uneven terrain and adapt to dynamic loading patterns.
  • Foot proprioception, to enhance foot-to-brain feedback mechanisms that promote balance and stability.
In addition to the Janda Short Foot approach to foot core training, your treatment protocol may include:
  • Perturbation exercises with C.A.R.E.N, our computer-assisted rehabilitation environment
  • Gait retraining with AI-assisted intrinsic feedback
  • Dynamic neuromuscular stabilization (DNS)
  • Anatomy in Motion (AIM)
  • Manual foot manipulation and myofascial release therapy
  • Exercises for the lower kinetic chain
  • Foot proprioception exercises

Preventing Foot and Ankle Pain and Dysfunction

There are several things you can do now to avoid foot pain in the future:

  • Maintain a healthy weight — excess body fat is deadweight that intensifies the forces that cause foot pain.
  • Exercise regularly — strong muscles throughout your body help to manage force loads during physical activity, diverting them from your feet.
  • Wear supportive shoes that absorb shock. High heels, flimsy sandals, and shoes with flat soles force your feet into unnatural movement patterns that make them work harder.
  • If you’re athletic or physically active, get a gait and/or biomechanical analysis to ensure your feet are not being overworked by faulty movement patterns.

Get the Best Foot Strengthening Therapy
for Foot Pain Relief in NYC

If you suffer from foot and ankle pain, don’t waste your time and money on mainstream podiatrists who treat your symptoms without fixing their underlying cause. At NDYNRehab, we treat the whole patient, not just their symptoms. Our accurate diagnosis and personalized one-on-one treatment approach are designed to get to the bottom of your foot pain and resolve it for good. Contact NYDNRehab today, and get fast and effective foot core physical therapy that really works!

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    Foot Core Training FAQs

    How does foot core training affect running gait?

    Foot core training focuses on strengthening the intrinsic muscles that support the arch of the foot, enabling the foot to adapt throughout the gait cycle during walking and running. The foot intrinsic muscles give the arch its spring-like action as the muscles store elastic energy at heel strike, to be released at the push-off phase of the gait cycle.

    Do weakened foot core muscles cause other problems?

    Weak intrinsic foot muscles can cause problems anywhere along the lower kinetic chain, creating ankle, knee and hip pain, and even affecting the pelvic floor. A weak foot core dramatically increases your risk of running and athletic injuries.

    How important is shoe choice to prevent foot core problems?
    <p style=”text-align: left;”>Footwear that provides support and shock absorption goes a long way toward preventing foot pain. Don’t fall for shoe selection sales strategies based on “foot type.” Find shoes that feel supportive and comfortable, without rubbing, pinching, or forcing your foot into a position that feels unnatural.</p>
    Does barefoot running help or harm the foot core?

    According to a recent scientific review, barefoot running alters the foot strike pattern, reduces stride length and affects impact loading, while posing a greater challenge to proprioceptors in the plantar fascia. Meanwhile, running injuries continue to be on the rise. Terrain can make a huge difference – running barefoot on sand may be beneficial, but running on hard surfaces like concrete can do more harm than good. You should strengthen your foot core before taking on barefoot running, and consider minimalist footwear options that allow for natural foot movement while still providing protection from rough terrain.

    What role does the plantar fascia play in foot stability?

    Your plantar fascia is a tough band of connective tissue that spans the bottom of your foot from heel to toe. A healthy plantar fascia is mobile and elastic, with a unique windlass mechanism that stores and releases elastic energy that propels you forward. When rigid, stiff or injured, the plantar fascia loses its elastic properties and reduces your foot core mobility and stability.


    In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

    Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

    The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

    Dynamic ultrasonography examination demonstrating
    the full thickness tear and already occurring muscle atrophy
    due to misdiagnosis and not referring the patient
    to proper diagnostic workup

    Demonstration of how very small muscle defect is made and revealed
    to be a complete tear with muscle contraction
    under diagnostic sonography (not possible with MRI)


    Complete tear of rectus femoris
    with large hematoma (blood)


    Separation of muscle ends due to tear elicited
    on dynamic sonography examination

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