physiotherapy kinesiology topic on foot but just cover on arch of foot part

1. Arches of foot

2. FOOT
ARCH
• Formed by complex structure of bones, ligaments and
tendons of the foot.
• Arranged in curve shape which functions to distribute
the exerted force to the both end of the foot equally.
FUNCTIONS OF THE ARCH OF FOOT
• Proportional weight distribution
• Acts as segmental lever
• Protects plantar vessels and nerves
• Arch foot is dynamic and pliable
Structural example of
an arch

3. Method of maintaining the
arch
 Shape of stones
 Intersegmental ties
 Tie beams
 Slings or suspension bridge

4. Factors that maintaining the
arch
1. Bones
2. Ligaments
3. Muscles
4. Tendons
Static stabilizer
Dynamic stabilizer

5. Arch of foot

6. Functions of each bone
 Talus
* to form a connection between leg and foot so that body weight
may be transferred from ankle to leg.
* to enable to walk and maintain balance.
* to help movement of ankle and together with calcaneus if
facilitates the movement of foot.
 Navicular
* play roles in distribution of body weight through bones in foot.
*Helps to hold the arteries running through the foot
 Cuboid
* provide stability to foot
 Metatarsal
* support weight bearing of the body
* they work with ligament to perform movement.

7.  Phalanges
* Allow metatarsal head to continuosly support the weight of body as
foot move from heel to toe.
 Cunieform : 1st cuneiform, 2nd cuneiform, 3rd cuneiform
* 1st cuneiform is the attachment for numerous ligament, such as the
peroneus longus and libialis anterior’s tendon.
*2nd and 3rd helps to hold the arteries running through the foot.
* 3rd to support the body while playing role in motion.

8. Ligaments
 Ligaments hold the tendons in place and stabilize the joints.
 Allow the arch to curve or flatten, providing balance and giving the
foot strength to initiate the act of walking by stretching and
contracting
 Medial ligaments on the inside and lateral ligaments on outside of
the foot provide stability and enable the foot to move up and down.
 The longest of these, the plantar fascia, forms the arch on the sole
of the foot from the heel to the toes
 Example : plantar ligament, the plantar calcaneocuboid ligament
and the plantar calcaneonavicular ligament

10. Muscles and tendons
 Long flexor muscles and small muscles of foot can exert their action
on bones of forepart of foot and toes
 Greatly assist the forward propulsive action of gastrocnemius and
soleus
 Active muscular forces assist the arch when stresses and loads on
the foot
 Tendons are inelastic but flexible and serve to concentrate the pull of
a muscle on a small area of attachment
 Example: tibialis anterior, tibialis posterior, tendon of tibialis
posterior, tendon of flexor digitorum longus

12. Arches of foot
 Longitudinal arch
 Medial
 Lateral
 Transverse arch

13. Medial Longitudinal arch
 The arch is very tall
 Extremely resilient due to its large number of component bones
‹ FACTORS STRUCTURES
Bones • ‹Formed by:
i) calcaneus iv) 3 cuneiforms
ii) talus v) 1st, 2nd, 3rd metatarsal
iii) navicular
• Talus “key stone” rests on navicular and on sustentaculum tali of calcaneus
• Joint: talocalcaneonavicular & subtalar
Maintained by MUSCLES
• Tibialis anterior
• Tibialis posterior
• Flexor digitorum longus
• Flexor hallucis longus
• Abductor hallucis
• Flexor digitorum brevis
Long plantar ligaments, short plantar ligaments, spring ligaments, interosseous ligament,
deltoid ligament, plantar aponeurosis
Tendon of tibialis anterior, tendon of tibialis posterior

17. Lateral longitudinal arch
• The arch is flat and contains less number of bones
• Bears the body weight before medial arch comes into play
FACTORS STRUCTURES
Bones • ‹Formed by:
i) calcaneus
ii) cuboid
iii) 4th and 5th metatarsals
• Calcaneal angle of cuboid supports anterior lower articular surface of calcaneus
• Upward tilt of long axis of calcaneus
• Cuboid as a “key stone”
• Joint : calcaneocuboid joint
Maintained by • Peroneus longus
• Peroneus brevis
• Peroneus tertius
• Abductor digiti minimi
• Flexor digitorum brevis
• Flexor digitorum longus
Long and the short plantar ligaments, plantar aponeurosis
Tendon of peroneus brevis and tertius, tendon of tibialis posterior, tendon of flexor
digitorum longus.
*This arch is more stable and less adjustable than the medial one

20. MEDIAL LONGITUDINAL ARCH LATERAL LONGITUDINAL ARCH
Formed by more bones and joints Formed by less bones and joint
Characteristic feature is resiliency Characteristic feature is rigidity
Higher and more mobile Lower and less mobile
Involved in propulsion during locomotion Involved in receiving and supporting body
weight
Summit is formed by talus Summit is formed by calcaneum
Main joint is talocalcaneonavicular joint Main joint is calcaneocuboid joint

21. Transverse arch
FACTORS STRUCTURES
Bones • Formed by:
i) Cuboid
ii) Cuneiform
iii) Metatarsals
• Wedge shape of 3 cuneiforms
• Bases of middle of 3 metatarsals accentuate arch
Maintained by • Dorsal interossei
• Adductor hallucis
• Peroneus longus
• Peroneus tertius
• Tibialis anterior
Deep transverse ligament, plantar ligaments, dorsal ligaments:
• Dorsal cuboideonavicular ligament
• Dorsal intercuneiform ligaments
• Dorsal tarsometatarsal ligaments
• Dorsal metatarsal ligaments
Tendons of peroneus longus, peroneus brevis, peroneus tertius and tibialis posterior

24. Abnormal arch of
foot
PES CAVUS (HIGH
ARCH FOOT)
• The arch will appear higher
• Ankle rolled outwards slightly
• Usually a hereditary condition and in
rare cases, there may be an underlying
neurological problem
• Excessive supination- causes problems
for runners and other athletes
• The foot is less able to provide shock
absorption
• Can cause plantar fasciitis

25. PES PLANUS (FLAT
FEET)
• Little or no arch is seen
• It is called flat foot or fallen arch.
• When tendons do not pull together
properly
• The posterior tibial tendon, which
connects from lower leg along ankle,
to the middle of the arch is damage or
inflammed.
• Excessive pronation- Occurs when the
arches collapse and the ankles roll
inwards.
• Causing an imbalance and leading to
wear and tear in other parts of the
body

26. POSTERIOR TIBIAL
TENDON DYSFUNCTION
• Posterior tibial tendon becomes
inflamed or torn.
• Tendon may not be able to provide
stability and support for the arch of
the foot, resulting in flatfoot.
• An acute injury, such as from a fall,
can tear the posterior tibial tendon
or cause it to become inflamed. The
tendon can also tear due to overuse.
• The arch will slowly fall (collapse)
over time.

27. Plantar fasciitis
• Micro tears or inflammation of plantar fascia
• Plantar fascia- a fibrous band of connective tissue
located on the plantar surface of the foot
• Assists in forming the longitudinal arch of the foot
• Holds parts of the foot together, helps protect the
sole from injury
Achilles tendonitis
• Longest tendon in the body, connecting the calf
muscles to the heel bone behind the ankle joint.
• Persistent strain on the Achilles tendons causes
irritation and inflammation and also lead to
degeneration and thickening of the tendon.
• Cause over pronation (flat feet). As the feet roll
inwards excessively, the lower leg is forced to
rotate internally, putting a shearing force on the
calf muscles

29. References
 http://sportspodiatryinfo.wordpress.com/2010/08/09/the-transverse-metatarsal-arch/
 http://www.theodora.com/anatomy/arches_of_the_foot.html
 http://www.gla.ac.uk/t4/~fbls/files/fab/tutorial/anatomy/arch1.html
 Singh, V. (2014), Textbook of Anatomy (Regional and Clinical) Abdomen and
Lower Limb, 2nd ed., page 432-438, Elsevier Health Science, India.
 Snell, R.S. (2011), Clinical Anatomy by Regions, 9th ed., Lippincott Williams &
Wilkins, Baltimore.