The foot is the distal part of the human lower limb, which performs a supporting function when moving. The top part of the foot that a person sees when looking down is called the dorsum. The lower part in contact with the horizontal support - the foot (sole).
The specific anatomy of the foot is due to the phylogenetic development of evolutionary adaptive mechanisms associated with upright walking.
The foot as part of the human skeleton
Humans are the only species with a complex arched foot.
Also an adaptation to upright walking are such features of the foot as:
- shorter and more massive finger bones , forced to withstand constant stress;
- long elongated predigital part;
- significantly less flexibility and mobility of the joints compared to the hand;
- high bone density , thick skin and fat layer to protect bones and joints from injury;
- abundance and high density of nerve endings , allowing you to respond to information about the environment and appropriately adjust the nature of movement.
Physiological features and functions of the foot
Physiology and excessive stress on the feet is the cause of arthrosis: this is the price that a person is forced to pay for the benefits brought by upright walking. It is natural that most often people who suffer from arthrosis are those who are overweight and have a profession that requires them to stand on their feet for a long time and not walk much.
The constituent elements of the anatomy of the foot are the bone structure (supporting frame), connecting elements - joints and ligaments, and muscles that ensure mobility of the foot.
Mammalian and human feet in comparison
The occurrence of a structural and functional disorder in any group of elements has a negative impact on the others.
The main functions of the foot are:
- support during movement;
- leveling out body shocks during running, physical work and exercise (provided by the arch), which protects bones and visceral organs from injury during movement;
- assistance in adjusting postures and positions of body parts when walking upright.
Load on the arch of the human foot
Treatment
First aid
The limbs provide rest and an elevated position. For skeletal injuries, apply cold and immobilize with a splint or fixing bandage. In case of frostbite, an insulating bandage is applied; intensive warming of the feet is prohibited, as it can aggravate existing tissue damage. For non-traumatic foot pathologies, local anti-inflammatory and painkillers are used.
Conservative therapy
For fractures and dislocations, blockades, reduction or reduction, and application of a plaster cast are performed. The conservative treatment plan includes:
- Protective mode.
The specialist determines the mode of physical activity, the intensity of the load on the limb, and, according to indications, recommends the use of orthopedic devices and additional means of support (crutches, canes). - Drug therapy.
NSAIDs of general and local action are most often used. Infectious diseases require the prescription of antibacterial or antiviral drugs, vascular pathologies require medications to normalize blood circulation, diabetes mellitus require correction of antidiabetic therapy. - Non-drug methods.
Patients are referred for exercise therapy, massage, manual therapy, physiotherapeutic treatment (electrical stimulation, electrophoresis, UHF, laser treatment, etc.).
Human foot bones
The foot integrates the following sections:
- tarsus (the back part connected to the lower leg), the tarsus consists of 5 bones;
- metatarsus (the middle part that forms the elastic arch), includes 5 bones;
- phalanges of the fingers, include 14 bones.
Thus, the foot is made up of 26 bones, and each bone has its own name.
Most people also have 2 small sesamoid bones. In rare cases, the foot includes 1-2 additional, anatomically not provided bones, which often cause foot health problems to their owners.
Tarsals
The talus is the highest bone of the foot and its upper side forms the ankle joint:
- The bone has no tendons or muscles attached.
- It has 5 articular surfaces on which a layer of hyaline cartilage is located.
- The heel also has many articular surfaces (6 pieces), multiple ligaments are tied to it, the weakening of which is often associated with the formation of flat feet.
- The Achilles tendon is attached to the convex rear part.
Talus of the foot
The navicular bone forms the inner part of the foot; by palpating the joint, the doctor determines the degree of flatfoot:
- Participates in the formation of the anatomical vault.
- Connected by a joint to the talus.
- Three wedge-shaped bones are attached to it in front.
- The cuneiform bones have articular surfaces at their proximal ends for connection with the first three metatarsals.
The cuboid bone is included in the upper tarsal part of the inner side.
Navicular bone of the foot
Metatarsal or metatarsal bones
Despite the fact that these five tubular bones differ in diameter and length (the thickest and shortest is the first bone, the most elongated is the second), their structure is identical.
They include:
- head;
- body;
- base.
The bodies of these bones have the shape of a pyramid with three ribs, and the heads have rounded anterior ends. The articular surfaces on the heads of the metatarsal bones are connected with the lower phalanges of the fingers, and on the bases of the bones - with the anterior tarsal bones.
Metatarsal bones of the foot
Phalanges of fingers
By analogy with the hand, the big toes have only proximal (lower) and distal (upper) phalanges, and the remaining fingers have three phalanges (intermediate, proximal and distal), connected by movable joints. These are generally small and thin tubular bones.
Sometimes the two phalanges of the little toes grow together (which is not a pathology).
The phalanges of the feet are noticeably shorter and thicker than those of the hands. This is due to the fact that the foot is not required to have the flexibility and development of fine motor skills like the fingers, but it does require strength and the ability to withstand long-term loads.
Phalanges of fingers
Like the metatarsal bones, the bones of the phalanges of the toes are protected by a fairly meager amount of soft tissue, so they are easily palpated, especially in lean, wiry people.
Sesamoid bones of the foot
Two such bones are located in the thickness of the tendons of the big toes in the area of \u200b\u200bthe junction of the metatarsal bones with the proximal phalanges of the big toes. They affect the severity of the metatarsal arch.
When X-raying the foot, they appear on the image as grains of a foreign substance in the thickness of the ligaments. Sometimes these bones have a bifurcated shape (this can be either a given from birth or a consequence of injury).
Sesamoid bones
Accessory or supernumerary bones
The most common bone is the external tibia (12% of the population, almost twice as common in women), which is connected to the scaphoid cartilage or ligaments. Its dimensions are variable; in people with large bones, it protrudes strongly downward, which entails constant rubbing of this area with shoes. Sometimes it is found in professional athletes.
Those who have an external tibia are recommended to wear arch supports or special insoles (orthopedic shoes for large bones). Treatment of the consequences caused by the bone is determined by the particular case of the clinical picture.
7% of the population has a triangular bone. On x-ray it can be confused with a fracture. An uneven border line and clearly focused pain indicate a fracture, a smooth, even border line indicates the presence of a triangular bone.
Diagram of foot bones with captions
Clubfoot.
This is a congenital deformity
foot, which is corrected gradually.
This is evidenced by the fact that the heel is raised and the toes are pointed down. The heel also points inwards and the entire foot looks as if it is compressed. The constant pain makes it very difficult for her to walk
.
People who struggle with this defect are treated differently. Stretching exercises and wearing special splints and orthoses are recommended.
Sometimes surgery is also required.
Features of joints, ligaments and cartilage
Complexes of joints are responsible for the mobility of the foot: intertarsal, tarsometatarsal, metatarsophalangeal and interphalangeal.
Intertarsal joints
They realize the connection between the bones of the tarsus.
The ankle joint is the highest point of the foot:
- Formed by the articular surfaces of the talus and the fork-shaped bones of the lower leg.
- This joint is responsible for the ability to pull the foot down or, conversely, vertically up.
- One of the features of this joint is that it is easier for children and adolescents to move upward, and for people aged after the completion of the formation of the skeleton - downward.
- The angle of possible joint mobility can be up to 90 degrees.
Ankle joint
The subtalar joint is cylindrical, formed by the posterior parts of the talus and calcaneus, and contains short ligaments.
talocalcaneal-navicular joint works synchronously with it The axis formed by this pair of joints serves as the center of supination and pronation of the foot.
Tarsometatarsal joints
The joints of this group connect the parts of the tarsus with each other and with the bones of the metatarsus. Most of them have flat articular surfaces and very little mobility.
In addition to the joints, numerous ligaments are responsible for the stability of this part of the foot, most of which are attached to the heel and outer parts of the foot. The largest of these connects the calcaneus to the proximal portions of all the tarsals (except those associated with the big toes).
Tarsometatarsal joints of the foot
Intermetatarsal joints
They have a flat surface shape and connect the lateral sides of the metatarsal bones.
They are connected by ligaments:
- plantar;
- interosseous;
- rear
Metatarsophalangeal joints
Formed by the posterior parts of the proximal phalanges and the rounded heads of the metatarsal bones. Despite their rounded shapes, these joints have rather low mobility (but still superior to the tarsometatarsal joints).
In older people, deforming osteoarthritis is quite common, which usually manifests itself as a painful lump on the inner side of the proximal phalanx of the big toe (thus, the metatarsophalangeal joint is affected).
Metatarsophalangeal joints of the foot
With inflammation of the joints (arthritis), in addition to visible signs of swelling in the affected joint, they are also manifested by an increase in body temperature (both general and in the area of the affected joint) and very sharp pains that draw all the patient’s attention to themselves, especially with increasing load on the foot. The pain can even make it difficult to fall asleep.
Interphalangeal joints
They connect the phalanges of the fingers and have fairly high mobility, but are inferior to similar joints of the fingers. They are responsible for the ability to flex and extend the fingers.
Muscles and nerves of the foot
The muscular system of the foot includes the muscles of the plantar surface and the dorsal surface. The muscles that connect the foot to the lower leg qualify as calf muscles.
The plantar muscles are divided into several groups:
- The outer group includes two muscles that provide flexion and abduction of the little finger (they are attached to its lower phalanx).
- In the inner are three muscles responsible for the movement of the thumb (flexion, protrusion and adduction). They connect the lower phalanx of the finger with the bones of the tarsus and metatarsus.
- The middle group includes several muscles whose function is flexion, protrusion and adduction of the fingers. The plantar muscles responsible for flexing the toes are called the flexor brevis muscles. The plantar muscles are much stronger and more resilient than the dorsal muscles, since they also bear a large load to support the arch.
Foot muscles
The dorsal surface includes two muscles called extensor brevis:
- One of them is connected to the thumb, the second to the rest.
- When the leg is directed forward during movement, the short extensors work.
- At one end they are attached to the lower phalanges of the fingers, at the other - to the heel bone.
Flat feet.
Flat feet is a deformity
associated with abnormal foot structure.
It consists of lowering the part that should be raised. Because of this, people with this defect often experience pain in the metatarsus when walking. Flat feet are treated with, for example, regular exercise, orthotics and shoes, massage, cryotherapy, kinesio taping, swimming or barefoot walking
. In some cases, patients also take painkillers and anti-inflammatory drugs.
Physiology of the circulatory system
The medial plantar artery divides into two grooves: one of which supplies blood to the flexor digitorum muscle, and the other to the muscle that abducts the pollicis laterally. The wider and more branched lateral plantar artery supplies many muscles of the foot.
The dorsal artery is divided into two branches - one goes between the thumb and index finger, the other goes deep to the sole, merging with the plantar arch.
Veins and arteries of the foot
The metatarsal arteries are divided into 4 plantar (continued by the plantar digital ones, extending to the lateral sides of the fingers) and 4 dorsal.
The veins of the foot are divided into:
- deep;
- rear;
- perforating
Hammer fingers.
Hammer fingers are a disease
, which is usually
caused by wearing the wrong
shoes.
If it is too tight, it causes pressure on the phalanx. Moreover, they may be the result of a deformity of the thumb, which affects the incorrect position of the fingers. The big toe then moves towards the next toe, which in turn
causes it to bend. In case of this disease, surgery.
Structure of the lower leg
The anatomy of the lower leg includes two tubular tibia bones - the tibia and the tibia.
The body of the tibia is formed in the form of a triangular prism, and its lower epiphysis is covered with cartilage and forms an articular connection with the talus bone of the foot. The upper epiphysis is branched into two cup-shaped condyles that form connections with the femoral condyles.
The body of the fibula also has an elongated triangular shape, but much thinner. Its upper diaphysis is attached to the tibia.
The structure of the bones of the lower leg
Foot diseases
Arthrosis or deforming osteoarthritis
Arthrosis is a degenerative joint disease in which nutritional deficiency of articular cartilage provokes bone deformation and inflammation in the cartilage shell. The main medical treatment is non-steroidal anti-inflammatory drugs.
It is advisable to combine medications with treated physical education and physiotherapeutic procedures. In any case, treatment is prescribed after an x-ray of the foot.
Arthrosis and arthritis
Arthritis or joint inflammation
Arthritis - characterized by an inflammatory process in the cartilage tissue of the joints in combination with swelling. The disease can have different causes, but most often they are either associated with metabolic diseases (gout, diabetes) or are of an infectious nature.
Drug treatment for arthritis is aimed at eliminating inflammation and includes:
- antibiotics;
- chondroprotectors;
- and non-steroidal anti-inflammatory drugs.
For successful treatment, the patient must monitor his diet, eliminating foods high in uric acid, as well as fatty and salty foods.
Foot deformity
There are different types of foot deformities:
Flat feet
- Clubfoot is usually caused by insufficient tone of the foot muscles or incorrect positioning of the legs when learning to walk, but it can also be congenital.
- Hollow foot is a consequence of paralysis, characterized by hypertrophy of the longitudinal arch and visual shortening of the foot. Treatment is special gymnastics and orthopedic inserts.
- Flat feet - widening of the metatarsus and flattening of the arch. Occurs with increased load in combination with insufficient elasticity of the arch muscles. Accompanied by an increase in the transverse distance between the bones of the metatarsus.
- Horsefoot is a consequence of paralysis of the triceps surae muscle, characterized by the location of the foot at an obtuse angle to the lower leg. In this condition, the regulating function of the foot is impaired.
- Heel foot - in contrast to the equine foot, the foot forms an acute angle with the lower leg. The condition can be either congenital or a consequence of paralysis. In the first case, its cause is a violation of the position of the fetus in the womb. Such feet are corrected with plaster casts.
Growths and other formations on the bones of the foot:
- Growths on the bones (exostosis) are a pathology of unknown origin, the appearance of a growth on the lower part of the heel. At first it consists only of cartilage; over time, solid calcium salts are deposited around the cartilage.
- Bone osteophytes are spine-like growths on bones. The most common are osteophytes of the calcaneus, developing in parallel with the inflammatory process in the Achilles tendon. Probably, a hereditary factor is involved in the occurrence of pathology (frequent occurrence in direct relatives).
Bone growths on the bones of the foot
Bursitis.
This type of deformity is most common in women. This is due to the incorrect position of the big toe, namely its lateral deviation. Often the toe overlaps the next toe. The joint becomes inflamed, leading to pain
. For bursitis treatment to be truly effective, it is worth choosing surgery, especially if the deformity is already very advanced. To slow down the development of bunions, you can also choose, for example, shoe insoles, corrective orthoses or special separators.
Foot injuries
Foot bone fracture
Regarding the symptoms of a fracture, it must be said that due to the large number of bones in the foot and the large differentiation of the functional load, the symptoms manifest themselves variably depending on the anatomy of the injury.
But there are also universal manifestations:
- displacement of the position of the foot (the inner surface is visible when viewed from above + displacement in the horizontal plane);
- pain (the nature is variable depending on the nature of the damage);
- rush of blood to the foot and swelling of the foot.
Ankle injury
Most often, the victims of fractures are the metatarsal bones (due to their characteristics - tubular structure, thinness, as well as the need to maintain an elastic arch, which can be a problem with poorly trained flaccid muscles of the foot).
The patient may sometimes be unaware of damage to the small bones of the tarsus (obvious pain and abnormal shape of the foot are not always present).
Fractures of the talus take the longest to heal (3-6 months) due to poorly developed blood flow in this area and the fact that this bone accounts for the largest percentage of body weight. The fastest time (a month to a month and a half) the finger phalanges grow together.
According to ICD-10, foot fractures are classified into:
- fracture of the thumb (closed and open);
- fracture of another finger (closed and open);
- unspecified fracture (closed and open);
- multiple foot injuries (closed and open).
If a suspected fracture is detected, it is necessary to call an ambulance and, if possible, apply a cold object (for example, food from the freezer) wrapped in two layers of towel to the site of injury.
Displaced fracture
Its signs are:
- shooting pain at the site of deformation;
- swelling of the entire limb, and not just the affected area;
- change in shape.
Closed foot fracture
Most often it affects the metatarsals (mechanical compression from above) and heels (both legs together) when landing unsuccessfully. Less commonly, it affects the talus in combination with the tibia. It is often splintered and may be accompanied by displacement.
Calcaneal fracture
Jones's fracture
Affects the outer metatarsals. Due to poor blood flow, about 20% of Jones fractures do not heal (and in general this type of injury is characterized by slow healing).
Risk groups include people who dance professionally and women who wear high heels a lot. If there is no displacement, the injured limb is bandaged for up to 3-4 weeks; in case of sensitive displacement, surgical intervention is used.
Fracture of the little toe
Stress fracture
Occurs with regular excessive physical exertion on unprepared feet. It differs from other fractures in its ease of detection by palpation and increased pain when putting weight on the leg.
Heel spur.
Heel spur is a disease
, manifested by growths on the surface of the heel bone.
This is the result of degenerative changes that cause inflammation of the plantar fascia. This, in turn, leads to its shortening and deepening of the valgus heel
. The first sign of the condition is throbbing pain in the heel. When treating the disease, anti-inflammatory and painkillers, exercises to strengthen muscles, orthopedic insoles and special shoes.