This year Current Pedorthics is presenting a refresher in foot anatomy and
physiology. An entire series of articles spanning the next six to eight issues will
re-acquaint you with the basic and advanced anatomy and physiology of the foot.
The first area we will discuss is the basic skeletal structure of the foot.
CEP
The Foot Bone is connected to the ... Foot Bone
The human foot is a marvel of engineering. This single anatomical part alone
is one of the most adaptable structures of the body providing locomotion and
adaptation to ground surfaces, all while operating in all of the three cardinal body
planes simultaneously. Knowing what moves, and where it moves, is important to
understanding the normal function of the foot.
First, it is good to remember that there are three cardinal planes to the foot:
Saggital, Transverse and Coronal (frontal). In each of these planes, there is also a
position and an orientation. With the Saggital plane, think of it as cutting a line
through the middle of the body – front (anterior) to back (posterior). The motion
in this plane is dorsiflexion or plantarflexion; the orientation is lateral to medial.
With the Coronal plane, the cutting line is through the body at a right angle to
the Saggital plane or from lateral to medial. Its orientation is anterior to posterior
in the leg and dorsal to plantar in the foot. The motion in this plane is abduction
and adduction. With these two cardinal planes alone, we are literally dividing the
body in quadrants.
With the Transverse plane, it uniquely allows pronation or supination of the foot
and the various mechanics of the foot, allowing for adjustment to any terrain
it is presented with. The orientation in this plane cuts the body mediolaterally
from top to bottom, with the motion in this plane being inversion or eversion.
There are also other orientations of the foot that can also be superior to inferior;
superior refers to the caudal (head) area and is proximal (the hip is proximal to
the knee), while inferior refers to the area below the head and is known as distal
(the ankle is distal to the knee).
What is unique with the foot is that it moves in all three cardinal planes at
essentially the same time. Knowing when a foot is moving abnormally in a
particular plane is key to managing it in as near normal condition as possible. To
put it simply, the foot moves up and down, in and out, and side to side with each
step. Pretty remarkable wouldn't you say?
Distinct Regions with Distinct Tasks
The foot is divided into three distinct regions; the forefoot, the midfoot, and the
rearfoot (also known as hindfoot). Each region has a specific task and takes on
the abnormalities of the division and anatomy proximal to it. An example of
this with the forefoot region is when the hip bone, connected to the leg bone,
connects to the ankle bone, has something amiss somewhere in this ‘connection
chain.’ When there are abnormalities in the foot, it can be caused by issues much
higher up in the connections associated with the anatomy in this area, than just
the foot in general. Rest assured, the foot bone will pay for it somewhere along
this line of connection.
Another marvel of this great human engineering is to consider that both human
feet and hands contain literally half the bones in the human body, and this is
because these four structures have the incredible abilities to move and adapt to
terrain and dexterity. As in a machine, it takes a lot of pulleys and levers to bring
in a ‘third dimension’ to life. Most orthopods work with bones in a single plane,
while some may work in twos (the shoulder is one example), but still a majority
work in a single plane.
Read This Article,
Take Survey to
Earn Continuing
Education Points
The Pedorthic Footcare Association
(PFA) offers Continuing Education Points
(CEPs), approved by the American Board
for Certification in Orthotics, Prosthetics
& Pedorthics, Inc. (ABC) and the Board
of Certification/Accreditation (BOC), via
specially designated articles within Current
Pedorthics magazine.
To take advantage of the program,
thoroughly read the adjacent article,
“It is All About the Foot Part 1: Basic
Skeletal Structure” and then visit www.
pedorthics.org and click on the Continuing
Education Opportunities tab to purchase the
10-question quiz associated with this article.
CEP quizzes cost $15 for members and $25
for non-members. The quizzes are worth 1.0
Scientific or Business CEP, depending on
the content. Successful completion of the
quiz will result in 1.0 CEP reported directly to
ABC and BOC at the end of each quarter.
Look for additional CEP-eligible articles in
future issues of the magazine; previous
articles are available in the magazine archive
at www.pedorthics.org.
If you have any questions, contact
PFA, at (703) 610-9035 or e-mail
[email protected].
Current Pedorthics
January/February 2014
23