I think you nailed it that we don't put stresses on our feet and ankles and so those particular muscles don't grow. This of course leads to challenges in running, etc.

I bought these balloon pods for standing on [1]. They create an unstable surface which your feet and ankle muscles must overcome. Its incredibly challenging. Adding in exercises like squats or med ball twists really make you work. You can feel the muscles in your feet and ankles working!

[1] https://www.amazon.com/Yes4All-Balance-Pods-Hedgehog-Hand/dp...

I wish more doctors did more root cause in most fields.