The exercise is useful for what it is designed for: to strengthen the intrinsic muscles in the foot. That is all. Nothing more and nothing less. It does not cure all the ails the foot, despite the claims by many of it supporters. It supposed to “cure” “overpronation” – it dosen’t. The evidence is clear on that. I can be useful in plantar fasciitis.
This is a concept that has been getting increased attention in recent years in clinical practice. It is a concept and clinical test of determining how hard it is to supinate the foot based on the assumption that the harder the force is, then if a foot orthotic is needed for something like, overpronation, then more force needs to come from the foot orthotic; so a rigid firm and inverted type foot orthotic is needed. Similarity if the force is low, then not much force is needed from the foot orthotic, so a soft flexible foot orthotic is indicated.
There has been some research done on it, but not a lot. This is probably limiting its more widespread use in clinical practice. The test for supination resistance does correlate quite well with some pathologies and not others.
The windlass mechanism is an extremely important function in the foot. It is the foot’s own natural arch supporting mechanism, so any inhibition of this mechanism is going to affect the integrity of the foot and it biomechanics. The plantar fascia or plantar aponeurosis attaches to the bottom of the heel and the base of the toes, so spans the arch of the foot to support it. When the heel lifts off the ground the toes bend relative to the metatarsals, so they tighten this plantar fascia, giving stability to the arch and foot during the propulsive phase of gait.
If there is any issues that affect the integrity of the windlass, then there are often consequences. The arch of the foot will not be able to resist the forces that are applied to it during propulsion and will collapse. This can result in a range of different pathologies such as plantar fasciitis. Also while not being able to support the arch will also contribute to any overpronation and the consequences of that.
If there is any sort of dysfunction of the windlass there are a number of different types of interventions that can be used such as lowering the force to get it established or to get the windlass to initiate or start working earlier.