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Cheatography

Muscles of the Foot Cheat Sheet (DRAFT) by

Muscles of the foot, Trigger point referrals

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Gait disorders

- If posterior muscle contract before full stance phase, foot will lock
- Prevents MTP joint dorsif­lexion - causes abduction and eversion of the foot to accomm­odate
- Kinetic chain dysfun­ction as 1st MTP weigh bears on its medial surface instead of plantar
Subtalar and midtarsal joints collapse - flat feet
Tib post becomes tethered around tibial malleoalus - causes pos tib tendos­yno­vitis and possible rupture
- Shift from pronation to supination fails to occur at toe off leading to
- stresses of medial column of the foot and medial aspect of heel (entire limb has to be abducted)
- Weakening of talona­vicular and subtalar joints
- Shearing forces occur on medial tubercle of the calcaneus

Quadratus Plantae - TrPs

- Can mimic heel spurs and plantar fasciitis

Quadratus Plantae

Origin: Calcaneus, Long plantar ligament
Insertion: Tendons of FDL
NS: Lateral plantar nerve (S1,S2)
Action: Assists FDL in flexion of DIP joints

Flexor Digitorum Brevis - TrPs

- Rolling iced rolling pin/water bottle­/golf ball good for releasing TrPs

Flexor Digitorum Brevis - Palpation

- Locate Plantar surface of the heel and 2-5th toes
- Palpate along arch of foot, flex and relax toes

Flexor Digitorum Brevis

Origin: Calcaneus
Insertion: Middle Phalanges of toe 2-5
NS: Medial plantar nerve S1-S2
Action: Flexion of the lateral four digits

Abductor Digiti Minimi (Foot) - TrPs

Abductor Digiti Minimi (Foot) - Palpation

- Locate plantar surface of the heel and lateral surface of 5th toe
- Palpate between those points
- Ask pt to abduct­/flex 5th toe

Abductor Hallucis - TrP

- Can entrap posterior tibial nerve / two branches of the lateral and medial plantar nerves against the medial tarsal bones

Abductor Hallucis - Palpation

- Locate medial surface of the heel and medial side of first toe
- Palpation between those points
- Get pt to flex first toe against resistance

Abductor Hallucis

Origin: Medial process of calcaneal tuberosity , plantar aponeu­rosis, flexor retina­culum
Insertion: Medial aspect of base of 1st phalanx of hallux
NS: Medial Plantar nerve S1, S2
Action: Abducts hallux

EDB - TrPs

- Pain usually does not occur above ankle

EDB - Palpation

- Slide two inches off the lateral malleolus
- Lateral to EDL tendons
- Get patient to extend toes against resistance

Extensor Digitorum Brevis and EHB

EDB
Origin: Dorsal surface of calcaneus
Insertion: Proximal dorsal region of middle phalanges 2,3,4
NS: Deep fibular Nerve L5-S1
Action: Extends digits 2-4
Can have a slip attaching onto the base of proximal phalanx of the hallux (EHB)

Foot mechanics during Gait

- Heel strike - Supinated position, body moves forward, weight travels through lateral heel and 5th metatarsal base, foot then pronates
- Stance phase - weight transfers to medial side through midtarsal bones
- Toe off - Shift from pronation to supination when propulsion happens, achilles activate, forces transf­erred through plantar fascia to 1st MT joint

Abductor Digiti Minimi (Foot)

Origin: Plantar Aponeu­rosis
Insertion: 5th toe/ph­alanges
NS: Lateral plantar nerve S1-S3
Action: Flexion and abduction of the 5th toe

Plantar Interossei (foot) - TrPs

- Runs along body of the muscle

Plantar Interossei (foot)

Origin: Metata­rsals, long plantar ligament
Insertion: Medial side of proximal phalanges of 3rd to 5th toe
NS: Lateral plantar nerve S2-S3
Action: Adduct toes

Dorsal Interossei (foot) - TrPs

- TrPs run along line of muscle

Dorsal Interossei (foot) - TrPs

- TrPs run along line of muscle

Dorsal Interossei (foot)

Origin: Metata­rsals
Insertion: Proximal phalanges
NS: Lateral plantar nerve S2-S3
Action: Abducts toes

Adductor Hallucis - TrPs

Adductor Hallucis

Origin: Oblique head: Proximal ends of middle 3 metatarsal bones Transverse head: MTP, ligaments of lateral 3 toes
Insertion: Lateral side of base of 1st phalanx of the 1st toe, sesamoid apparatus
NS: Lateral Plantar Nerve S2 and S3
Action: Adducts Hallux

Flexor Hallucis Brevis - TrPs

- Help prevents clawing of great toe

Flexor Hallucis Brevis

Origin: Plantar aspect of cuneif­orms, plantar calcan­eoc­uboid ligament, long plantar ligament
Insertion: Medial head: Medial sesamoid bone of the MTP joint, proximal phalanx of great toe
Lateral Head: Lateral sesamoid bone of the MTP joint, proximal phalanx of great toe
NS: Medial plantar nerve S1-S2
Action: Flex Hallux

Flexor Digiti Minimi Brevis

Origin: 5th Metatarsal bone
Insertion: 1st Phalanx of the fifth toe
NS: Superf­icial branch of lateral plantar nerve S2-S3
Action: Flexion and adduction of the 5th toe

Lumbricals TrPs

- Runs along body of the muscle
- Add leverage to the toes to dig in more effect­ivetly when walking on soft sand

Lumbricals

Origin: Medial borders of long flexor tendons
Insertion: Proximal phalanges and extensor tendons of the 4 lateral toes
NS: Medial and lateral plantar nerves S3
Action: Flexes MTP joints, extends interp­hal­angeal joints