Understanding the Anatomy of the Foot and Common Foot Problems

An Overview of the Parts of the Foot

The human foot is a complex structure containing many bones, muscles, ligaments, and tendons that all work together to provide support, balance, and mobility. Understanding the basic anatomy of the foot can help diagnose and treat common foot problems.

Bones of the Foot

There are 26 bones in each foot. These bones can be grouped into 3 sections:

• The tarsal bones (7 total) - these form the rearfoot and midfoot.
• The metatarsal bones (5 total) - these are the long bones of the forefoot.
• The phalanges (14 total) - these are the toe bones.

Some of the key tarsal bones include:

• Calcaneus - heel bone
• Talus - connects the leg and foot
• Navicular - midfoot bone
• Cuboid - outer midfoot bone

The metatarsal bones are numbered 1-5, with the first metatarsal bone being the innermost and the fifth metatarsal being the outermost.

Each toe contains 3 phalanges, except for the big toe which only has 2.

Joints of the Foot

There are multiple joints in the foot that provide flexibility:

• Ankle joint - between the talus and the tibia and fibula of the lower leg
• Subtalar joint - between the talus and calcaneus
• Tarsometatarsal joints - between the metatarsal bones and tarsal bones
• Metatarsophalangeal joints - where the metatarsals connect to the phalanges
• Interphalangeal joints - between the phalanges

Two minor joints are the transverse tarsal joint (Chopart’s joint) located in the midfoot, and the tarsometatarsal joint (Lisfranc joint) found between the midfoot and forefoot.

Arches of the Foot

The foot contains arches that help distribute body weight and allow the foot to function as a shock absorber.

The main arches are:

• Medial longitudinal arch - runs along the inside of the foot from the calcaneus to the first metatarsal and big toe.
• Lateral longitudinal arch - spans the outer border of the foot from the calcaneus to the fifth metatarsal.
• Transverse arch - extends across the midfoot.

These arches are supported by bones, muscles, tendons, and ligaments. Fallen arches or flat feet can occur if the arch structure becomes weakened or damaged.

Muscles of the Foot

There are numerous small muscles in the foot. Some of the key muscles are:

• Anterior tibial muscle - allows upward flexion of the foot
• Posterior tibial muscle - supports the arch
• Peroneus longus and brevis - evert the foot
• Gastrocnemius and soleus - plantarflex the foot
• Flexor digitorum longus - flexes the toes
• Abductor digiti minimi - moves the little toe away from the others
• Lumbricals - flex the metatarsophalangeal joints

The foot contains many more small muscles that control fine motions of the foot and toes.

Ligaments of the Foot

The ligaments provide stability to the foot and connect bone to bone.

Important ligaments include:

• Plantar fascia - thick connective tissue along the sole
• Achilles tendon - attaches the calf muscles to the calcaneus
• Anterior talofibular ligament - on the outer ankle
• Calcaneofibular ligament - also on the outer ankle
• Deltoid ligament - on the inner ankle

Injuries to the ligaments, such as sprains, are common causes of foot and ankle pain.

Tendons of the Foot

Tendons connect muscles to bones. The largest tendon in the foot is the Achilles tendon, but there are also many smaller tendons:

• Peroneus longus tendon - runs under the foot to the big toe
• Peroneus brevis tendon - connects to the fifth metatarsal
• Tibialis anterior tendon - attaches to the medial cuneiform and first metatarsal
• Tibialis posterior tendon - plays a key role supporting the medial longitudinal arch
• Flexor hallucis longus tendon - helps flex the big toe

Tendon injuries or inflammation, known as tendonitis, can cause localized foot pain.

Common Foot Problems and How to Treat Them

Understanding the anatomy of the foot helps in diagnosing and treating foot disorders. Here are some of the most common foot problems:

Heel Spurs

A heel spur is a bony protrusion on the underside of the heel bone. It is often related to plantar fasciitis, which is inflammation of the long ligament running along the bottom of the foot.

Heel spurs can cause localized tenderness and pain. Treatment options include:

• Rest
• Ice packs
• Anti-inflammatory medications
• Physical therapy exercises
• Orthotics or shoe inserts
• In rare cases, surgery to remove the spur

Bunions

A bunion is an enlargement of the joint at the base of the big toe. It causes the big toe to angle inward toward the other toes.

Bunions develop over time and can run in families. Treatment includes:

• Wearing proper footwear with a wide toe box
• Bunion pads to relieve pressure
• Orthotics
• Medication for pain and inflammation
• In severe cases, bunion surgery to realign the big toe

Hammertoes

Hammertoes occur when the middle joint of a toe becomes bent and the toe is forced into a hammer-like position.

Hammertoes can be quite painful. Treatment approaches involve:

• Pads to relieve pressure on the toes
• Toe spacers to realign the bent toe
• Custom shoe inserts
• Exercises to stretch the toes
• Hammertoe surgery to correct the deformity

Plantar Fasciitis

Plantar fasciitis is inflammation of the plantar fascia, the thick ligament along the sole. It causes stabbing heel pain.

Recommended treatment options include:

• Rest
• Massage
• Stretching exercises
• Night splints
• Shoe inserts
• Anti-inflammatory medications
• Physical therapy
• Corticosteroid injections
• Extracorporeal shock wave therapy

Ingrown Toenails

Ingrown toenails occur when the edge of the nail grows into the surrounding skin. They often become infected.

Treatment can involve:

• Proper toenail trimming technique
• Elevating the corner of the nail
• Antibiotics for infection
• Minor in-office surgical procedures
• Removal of part or all of the nail

Athlete's Foot

Athlete’s foot is a fungal infection that causes itching, redness, and peeling between the toes. It thrives in damp environments.

To treat athlete’s foot:

• Keep feet clean and dry
• Apply antifungal creams, powders, or sprays
• Use antifungal foot powder in shoes
• Wear moisture-wicking socks
• Disinfect shoes to kill fungi

For severe or recurrent cases, oral antifungal medication may be prescribed.

When to See a Podiatrist About Foot Problems

A podiatrist specializes in diagnosing and treating conditions related to the foot and ankle. See a podiatrist promptly if you experience:

• Persistent or worsening foot pain
• Severe foot injuries
• In-toeing or out-toeing in children
• Foot ulcers or wounds
• Infections that do not improve
• Abnormal growths or masses on the foot
• Symptoms of arthritis
• Issues from diabetes affecting the feet

Early diagnosis and treatment of foot issues can often prevent complications. Do not ignore foot pain that does not get better on its own. See a podiatrist for an evaluation and individualized treatment plan to get you back on your feet!

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.