The FootThe Foot

Foot AnatomyFoot Anatomy

The foot has many articulations which The foot has many articulations which makes it a complex bone and soft tissue makes it a complex bone and soft tissue structure that undergoes a great deal of structure that undergoes a great deal of stress.stress.

Most athletic trainers will hear more Most athletic trainers will hear more complaints about this region than any complaints about this region than any other except the ankle.other except the ankle.

Osseous StructuresOsseous Structures

The foot is composed of 26 bonesThe foot is composed of 26 bones

It is subdivided into three regionsIt is subdivided into three regions HindfootHindfoot Midfoot Midfoot ForefootForefoot

Hindfoot Hindfoot

This region includesThis region includes The talusThe talus The calcaneusThe calcaneus And their midtarsal articulations with the And their midtarsal articulations with the

navicular and cuboid bonesnavicular and cuboid bones

MidfootMidfoot

This region includesThis region includes The navicularThe navicular The cuboid The cuboid And the 3 cuniform bones (numbered medial And the 3 cuniform bones (numbered medial

to lateral)to lateral)

ForefootForefoot

This region is comprised ofThis region is comprised of The metatarsalsThe metatarsals And the phalangesAnd the phalanges

Not included in the 26 bones are the 2 Not included in the 26 bones are the 2 sesamoid bonessesamoid bones These are the floating bones at the base of These are the floating bones at the base of

the great toe.the great toe.

ArchesArches

There are 2 arches in the footThere are 2 arches in the foot Transverse arch Transverse arch Longitudinal archLongitudinal arch

These are both held together by ligaments These are both held together by ligaments (static) and musculotendon units (static) and musculotendon units (dynamic).(dynamic).

Medial Longitudinal ArchMedial Longitudinal Arch

Consists of the calcaneal tuberosity, the talus, Consists of the calcaneal tuberosity, the talus, the navicular, three cuneiforms, and the 1the navicular, three cuneiforms, and the 1stst , 2 , 2ndnd, , and 3and 3rdrd metatarsal bones metatarsal bones

It is maintained by the tibialis anterior, tibialis It is maintained by the tibialis anterior, tibialis posterior, flexor digitorum longus, flexor hallucis posterior, flexor digitorum longus, flexor hallucis longus, abductor hallucis, and the flexor longus, abductor hallucis, and the flexor digitorum brevis musclesdigitorum brevis muscles

The ligaments included are the long plantar The ligaments included are the long plantar fascia and the plantar calcaneonavicular fascia and the plantar calcaneonavicular ligament.ligament.

Tibialis Anterior

Tibalis Posterior

Lateral longitudinal archLateral longitudinal arch

Is make up of the calcaneus, cuboid, and the 4Is make up of the calcaneus, cuboid, and the 4 thth and 5and 5thth metatarsal bones metatarsal bones

This arch is more stable and less adjustable This arch is more stable and less adjustable than the MLA.than the MLA.

It is maintained by the peroneus longus, It is maintained by the peroneus longus, peroneus brevis, peroneus tertius, abductor peroneus brevis, peroneus tertius, abductor digiti minimi, and flexor digitorum brevis musclesdigiti minimi, and flexor digitorum brevis muscles

The ligaments included are the long plantar The ligaments included are the long plantar ligament and the short plantar ligamentligament and the short plantar ligament

Transverse ArchTransverse ArchIs maintained by the tibialis posterior, tibialis Is maintained by the tibialis posterior, tibialis anterior, and the peroneus longus muscles, and anterior, and the peroneus longus muscles, and the plantar fasciathe plantar fasciaIt consists of the navicular, cuneiforms, cuboid, It consists of the navicular, cuneiforms, cuboid, and metatarsal bones.and metatarsal bones.It is divided into 3 partsIt is divided into 3 parts TarsalTarsal Posterior metatarsalPosterior metatarsal Anterior metatarsalAnterior metatarsal

A loss in the anterior metatarsal arch results in A loss in the anterior metatarsal arch results in callus formation under the heads of the callus formation under the heads of the metatarsal bones.metatarsal bones.

ArticulationsArticulationsSubtalarSubtalar Found in the hindfoot Found in the hindfoot It is a synovial joint having 3It is a synovial joint having 3° of freedom° of freedom

Resting position- Midway between the extremes of range of Resting position- Midway between the extremes of range of motionmotionClosed packed position- supinationClosed packed position- supinationMovements possible- gliding and rotationMovements possible- gliding and rotation

Metatarsophalangeal Metatarsophalangeal There are 5 of them; they are all synovial joints with 2 There are 5 of them; they are all synovial joints with 2

degrees of freedom.degrees of freedom.Resting position- midway between extreme ranges of motion Resting position- midway between extreme ranges of motion (10(10° extention)° extention)Closed packed position- full extensionClosed packed position- full extensionMovements possible- flexion, extention, abduction, and Movements possible- flexion, extention, abduction, and adductionadduction

Interphalangeal jointsInterphalangeal joints Synovial hinge joints with 1Synovial hinge joints with 1°°of freedomof freedom Resting position- Slight flexionResting position- Slight flexion Closed packed position- Full ExtensionClosed packed position- Full Extension

LigamentsLigaments

Long PlantarLong Plantar

Lateral RetinaculumLateral Retinaculum

Nerves and other structuresNerves and other structures

Peroneal nervePeroneal nerve

Tibial nerveTibial nerve

Pedal pulsePedal pulse

Special TestsSpecial Tests

Compression test Compression test (pott’s fracture)(pott’s fracture)

Percussion TestPercussion Test

Tinel’s SignTinel’s Sign

Found in 2 places around the ankleFound in 2 places around the ankle

Anterior branch of the deep peroneal Anterior branch of the deep peroneal nervenerve

Posterior tibial nerve as it passes behind Posterior tibial nerve as it passes behind the medial malleolusthe medial malleolus

In both cases, tingling or paresthesia felt In both cases, tingling or paresthesia felt distally is a positive signdistally is a positive sign