How Is Foot Strength Related to Falls — and Why It Matters for Brain Health

Last Updated: December 2025

Dr. Jessica Knape of HealthSpan Internal Medicine in Boulder, CO, explains that fall risk often begins in the feet—even before balance problems appear. Weak foot muscles, stiff ankles, and reduced sensory feedback can slowly undermine stability. She highlights that strengthening the feet is a key strategy not only for preventing falls, but also for supporting brain function, confidence, and long-term independence.

Falls are one of the leading causes of injury, hospitalization, and loss of independence in adults over 60.
But few people realize that the first warning signs of fall risk often begin in the feet — long before balance seems impaired.

Weak foot muscles, stiff ankles, and loss of sensory feedback can quietly erode stability.
At HealthSpan Internal Medicine in Boulder, CO, we teach patients that maintaining foot strength isn’t just about avoiding falls — it’s about protecting brain function, confidence, and independence.

HealthSpan Insight

• Strong, flexible feet are the foundation of balance and mobility.

• Foot weakness contributes to falls, hip fractures, and cognitive decline through reduced sensory input and activity.

• Strengthening foot muscles improves stability, posture, and even brain health.

1. Why Foot Strength Is So Important

Your feet are sophisticated sensory organs — each containing 26 bones, 33 joints, and over 100 muscles, tendons, and ligaments.
They continuously send feedback to your brain about position, pressure, and balance through proprioceptive nerves.

When foot muscles weaken or mobility declines:

• The brain receives less accurate information about where the body is in space.

• Small balance corrections become delayed or inefficient.

• Posture changes, often creating a forward lean that increases fall risk.

Over time, this leads to a “disconnect” between the brain and the body — one that can be retrained but is often overlooked until a fall happens.

2. The Vicious Cycle: Weak Feet → Reduced Activity → Weaker Brain

When walking becomes uncomfortable or unsteady, people naturally move less.
Less movement reduces:

• Blood flow to the brain

• Vestibular stimulation (balance signals from movement)

• Neuroplasticity, the brain’s ability to adapt

This creates a feedback loop where both muscle and brain function decline together — a phenomenon often called motor-cognitive coupling.

Research shows that mobility loss is not just a musculoskeletal issue — it’s a predictor of cognitive decline.
Regular weight-bearing, dynamic movement keeps both the nervous system and musculoskeletal system sharp.

3. Common Causes of Foot Weakness and Balance Loss

• Sedentary lifestyle: Sitting most of the day causes foot muscles to atrophy.

• Supportive shoes and orthotics: While sometimes necessary, they can over time “deactivate” intrinsic foot muscles.

• Peripheral neuropathy: Diabetes, nutrient deficiencies (like B12), or toxins can impair nerve sensation.

• Arthritis or foot deformities: Stiffness limits range of motion and reduces proprioceptive feedback.

• Postural instability: Core and hip weakness often coexist with foot weakness.

These changes often accumulate slowly, which is why foot-strengthening is critical before a fall occurs.

4. The Connection Between Foot Function and Brain Health

Your balance depends on constant communication between the feet, inner ear, eyes, and brainstem.
When the feet stop delivering clear information, the brain has to “guess” your position — increasing the likelihood of a stumble.

MRI studies show that older adults with poor balance also have reduced activity in the parietal and cerebellar regions — areas tied to spatial awareness and coordination.
Strengthening foot muscles and improving sensory input helps reactivate these neural circuits, improving both movement and cognition.

In fact, gait and cognitive health are so intertwined that some researchers now describe walking as a “sixth vital sign” of brain aging.

5. How to Test Your Foot and Balance Health

You can do a few simple checks at home:

• Toe raise test: Can you lift your big toe independently of the others while standing?

• Single-leg balance: Can you balance on one foot for at least 10 seconds without wobbling?

• Foot posture: Are your arches collapsing or rolling inward?

• Barefoot mobility: Can you move your toes easily, or do they feel rigid?

If these are difficult, your feet may already be deconditioned — but recovery is absolutely possible.

6. How to Rebuild Foot Strength and Balance

The goal is to restore strength, flexibility, and sensory feedback.

A. Go Barefoot (Safely)

Spend short periods barefoot or in minimalist shoes on safe, textured surfaces (like yoga mats or grass).
This reawakens nerve endings and strengthens stabilizer muscles.

B. Try Toe and Arch Exercises

• Short foot exercise: Press your big toe down and “lift” your arch without curling your toes.

• Towel scrunches: Pull a towel toward you using your toes.

• Marble pick-up: Use your toes to pick up marbles or small objects.

C. Strengthen the Chain Above

Strong hips and core are essential for balance.
Incorporate squats, glute bridges, and side steps to build integrated stability.

D. Practice Dynamic Balance

• Stand on one leg while brushing teeth or talking on the phone.

• Try balance pads or wobble boards to challenge proprioception.

• Tai chi and yoga are excellent for foot and postural coordination.

E. Restore Nerve Function

Ensure optimal B-vitamin levels, thyroid health, and circulation — especially for those with diabetes or peripheral neuropathy.

7. How Brain Health Improves With Better Foot Function

Improving foot strength and balance does more than reduce falls. It:

• Increases cerebral blood flow through dynamic movement.

• Enhances neuroplasticity via sensory input.

• Improves mood and confidence, reducing fear-based immobility.

• Stimulates dopamine and serotonin, helping motivation and emotional stability.

Movement keeps the brain alive — and the feet are the roots of that movement.

8. When to Seek Medical or Functional Assessment

You should seek evaluation if you notice:

• Frequent tripping or imbalance

• Numbness or tingling in the feet

• Changes in gait (shorter steps, slower pace)

• Unexplained leg fatigue or stiffness

At HealthSpan Internal Medicine, we use a multisystem fall-risk assessment — checking neurological, metabolic, and musculoskeletal factors.
This includes balance testing, gait analysis, B12 levels, thyroid and hormone evaluation, and medication review.

Often, what looks like a “balance issue” is really a combination of inflammation, weakness, or sensory loss — all reversible with the right plan.

Bottom Line

Your feet are more than just support structures — they are sensory messengers to your brain.
When they’re strong and flexible, they protect you from falls and help maintain clear neural communication.
When they weaken, the risk of physical and cognitive decline rises together.

By training your feet, improving sensory input, and maintaining strength from the ground up, you protect not only your mobility — but your Brainspan.

At HealthSpan Internal Medicine in Boulder, CO, we help patients restore balance and vitality through integrated assessment, targeted exercise, and preventive hormone and nutrient optimization.

Schedule a Brain & Neuromuscular Optimization Evaluation with Dr. Knape to assess your fall risk, foot and lower‑extremity strength, and develop a personalized plan that supports balance, mobility, and brain health throughout aging.

👉 Book your Discovery Call today.

Sources

• Hallux (Big Toe) Strength & Fall Risk in Older Adults - MDPI

• Ankle & Foot Exercises Improve Strength, Balance, and Stability - PubMed

• Foot & Ankle Characteristics Linked to Falls in Older Adults - PubMed

• Toe Grip Force Predicts Falls in Community‑Dwelling Older Adults - PubMed

• Foot Muscle Strength Declines with Age & Affects Postural Stability - PubMed

Medically reviewed by
Dr. Jessica Knape, MD, MA Board Certified in Internal Medicine and Integrative and Holistic Medicine
Healthspan Internal Medicine — serving patients in Boulder, CO

Book a Discovery Call | About Dr. Knape

This content is for educational purposes and does not replace personalized medical advice.