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In Depth Tutorials and Information
metatarsals and cuneiforms and cuboid, are capable of considerable
movement, far more than previously thought (
Lundgren et al 2008
, Nester
et al 2007). Certainly the range of motion between navicular and talus,
and cuneiforms and navicular can be comparable, and there is signifi-
cantly greater movement of metatarsals 4 and 5 compared with 1, 2 and
3. All of this illustrates the importance of these joints in performing the
overall movements of the foot, and it is not the rearfoot which makes the
major contribution as is often believed; in fact, all parts of the foot con-
tribute equally to the movements within, and therefore of, the foot.
Key
Concept
The midtarsal and forefoot joints are as important as the rearfoot joints
in producing foot motion.
medial arch of the foot
The medial longitudinal arch of the foot has attracted considerable atten-
tion because it provides a very visible indicator of the pronated or supi-
nated position of the foot and because it is often associated with foot
problems and injury. The higher the arch of the foot, the more supinated
the position of the foot and vice versa.
The medial arch is formed by the calcaneus, talus, navicular, medial
cuneiform and first metatarsal, and so the position and movement of all
these bones can affect the medial arch height. In addition, the surface of
the arch is formed by the muscles and soft tissues on the plantar surface
of the foot, and their size and condition can also influence the visual
appearance of arch height (
Figure 1.3
). The forces generated by these
muscles and the plantar fascia will produce plantarflexion moments at all
the joints of the medial arch and are therefore able to directly influence
the pronated (
Figure 1.4
) or supinated positions of the foot.
the foot and lower limb in gait
Gait is the primary physical activity we all undertake and it remains the
focus when investigating possible aetiologies of foot and lower limb prob-
lems, and when designing foot orthoses and footwear.
In the simplest terms, there are three parts to the gait cycle. In phase
1, the body accepts weight as the foot hits the ground. In phase 2, body
weight is moved from behind the foot to in front of it. In phase 3, the foot
prepares to leave the ground and propels the body forwards into the step
of the adjacent foot.
