Arches of the Foot Flashcards
How many arches are there?
There are three arches:
Two longitudinal (medial and lateral) and one anterior transverse arch.
They are formed by tarsal and metatarsal bones and supported by ligaments and tendons in the foot.
Their shape allows them to act as a spring (propulsion device), bearing the weight of the body and absorbing shock produced during locomotion. This allows us to walk and run.
Longitudinal arches
Medial arch
Higher of the two longitudinal arches - formed by the calcaneus, talus, navicular, cuneiforms and the proximal end of the metatarsals.
It is supported by:
1) Muscular support - tibialis anterior and posterior, fibularis longus, flexor digitorum longus, flexor hallucis, and the intrinsic foot muscles.
2) Ligamentous support - plantar ligaments (long plantar, short plantar, and plantar calcaneonavicular ligaments), medial ligament of the ankle joint.
3) Bony support - shape of the bones of the arch.
4) Other - plantar aponeurosis
Lateral arch
Lies on the ground in the standing position. Formed by the calcaneous, cuboid, and 4th and 5th metatarsal bones. It is supported by:
1) Muscular support - fibularis longus, flexor digitorum longus, and the intrinsic foot muscles.
2) Ligamentous support - plantar ligaments (in particular the short and long plantar, and the plantar calcaneonavicular ligaments).
3) Bony support - shape of the bones of the arch.
4) Plantar apneurosis
Transverse arch
Located in the coronal plane. Formed by the metatarsal bases, cuboid, and cuneiform bones.
Muscular support - fibularis longus and tibialis posteiror
Ligamentous support - plantar ligaments (in particular the short and long plantar and the calcaneonavicular plantar ligaments).
Bony support - wedge shape of the bones of the arch.
Other support - plantar aponeurosis
Clinical relevance: pes cavus
Pes cavus, or high arch of the foot, is characterised by a high medial longitudinal arch.
It can appear in early life and become symptomatic with increasing age.
Due to a high arch, the shock absorbin ability is reduced. An increased degree of stress is placed on the hindfoot ball and heel of the foot.
Symptoms: pain the foot (can radiate to the ankle, leg, thigh and hip).
Causes: idiopathic, hereditary (e.g. from club foot), or secondary to neuromuscular damage, such as in poliomyelitis.
Treatment: managed by supporting the foot with special shoes or sole cushioning inserts, reducing the amount of weight the foot has to bear. Reducing weight helps.
