Cheatography
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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
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
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