Archs of the foot--May 023

Foot as functional unit

Foot has two important functions (1) support
body weight (2) as a lever to propel body
forward in walking and running

If the foot possessed a single strong bone

instead of series of small bones , it could sustain
body weight and forward propulsion
but could not adapt itself to uneven surfaces

Because lever (foot) is segmented with multiple

joints of (27 bones ) ,the foot is pliable and can
adapt itself to uneven surfaces.

Long flexor muscles and small muscles of the

foot can exert their action on the bones of the
forepart of the foot & toes (takeoff point of the
foot) greatly assist the propulsive action of
gastrocnemius and soleus ms
Why human feet evolved arches—and what happens if you lack them
 Arches
A segmented structure can hold up weight only if it is built
in the form of arch

Foot has three arches which are present at birth ,these are
medial, lateral , transverse arch

In young child the foot appears to be flat

because of the presence of large amount of subcutaneous
fat on the sole of foot

Imprint of of a wet foot on the floor in standing position,

one can see heel, lateral margin of the foot , pad under
the metatarsal heads, pads of the distal phalanges, are in
contact with the ground

The body weight on standing is distributed through the

foot via heel behind & points of contact with ground in
front
Effort

/Force
 Arch bones
Medial longitudinal arch
Calcaneum
Talus
Nvicular
Three cunieform
First three metatarsal bones
Lateral longitudinal arch

Calcaneum
Cuboid
4th , 5th metatarsal bones

Transverse arch
bases of the metatarsal bones
cuboid
Three cuneiform bones
Medial cuneiform
 Arch support mechanisms

Following engineering methods underlie the support of a stone bridge and help
explain the methods used to support the arches of the foot.

Shape of the stone :- to make the stones wedge shaped,with the thin edge of the
wedge lying inferiorly. The most important stone is the key stone that occupies the
center of the arch

Inferior edges of stones tied together :-interlocking the stones or binding their lower
edges with metal staples

Use of beams :- when the span of the bridge is large and the foundations at either end
are insecure, a tie beam connecting the ends effectively prevents separation of the
pillars & consequent sagging of the arch

Suspension bridge :- maintenance of the arch depends on suspending the arch from a
cable above the level of he bridge
 Constructed by the British
government in 1909 In Katlang
town distt. Mardan , through this
bridge the water of swat river
passes

Keystone
Keystone arch bridges
Historical Arch bridge for railway tract near phase 3 chawk hayat abad peshawar
Mughal era bridge An historic bridge built during the era of Mughal Emperor Shah Jehan in
Chamkani area over Bara river peshawar , about 290 feet long and 33 feet wide founded over 26 big
and small pillars is about 400 years old
lock stones arch bridge
lock stones arch bridge
Lock Stone arch
bridges
Tie beam bridge
Tie beam bridge
 Suspension bridge

Goldengate bridge was built in january 1933 ,122,000 vehicles pass per
day through this bridge, At 1.7 miles (2.7 kilometres) in length, the
Golden Gate Bridge is one of the longest suspension bridges in the
world. Above all, it's the most treasured and representative symbol of
the city of San Francisco.
Medial longitudinal arch maintenance
1)Shape of bones :-sustentaculum tail of
calcaneum holds up the talus; concave
proximal surface of navicular bone hold
rounded head of talus; slight concavity of the
proximal surface of the medial cuneiform
bone receive navicular

Rounded head of talus is the keystone in the

center of of the arch

2) Inferior edges of bones tied together by

plantar ligaments,impotrtant one is spring
ligament (calcaeonavicular lig
tendinous extensions of the insertion of
tibialis posterior
3) Tie beam Tying ends of arch together :-

plantar aponeuerosis
Sole muscles (medial part of flexor digitorum
brevis, flexor halucis brevis, abductor halucis)
flexor halucis longus,
medial part of flexor digitorm longus

4) Suspending arch from above :- by tibialis

anterrior and posterior and medial ligament
(deltoid kigament) of ankle joint
(Spring ligament)
Lateral longitudinal arch maintenance

1) Shape of the bone: distal end of

calcaneum and proximal end of cuboid,
that is also keystone

2) Inferior edges of bones tied together by

long and short ligaments and origins of
short muscles from the forepart of the
foot
3) Tying ends of arch together : plantar
aponeurosis ,abductor digiti minimi,
lateral part of flexor digitorum longus
and brevis
4) Suspending arch from above by
peroneus longus and brevis
Transverse arch maintenance
Shape of bones : marked wedge shaping of
cuneiform bones ,cuboid , bases of metatarsal
bones,intermediate cuniform is keystone

Inferior edges of bones tied together :-

by the deep transverse ligaments,
Strong plantar ligaments,
Origins of plantar muscles from the forepart of
the foot ,
Dorsal interossei

Tying ends of arch together is peroneus longus

tendon

Suspending arch from above :- peroneus

longus and brevis tendons

,
 Clinical problems associated with the arches of the foot

• Of the three arches medial longitudinal arch is the largest and clinically
the most important .

• shape of the bones , the strong ligaments and the tone of the muscles all
maintain the arches

• Tibialis anterior and posterior, peroneus longus, small muscles of the foot,
play no important role in the normal static support of the arches

• In the active foot (walking/running) the tone of the muscles is an

important factor in arch support ,
 Pes planus (flat foot)
• Is a condition in which medial longitudinal
arch is depressed or collapsed , as a
result , forefoot is displaced laterally and
everted

• Head of talus is no longer supported and

body weight forces it downward and
medially between calcaneum & navicular
bone

• When this deformity has existed for some

time, then the ligaments around and of
ankle joints permanently
stretched ,muscles & tendons also
permanently stretched

• The causes of flat foot is congenital and

acquired
 Flatfoot (pes planus)

 Medial longitudinal arch is depressed or

collapsed .
 Causes
Muscles are fatigued by :-

excessive exercise e.g, a long rout hike,

standing for long periods (nurses

Waitres) , by illness, overweight

muscular support gives way, muscles and

ligaments and tendons are permanently
stretched and pain is produced , foot become
flate

•
 Pes cavus (claw foot)
• Medial longitudinal arch is unusually
high

• most cases are caused by muscle

imbalance resulting in most cases
from :-

• poliomyelitis and neuromuscular

diseas