Current Pedorthics | January-February 2014 | Vol. 46, Issue 1 | Page 25

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