The FootChapter 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 Talus Calcaneus Navicular Cuboid Cuniforms
Medial Intermediate Lateral
Metatarsals & Phalanges
Sesamoid Bones 2 (medial and lateral) Under great toe Functionpulley, increase leverage of
tendons that control great toe
Joints of the Foot 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
• 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
Plantar Fascia
Foot Arches Functions
1. Support body weigh in an economical fashion2. Absorb the impact of walking, running, jumping or
any other weight bearing activity3. 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 FootIntrinsic 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
Warm - Up
• You will need the following:– Scissors– Glue– 7 colored pencils or markers
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
• Correct training errors• Ice• Massage• Evaluate shoes &
activity level• Arch support• Heel cup or cushion
Plantar Fasciitis—Treatment
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
Muscle Movement Foldable• Label each flap on of the
directional terms– Toe Flexion– Toe Extension– Ankle Eversion– Ankle Dorsiflexion– Ankle Plantarflexion
• Glue picture of movement on the under side of the flap. Write the muscle names under the correct flap.
• Flexor Hallucis Longus• Extensor Digitorum Longus• Tibialis Posterior• Peroneus Longus• Extensor Hallucis Longus• Flexor Hallucis Brevis• Gastrocnemius• Peroneus Brevis• Soleus• Tibialis Anterior• Peroneus Tertius• Flexor Digitorum Longus
Common Injuries Brochure
• Include the following:– Bones that are found in the foot
• Draw the anatomy– How to prevent foot injuries– Basic definition of each foot injury which
includes the symptoms they would experience and where
– Common treatments– Rehabilitation
• Draw a picture of athlete completing rehab