The Foot
Chapter 17
Foot Anatomy
26 Bones
7 Tarsal
5 Metatarsal
14 Phalanges
38 Joints
4 Arches
Bones of the Foot
Bones of the Foot
Bones of the Foot
Tarsal Bones
Talus
Calcaneus
Navicular
Cuboid
Cuniforms
Medial
Intermediate
Lateral
Metatarsals & Phalanges
Sesamoid Bones
2 (medial and lateral)
Under great toe
Functionpulley, increase leverage of
tendons that control
great toe
Joints of the Foot
Tibiotalar
Talocrural
Subtalar
Talonavicular
Calcaneocubiod
Metarsocunieform
Joints of the Foot
Metatarsophalangeal
Joint
Proximal
Interphalangeal Joint
Distal Interphalangeal
Joint
Regions of Foot
Forefoot
Metatarsals
Phalanges
Midfoot
Navicular
Cuboid
3 Cuniforms
Hindfoot
Calcaneus
Talus
Regions of the Foot
Plantar Fascia
• Thick white band of fibrous tissue
originating from the medial tuberosity of
the calcaneus and ending at the proximal
heads of the metatarsals
• Work with ligaments to support arches
during weigh bearing and downward
forces
Foot Arches
Functions
1. Support body weigh in an economical fashion
2. Absorb the shock of weight bearing
3. Provide a space on the plantar aspect of foot for
blood vessels, nerves, and muscles
Medial Longitudinal Arch
• Highest of 3 arches of
foot
• Calcaneus, Talus,
Navicular, Cuniforms &
1st three metatarsals
• Supports—
– Ligaments:
• Spring ligament
• Plantar fascia
– Tendons:
• Tibialis posterior
• Tibialis anterior
Lateral Longitudinal Arch
• Lower and flatter
• Calcaneus, Talus,
Cuboid, 4th & 5th
metatarsals
• Supports—
– Ligaments:
• Short plantar ligament
• Plantar fascia
– Tendons:
• Peroneus longus
Transverse Arch
• Cuniforms, Cuboid, &
5th metatarsal
Shoe Wear Patterns
• Excessive Pronation
– Wear out front of shoe
under 2nd metatarsal
• Excessive Supination
– Wear out lateral border of
shoe
• Common Misconception
– Wearing out the back
lateral corner of the shoe
means you pronate
– This is normal wear pattern
Gait
Pulse
• Posterior Tibial Artery
• Medial Malleolous
• Dorsalis Pedis artery
• Extensor Tendon
Great Toe
Foot Movements
Dorsiflexion Inversion
Plantar Flexion Eversion
Pronation Supination
Muscles of Foot
Intrinsic Muscles Extrinsic Muscles
• Relate to specific body • Muscle outside a body
part or bone part, organ, or bone
• Flexor hallucis longus • Gastrocnemius
• Flexor hallucis brevis
• Flexor digitorum longus
• Extensor digitorum
longus
• Abductor hallucis
• Abductor digiti minimi
• Tibialis posterior
Muscles of the Foot
Muscles of the Foot
Muscles of the Foot
Common
Injuries
of the Foot
Fractures & Stress Fractures
• Impair ability to perform
competitively
• NWB
• More swelling & pain than
ligament sprain
• Point tenderness present
• Obvious deformity often
present
• Usually occur acutely;
result of traumatic episode
Jones Fracture
• Fracture to the
diaphysis at the base
of the 5th metatarsal
• Repetitive stress,
direct force, or
inversion and PF of
foot
• Healing slow; high
nonunion rate
Retrocalcaneal Bursitis
• Swelling of the bursa at the back of the
calcaneus under the Achilles tendon
• S/sxs:
– Pain in heel
– Painful to touch
– Pain worse when
rising on toes
– Red, warm skin over
back of heel
Plantar Fascia
• Wide, non-elastic ligamentous tissue that
extends from the anterior portion of
calcaneus to heads of metatarsals
• Supplies support to longitudinal
arch
Plantar Fasciitis
• Strain/irritation of the • Pain, tenderness on
plantar fascia bottom of foot near
• Caused by: heal (especially in
– Overuse am)
– Unsupportive footwear • Untreated will lead to:
– Tight Achilles tendon – Bone imbalance
– Running on hard – Heel spurs
surfaces – Muscle strains
– Chronic irritation – Shin splints
Plantar Fasciitis—
Treatment
• Correct training errors
• Ice
• Massage
• Evaluate shoes &
activity level
• Arch support
• Heel cup or cushion
Arches
Pes Planus
• Flat foot
• Associated with excessive
pronation
• Multiple causes:
– Lack of shoe support
– Weak muscles
• Pain & weakness in medial longitudinal arch
• Calcaneal eversion
• Navicular bulging
• Flattening of arch
Pes Cavus
• aka Clawfoot, hollow foot
• Associated with excessive supination
• Shock absorption poor
• General foot pain and metatarsalgia
common
• Abnormally short Achilles tendon
• Calluses ball and heel
Arch Sprains
• Ligaments stretch, • Causes:
thus fail to hold bones – Overuse
of foot in position – Overweight
• When arch – Fatigue
weakened, it cannot – Training on hard
absorb shock surfaces
normally – Non-supportive shoes
– Shoes in poor
condition
Turf Toe
• Great toe strain
• Hyperextension of the first MTP joint of the
big toe
• Treatment:
– RICE & Support
– Limit movement
– Turf toe taping
Heel Spur
• Bony growth on calcaneus
• Causes painful inflammation
• Aggravated by exercise
• As foot flattens, plantar
fascia is stretched & pulled
where it attaches to calcaneus
calcaneus reacts by
forming spur of bony material
Heel Contusion
• Irritation of the lateral aspect of the heel
• Sudden stop-and-go or sudden change in
movement
Heel Contusion—Treatment
• Cold application before activity
• Ice & elevation after activity
• Absorb shock—
– Heel cups
– Donut pad
Sever’s Disease
• Traction injury at the apophysis of the
calcaneus where the Achilles tendon
attaches
• Young, physically active athletes
– Comparable to Osgood-Shlatter’s disease (at
tibial tubercle of knee)
• Pain occurs during vigorous activity and
does not continue during rest
Blisters
• Occur on any part of body where there is
friction
• Most common on feet or heels
• Treatment Goals:
– Relieve pain
– Keep from enlarging
– Avoid infection
Blisters—Treatment
• Wash area thoroughly • Prevention:
• Use sterile blade to – Wear work gloves
cut small hole in – Break in new skin
blister – Petroleum jelly/skin
lube
• Squeeze out clear
– Adhesive bandage
fluid
• Do not remove skin
Prevention of Foot Injuries
• Selecting appropriate footwear
• Using shoe orthotic
• Foot hygiene
Rehabilitation of the Foot
• Towel pulls
• TheraBand®
• Marble pick-up