ARCHES OF FOOT

LEARNING OBJECTIVES

Understand the arches of foot and the factors

responsible for their maintenance

Recognize the injury when it occurs and be able to

evaluate plantar fasciitis.

Learn about advices regarding the rehabilitation for

plantar fasciitis.

ARCHES OF FOOT

Lecture outline
Anatomy of the foot

As stated before, there are 26 bones, 33 joints, 106 ligaments, 19 foot muscles and 11
muscles in the lower leg.
The foot enables us, through subtle movements, to walk and run up to 10,000 to 17,000
steps a day.
During our lives our feet carry us between 65,000 and 115,000 miles.

The arches of the foot function as shock absorbers, supporting the body and
enabling stable ambulation.

The Planter Fascia:

The plantar fascia is a dense, fibrous membrane that spans the entire length of the foot
It originates at the tubercle of the calcaneus and attaching at the proximal phalanges.
The fascia protects the underside of the foot and helps support the arches.
It consists of a thick central portion and thinner lateral and medial bands that provide
flexibility and help maintain the longitudinal arch

Division of the Foot

The foot is composed of 26 bones
Clinicians divide the foot in three regions
Hindfoot
Midfoot
Forefoot

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

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

Forefoot
This region includes
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.

Arches of Foot
Arches held by tendons & ligaments
Allow foot to support weight of the body:
Ball of foot 40% weight.
Heel
60% weight
Provide leverage for walking
Crucially very important for maintaining the neurovascular status of the plantar aspect of
foot
Fully developed by age 13

There are 2 arches in the foot

Transverse arch
Longitudinal arches
Medial longitudinal Arch
Lateral longitudnal Arch
These are both held together by ligaments (static) and musculo-tendon units (dynamic).

Medial Longitudinal Arch

Consists of:

Calcaneal tuberosity
Talus
Navicular
Three cuneiforms
1st , 2nd, and 3rd metatarsals

Maintained by:

Tibialis anterior
Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus
Abductor hallucis
Flexor digitorum brevis
The ligaments included are the long plantar fascia and the plantar calcaneo-navicular
ligament.

Lateral longitudinal arch

Consists of:

Calcaneus
Cuboid
4th and 5th metatarsal bones
Maintained by:
Peroneus longus
Peroneus brevis
Peroneus tertius
Abductor digiti minimi
Flexor digitorum brevis muscles
This arch is more stable and less adjustable than the Medial one.
The ligaments included are the long and the short plantar ligaments

Plantar fascia
It is a ligament that supports the longitudinal arch of the foot.
It is a tough, fibrous band of connective tissue that runs from the heel bone to the ball of the foot.
The plantar fascia is made up of predominantly longitudinally collagen fibers.
In the ligament, there are three distinct structural components, the medial, central and the lateral
component.
The central component is the largest and most prominent.

Plantar Fascitis
An inflammation caused by excessive stretching of the plantar fascia.
Results from repeated trauma to the tissue where it attaches to the calcaneus
The result of the damage and inflammation is a dull, aching pain under the foot.