Foot Arches

Question 1

Medial longitudinal arch

Answer 1

Higher of two longitudinal arches
Formed by calcaneus, talus, navicular, 3 cuneiforms + first 3 metatarsal bones
- Muscular support - tibialis anterior/posterior, fibularis longus, flexor digitorum longus, flexor hallucis + intrinsic foot muscles
- Ligamentous support - plantar ligaments, medial ligament of the ankle joint
- Bony support - shape of bones of arch
- Other - plantar aponeurosis

Question 2

Lateral longitudinal arch

Answer 2

Flatter of two longitudinal arches
Formed by calcaneus, cuboid + 4th and 5th metatarsals
- Muscular support - fibularis longus, flexor digitorum longus, flexor hallucis + intrinsic foot muscles
- Ligamentous support - plantar ligaments
- Bony support - shape of bones of the arch
- Other - plantar aponeurosis

Question 3

Transverse arch

Answer 3

Formed by metatarsal bases, cuboid and 3 cuneiform bones

• Muscular support - fibularis longus + tibialis posterior
• Ligamentous support - plantar ligaments + deep transverse metatarsal ligaments
• Bony support - wedged shaped bones of arch
• Other - plantar aponeurosis

Question 4

Pes Cavus

Answer 4

High medial longitudinal arch
Ability to shock absorb when walking is reduced and there is increased stress on ball and heel of foot
Symptoms - pain in foot which can radiate to ankle, leg, thigh and hip -> pain transmitted up lower limb due to high stress placed on the hindfoot during heel strike
Causes - idiopathic, hereditary, underlying congenital foot problem such as club foot, secondary to neuromuscular damage such as poliomyelitis
Treatment - special shoes/sole cushioning inserts, reducing weight

Question 5

Pes Planus

Answer 5

Flat footed, loss of longitudinal arches
Arches don’t develop until about 2-3 so during infancy = normal
Cause - damage to tight tendons of the foot, idiopathic
Symptoms - few if any, may result in foot/ankle pain in children, in adults feet may ache after prolonged activity
Treatment - arch-supporting inserts for shoes