In this slide you will get to know about all the 4 layers of sole along with their clinical's.

1.  Represented to: Dr Hina vaish (PT)
 Represented by: Kritika singh
 Session:2017-2018
 Submitted on: 18/08/17
Muscles of sole

2. 1.Flexor digitorum brevis: (muscle lie deep to plantar aponeurosis
Origin- 1.medial tubercle of calcaneum.
2.plantar aponeurosis.
3.Medial and lateral intermuscular septa.
Insertion-The muscle ends in 4 tendons for the lateral four toes. Opposite
the end of proximal phalanx each tendon divides into 2 slips that are inserted
into the margins of the middle phalanx. The tendon of the FDL(for that digit)
passes through the gap between the two slips. NOTE that the insertion is
similar to that of FDS of hand.
Nerve supply- Medial plantar nerve.
Action- flexion of toe at proximal interphalangeal joints and
metatarsophalangeal joints.
Muscles of the first layer of the sole

3. 2.Abductor hallucis:(lie around
medial border of foot)
Origin- 1.Medial tubercle of calcaneum.
2.flexor retinaculum.
3.Deep fascia covering it.
4.medial intermuscular septum.
Insertion-the tendon fuses with the medial portion of the tendon of
FHB it is inserted into the medial side of the base of proximal
phalanx of the great toe
Nerve supply- Medial planter nerve.
Action- Abduction of great toe away from second toe.

4. 3.Abductor digiti minimi (lie around
lateral border of foot)
Origin-1.Medial & lateral tubercles of calcaneum.
2.Lateral intermuscular septum.
3.Deep fascia covering it.
Insertion-Tendon fuses with the tendon of the flexor digiti
minimi brevis. Inserted into lateral side of the base of
proximal phalanx of little toe
Nerve supply-Main trunk of lateral planter nerve.
Action-Abduction of little toe.

5. Diagram showing
muscle of 1st
layer of sole

6. Muscle & tendon of 2nd layer of sole
1.FDL: (Muscle of calf)
Origin- From upper 2/3rd of medial part ofposterior surface of
tibia below soleal line.
Insertion-The muscle divides into 4 tendons. Each is inserted
into planter surface of distal phalanx of 2nd to 5th digits.
Nerve supply- Tibial nerve
Action- 1.Plantar flexion of lateral 4 toe.
2.Plantar flexion of ankle.
3.Maintain medial longitudinal arch.

7. 2.Flexor digitorum accessorius(it is so
called because it is accessory to flexor digitorum
longus)
Origin-arise by 2 heads
1.Medial head large & fleshy arise from medial
concave surface of calcaneum.
2.Lateral head small & tendinous arise from
calcaneum in front of lateral tubercle.
The 2 heads unite at an acute angle.
Insertion-Inserted into lateral side of tendon of FDL
Nerve supply- Main trunk of lateral planter nerve.
Action-1.Straightens the pull of the long flexor tendon.
2.Flexes the toe through long tendon.

8. 3.Lumbricals(4 in no. from medial to lateral side)
Origin-Arise from tendon of FDL.1st lumbrical is unipinnate and
other are bipinnate.1st lumbrical arise from medial side of 1st
tendon of FDL,2nd arise from adjacent side of 1st & 2nd tendon
of FDL,3rd arise from adjacent sides of 2ns & 3rd tendon of
FDL,4th arise from adjacent side of 3rd & 4th tendon of FDL.
Insertion-Their tendons pass forwards on the medial side of
the metatarsophalangeal joints of the lateral 4 toes, & then
dorsally for insertion into the extensor expansion.
Nerve supply-1st muscle by medial plantar nerve & other 3
by deep branch of lateral planter nerve.
Action-Maintain extension of the digits at interphalangeal joint
so that in walking ar running toes do not buckle under.

9. 4.Flexor hallucis longus(muscle of calf)
Origin-Lower 3/4th of posterior surface of fibul except
lowest 2.5cm & adjoining interosseous membrane.
Insertion- Plantar surface of base of distal phalanx of
the great toe.
Nerve supply-Tibial nerve.
Action-1. Planter flexor of the big toe.
2.Plantar flexor of ankle joint.
3.Maintain medial longitudinal arch.

10. Diagram of
muscles &
tendons of 2nd
layer of sole

11. Muscles of 3rd layer of sole
1.FHB(Flexor hallucis brevis)
Origin-It arises by Y-shaped tendon.
1.Lateral limb from medial part of plantar surface of cuboid bone
,behind groove of peroneous longus & from adjacent side of the lateral
cuniform bone.
2.Medial limb is a direct continuation of the tendon of tibialis posterior
into the foot.
Insertion-muscle splits into medial and lateral parts each of which ends in a
tendon. Each tendon inserted into corresponding side of the base of
proximal phalanx of the great toe.
Nerve supply-Medial planter nerve.
Action- Flexes proximal phalanx at metatarsophalangeal jointof great toe.

12. 2.Adductor hallucis
Origin-Arise by 2 heads
1.Oblique head large, & arises from base of the 2nd ,3rd,&
4th metatarsals, from the sheath of the tendon ofperoneus
longus.
2.Transverse head small, & arises from deep metatarsals
ligament, & plantar ligaments of the metatarsophalangeal joint
of 3rd ,4th & 5th toe.
Insertion-On the lateral side of the base of the proximal
phalanx of big toe,in common with the lateral tendon of the
FHB.
Nerve supply- Deep branch of lateral planter nerve, which
terminates in this muscle.
Action-1.Adductor of great toe towards the 2nd toe.
2.Maintains transverse arch of the foot.

13. 3.Flexor digiti minimi brevis(lie
around 5th metatarsal)
Origin-1.Base of the 5th metatarsal bone.
2. Sheath of the tendon of peroneous longus.
Insertion-Into lateral side of base of proximal phalanx
of little toe.
Nerve supply- Superficial branch of lateral planter
nerve.
Action- Flexes the proximal phalanx at the
metatarsophalangeal joint of the little toe.

14. Diagram of
muscle of 3rd
layer of sole.

15. Muscle of 4th layer of sole
1.Plantar interossei (tendon pass on medial side of
3rd 4th , & 5th toe)
Origin-Base of medial side of 3rd, 4th, 5th metatarsals.
Insertion- Medial side of base of proximal phalanges & dorsal
digital/extensor expansion of 3rd ,4th , 5th toe
Nerve supply- 1st & 2nd by lateral plantar(deep branch)
3rd by lateral plantar(superficial branch)
Action-1.Adductors of 3rd,4th &5th toe towards the axis.
2.Flexors of metatarsophalangeal joint.
3. Extensors of interphalangeal joints of 3rd , 4th & 5th
toe.

16. 2.Dorsal interossei(4 bellies, unipinnate, fill up
gap between metatarsal)
Origin-Adjacent side of metatarsal bones.
Insertion-Bases of proximal phalanges & dorsal digital
expansion of toes;1st on medial side of 2nd toe;2nd on
lateral side of 2nd toe;3rd on lateral side of 3rd toe;4th on
lateral side of 4th toe
Nerve supply- 1st , 2nd, 3rd by lateral plantar (deep
branch) 4th by superficial branch of lateral plantar.
Action- 1.Abductors of toes from axis of 2nd toe
2.1st & 2nd cause medial and lateral abduction of
2nd toe, 3rd & 4th for abduction of 3rd & 4th toe.

17. 3. Tibialis posterior
Origin- posterior surface of leg bone.
Insertion- tuberosity of navicular.
Nerve supply-Tibial nerve
Action- Plantar flexor of ankle

18. 4. Peroneus longus
Origin-Upper part of lateral surface of fibula.
Insertion- Base of 1st metatarsal.
Nerve supply- Superficial peroneal nerve
Action- Evertor of foot.

19. Diagram of
dorsal interossei

20. Diagram of
plantar interossei

21. CLINICAL ANATOMY
 Fracture of shaft of 2nd , 3rd, 4th metatarsal bones is called
MARCH FRACTURE. It is seen in army personnel,
policemen as they have to march a lot. It occurs due to
decalcification and vascular necrosis.
 Normal architecture of foot is subjected to insults due to
HIGH HEELS. Female looks taller, smarter but may suffer
from sprains and dislocations of the ankle joint.
 Longitudinal arch are exaggerted leading to pes cavus
 If foot is dorsiflexed, person walks on heel this is talipes
calcaneus.

22. •If foot is plantar flexed
person ,person walkes
on toe this is talipes
equinus
•If medial border of foot
is raised person walk on
lateral border of foot this
is talipes varus.
•If lateral border of foot is
raised, person walkes on
medial border of foot the
condition is called talipes
valgus.
•Most common is talipes
equinovarus in which
heel is medial, foot is
plantar flexed and
inverted with high medial
longitudinal arch.