Short Foot Exercises as a Preventive Strategy for ACL Injury in Women with Dynamic Knee Valgus.

Background: Dynamic knee valgus (DKV) is a well-established contributor to knee injuries, with women at higher risk. Traditional rehabilitation often emphasizes proximal muscle strengthening, but growing research suggests that foot and ankle dysfunction may play a critical role in DKV development. This study aimed to investigate the effects of a 6-week short foot exercise (SFE) program on the DKV angle, navicular drop, ankle dorsiflexion range of motion (DFROM), and proprioceptive acuity at the knee and ankle in women with DKV. Methods: This quasi-experimental study involved 28 female university students (aged 20-30 years) with DKV and excessive navicular drop, assigned to either an SFE group or a control group. The intervention group performed supervised SFE sessions 3 times per week for 6 weeks. Measurements taken before and after the intervention included DKV angle, navicular drop, ankle DFROM, and proprioceptive acuity at the knee and ankle. Appropriate parametric and nonparametric statistical tests (t-tests, analysis of covariance, Mann-Whitney U, and Wilcoxon test) were used based on data distribution. Results: After the intervention, the SFE group demonstrated significant improvements compared to the control group in DKV angle (adjusted mean difference = -4.0°, 95% CI: -6.0° to -2.1°, p = 0.001, d = 2.04), navicular drop (-4.2 mm, 95% CI: -5.4 to -2.9 mm, P<0.001, d=2.08), and ankle DFROM (+6.9°, 95% CI: 5.2° to 8.7°, P<0.001, d=2.89). Knee joint proprioception error decreased by -1.2° (95% CI: -1.8° to -0.7°, P<0.001, d=1.47), and ankle proprioception error (dorsiflexion) improved by -1.4° (95% CI: -2.5° to -0.6°, P=0.002, r=0.60). The control group showed no significant changes in any outcome (all P>0.05). Conclusion: A structured 6-week SFE program effectively enhances foot posture, ankle mobility, and proprioceptive control, leading to reduced knee valgus in young women. These findings support the inclusion of distal kinetic chain exercises in rehabilitation programs aimed at correcting lower limb dysfunction and preventing knee injuries.