The Foot

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The Foot
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Foot Anatomy

• The foot has many articulations which makes it a
  complex bone and soft tissue structure that
  undergoes a great deal of stress.
• Most athletic trainers will hear more complaints
  about this region than any other except the ankle.

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Osseous Structures

• The foot is composed of 26 bones
• It is subdivided into three regions
• Hindfoot
• Midfoot
• Forefoot

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Hindfoot

• This region includes
• The talus
• The calcaneus
• And their midtarsal articulations with the
  navicular and cuboid bones

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Midfoot

• This region includes
• The navicular
• The cuboid
• And the 3 cuniform bones (numbered medial to
  lateral)

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Forefoot

• This region is comprised of
• The metatarsals
• And the phalanges
• Not included in the 26 bones are the 2 sesamoid
  bones
• These are the floating bones at the base of the
  great toe.

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Arches

• There are 2 arches in the foot
• Transverse arch
• Longitudinal arch
• These are both held together by ligaments
  (static) and musculotendon units (dynamic).

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Medial Longitudinal Arch

• Consists of the calcaneal tuberosity, the talus,
  the navicular, three cuneiforms, and the 1st ,
  2nd, and 3rd metatarsal bones
• It is maintained by the tibialis anterior,
  tibialis posterior, flexor digitorum longus,
  flexor hallucis longus, abductor hallucis, and
  the flexor digitorum brevis muscles
• The ligaments included are the long plantar
  fascia and the plantar calcaneonavicular ligament.

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Tibalis Posterior
Tibialis Anterior
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Lateral longitudinal arch

• Is make up of the calcaneus, cuboid, and the 4th
  and 5th metatarsal bones
• This arch is more stable and less adjustable than
  the MLA.
• It is maintained by the peroneus longus, peroneus
  brevis, peroneus tertius, abductor digiti minimi,
  and flexor digitorum brevis muscles
• The ligaments included are the long plantar
  ligament and the short plantar ligament

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Transverse Arch

• Is maintained by the tibialis posterior, tibialis
  anterior, and the peroneus longus muscles, and
  the plantar fascia
• It consists of the navicular, cuneiforms, cuboid,
  and metatarsal bones.
• It is divided into 3 parts
• Tarsal
• Posterior metatarsal
• Anterior metatarsal
• A loss in the anterior metatarsal arch results in
  callus formation under the heads of the
  metatarsal bones.

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Articulations

• Subtalar
• Found in the hindfoot
• It is a synovial joint having 3 of freedom
• Resting position- Midway between the extremes of
  range of motion
• Closed packed position- supination
• Movements possible- gliding and rotation
• Metatarsophalangeal
• There are 5 of them they are all synovial joints
  with 2 degrees of freedom.
• Resting position- midway between extreme ranges
  of motion (10 extention)
• Closed packed position- full extension
• Movements possible- flexion, extention,
  abduction, and adduction

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• Interphalangeal joints
• Synovial hinge joints with 1of freedom
• Resting position- Slight flexion
• Closed packed position- Full Extension

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Ligaments

• Long Plantar
• Lateral Retinaculum

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Nerves and other structures

• Peroneal nerve
• Tibial nerve
• Pedal pulse

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Special Tests

• Compression test (potts fracture)

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Percussion Test
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Tinels Sign

• Found in 2 places around the ankle
• Anterior branch of the deep peroneal nerve
• Posterior tibial nerve as it passes behind the
  medial malleolus
• In both cases, tingling or paresthesia felt
  distally is a positive sign