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
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

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
Talus
Calcaneus
Navicular
Cuboid
Cuniforms
 Medial
 Intermediate
 Lateral
Metatarsals & Phalanges
Sesamoid Bones
 2 (medial and lateral)
 Under great toe
 Functionpulley, increase leverage of
tendons that control
great toe
Joints of the Foot

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
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
 Plantar Flexion
 Pronation
 Inversion
 Eversion
 Supination
Muscles of Foot
Intrinsic Muscles
• Relate to specific body
part or bone
•
•
•
•
Flexor hallucis longus
Flexor hallucis brevis
Flexor digitorum longus
Extensor digitorum
longus
• Abductor hallucis
• Abductor digiti minimi
• Tibialis posterior
Extrinsic Muscles
• Muscle outside a body
part, organ, or bone
• Gastrocnemius
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
plantar fascia
• Caused by:
–
–
–
–
Overuse
Unsupportive footwear
Tight Achilles tendon
Running on hard
surfaces
– Chronic irritation
• Pain, tenderness on
bottom of foot near
heal (especially in
am)
• Untreated will lead to:
–
–
–
–
Bone imbalance
Heel spurs
Muscle strains
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,
thus fail to hold bones
of foot in position
• When arch
weakened, it cannot
absorb shock
normally
• Causes:
–
–
–
–
Overuse
Overweight
Fatigue
Training on hard
surfaces
– 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
• Use sterile blade to
cut small hole in
blister
• Squeeze out clear
fluid
• Do not remove skin
• Prevention:
– Wear work gloves
– Break in new skin
– Petroleum jelly/skin
lube
– Adhesive bandage
Prevention of Foot Injuries
• Selecting appropriate footwear
• Using shoe orthotic
• Foot hygiene
Rehabilitation of the Foot
• Towel pulls
• TheraBand®
• Marble pick-up