Chapter 14: The Foot and Toes

Chapter 14: The Foot and Toes

Key Study Points: Foot and Toes

  • Bony Anatomy: Identifies the bones that comprise the foot.
  • Arches and Fascia: Discusses the structural support and shock absorption features of the foot.
  • Common Injuries and Signs of Injury: Details prevalent injuries to the foot and their symptoms.
  • Lab Practical: Considerations for practical assessments related to foot injuries.
  • Questions to Ask During History: Important inquiries that aid in understanding patient history related to foot issues.
  • Anatomy: Detailed anatomical overview of the foot.
  • List of Special Tests for Body Parts: Tests commonly used to assess foot injuries.
  • List Common Injuries: Recap of frequent injuries affecting the foot and toes.

Anatomy of the Foot: Bones

  • Functions of the Foot:
    • Absorbs force from walking and running.
    • Acts as a stable base of support for the body.
  • Number of Bones in the Foot: 26 bones total, consisting of:
    • Seven Tarsal Bones
    • Talus: Connects with the tibia and fibula to form the ankle joint.
    • Calcaneus: Also known as the heel bone, located at the back of the foot.
    • Navicular
    • Cuboid
    • Three Cuneiform Bones: Medial, intermediate, and lateral cuneiforms.
    • Five Metatarsal Bones: Long bones in the midfoot.
    • Fourteen Phalangeal Bones: Toe bones, with three in each toe except for the big toe, which has two.

Anatomy of the Foot: Joints and Connective Tissue

  • Ligaments and Fascia:
    • The bones are secured together through a network of ligaments and fascia contributing to overall stability and function.
  • Arches of the Foot:
    • Metatarsal Arch: Runs from the first to the fifth metatarsal.
    • Transverse Arch: Spans across the transverse tarsal bones.
    • Medial Longitudinal Arch:
    • Starts at the medial border of the calcaneus.
    • Extends towards the distal head of the first metatarsal.
    • Lateral Longitudinal Arch: Mirrors the medial arch in structure.
  • Plantar Fascia (Plantar Aponeurosis):
    • A thick white band of fibrous tissue that starts from the medial aspect of the calcaneus.
    • It runs to the distal heads of the metatarsals, supporting the arches and distributing body weight.

Anatomy of the Foot: Muscles

  • Medial Movements:
    • Involve adduction and supination.
    • Muscles involved:
    • Behind medial malleolus: Tibialis Posterior, Flexor Digitorum Longus, Flexor Hallucis Longus.
    • In front of medial malleolus: Tibialis Anterior, Extensor Hallucis Longus.
  • Lateral Movements:
    • Involve abduction and pronation.
    • Muscles involved:
    • Behind lateral malleolus: Peroneus Longus, Peroneus Brevis (Fibularis Longus and Fibularis Brevis).
    • In front of lateral malleolus: Peroneus Tertius (Fibularis Tertius), Extensor Digitorum Longus.
  • Intrinsic Muscles:
    • Located on the plantar surface, responsible for toe flexion.
    • Muscles on the dorsum aid in toe extension and abduction.

Prevention of Foot Injuries

  • Emphasizes the importance of attention to athletes prone to:
    • Injuries caused by muscular or tendinous tightness.
    • Weakness or hypermobility in joints.
  • Remedial Options:
    • Exercise: Key to maintaining foot strength and flexibility.
    • Orthotics: Custom shoe inserts designed to correct biomechanical issues.
    • Footwear: Importance of appropriate shoes for specific activities.
  • Surface Training Considerations