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The Foot Consider the feet. Your feet are a complex system of 52 bones, 66 joints, 214 ligaments, 38 muscles and tendons. It is no wonder that 75% of North Americans will experience foot health problems of varying degrees, at some point in their lives. Your feet have an important job; they carry you throughout the day, with every step making an impact on your body. If your foot functions improperly it will have an effect on joints higher up the kinetic chain (your ankle, knee, hip and spine). This may result in pain or discomfort. Most individuals will seek out medical attention for the symptoms they are experiencing in their joints, but do not realize the source of their pain is their feet. The Arches The foot has two important functions: weight bearing and propulsion. These functions require a high degree of stability. In addition, the foot must be flexible, so it can adapt to uneven surfaces. The multiple bones and joints of the foot give it flexibility, but these multiple bones must form an arch to support any weight.
The foot has three arches. The medial longitudinal arch is the highest and most important of the three arches. It is composed of the calcaneus, talus, navicular, cuneiforms, and the first three metatarsals. The lateral longitudinal arch is lower and flatter than the medial arch. It is composed of the calcaneus, cuboid, and the fourth and fifth metatarsals. The transverse arch is composed of the cuneiforms, the cuboid, and the five metatarsal bases.
The arches of the foot are maintained not only by the shapes of the bones as well as by ligaments. In addition, muscles and tendons play an important role in supporting the arches.  
Muscles The muscles of the foot are classified as either intrinsic or extrinsic. The intrinsic muscles are located within the foot and cause movement of the toes. These muscles are flexors (plantar flexors), extensors (dorsiflexors), abductors, and adductors of the toes. Several intrinsic muscles also help support the arches of the foot.
The extrinsic muscles are located outside the foot, in the lower leg. The powerful gastrocnemius muscle (calf) is among them. They have long tendons that cross the ankle, to attach on the bones of the foot and assist in movement. The talus, however, has no tendon attachments. Plantar Fascia The plantar fascia is a thick, broad, inelastic band of fibrous tissue that courses along the bottom (plantar surface) of the foot. It is attached to the heel bone (calcaneus) and fans out to attach to the bottom of the metatarsal bones in the region of the ball of the foot. Because the normal foot has an arch, this tight band of tissue (plantar fascia) is at the base of the arch. In this position, the plantar fascia acts like a bowstring to maintain the arch of the foot.  Plantar fasciitis refers to an inflammation of the plantar fascia. The inflammation in the tissue is the result of some type of injury to the plantar fascia. Typically, plantar fasciitis results from repeated trauma to the tissue where it attaches to the calcaneus. This repeated trauma often results in microscopic tearing of the plantar fascia at or near the point of attachment of the tissue to the calcaneus. The result of the damage and inflammation is pain. If there is significant injury to the plantar fascia, the inflammatory reaction of the heel bone may produce spike-like projections of new bone called heel spurs. The spurs are not the cause of the initial pain of plantar fasciitis, they are the result of the problem. Most heel spurs are painless. Occasionally, they are associated with pain and discomfort and require medical treatment or even surgical removal  Plantar fasciitis (heel-spur syndrome) is a common problem among people active in sports, especially runners. It typically starts as a dull, intermittent pain in the heel and may progress to sharp, constant pain. Often, it is usually worse in the morning or after sitting, and then decreases as the patient begins to walk around. In addition, the pain usually increases after standing or walking for long periods of time, and at the beginning of a sporting activity. Often people who develop plantar fasciitis have several risk factors for doing so. They include: * Flat feet * High arched, rigid feet * Increasing age and family tendency * Running on toes, hills or very soft surfaces (sand) * Poor arch support in shoes * Rapid change in activity level Please visit the Services Page for more information on custom orthotics. |
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