The Foot

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.

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

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

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

Forefoot This region is comprised of The metatarsals The metatarsals And the phalanges 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. These are the floating bones at the base of the great toe.

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

Medial Longitudinal Arch Consists of the calcaneal tuberosity, the talus, the navicular, three cuneiforms, and the 1 st, 2 nd, and 3 rd 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.

Tibialis Anterior Tibalis Posterior

Lateral longitudinal arch Is make up of the calcaneus, cuboid, and the 4 th and 5 th 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

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

Articulations Subtalar Found in the hindfoot Found in the hindfoot It is a synovial joint having 3° of freedom 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. 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

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

Ligaments Long Plantar Lateral Retinaculum

Nerves and other structures Peroneal nerve Tibial nerve Pedal pulse

Special Tests Compression test (pott’s fracture)

Percussion Test

Tinel’s 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