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The arched foot is a distinctive human feature that allows bipedal locomotion and efficient weight transmission.
Although present from birth, arches are masked in infants due to fat in the soles.
They act as shock absorbers and springs during walking and running
Volume 2, BD Chaurasia’s Human …
.Longitudinal Arches
Medial longitudinal arch
Lateral longitudinal arch
Transverse Arches
Anterior transverse arch
Posterior transverse arch
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Higher, mobile, and resilient; acts as a shock absorber.
Shaped like a big arc of a small circle — with more bones and joints.
Calcaneus, talus, navicular, three cuneiforms, and first–third metatarsals.
Anterior end: Heads of 1st–3rd metatarsals.
Posterior end: Medial tubercle of calcaneum.
Keystone: Talus (its head supports the summit of the arch)
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.Anterior pillar: Talus → Navicular → 3 cuneiforms → 1st–3rd metatarsals.
Posterior pillar: Medial half of calcaneum.
Talocalcaneonavicular joint.
Ligamentous support:
Spring (plantar calcaneonavicular) ligament — supports head of talus.
Plantar aponeurosis — acts as tie-beam.
Muscular support:
Tibialis posterior, flexor hallucis longus, and flexor digitorum longus (posterior sling).
Tibialis anterior and peroneus longus act as stirrup-like supports pulling the arch upward.
Abductor hallucis and flexor digitorum brevis act as dynamic tie-beams
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.Lower, shorter, less mobile, and more rigid — transmits body weight to the ground.
Considered a small arc of a big circle.
Calcaneus, cuboid, and 4th–5th metatarsals.
Anterior: Heads of 4th and 5th metatarsals.
Posterior: Lateral tubercle of calcaneum.
Keystone: Cuboid
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.Anterior pillar: Cuboid and 4th–5th metatarsals.
Posterior pillar: Lateral half of calcaneum.
Calcaneocuboid joint.
Ligaments: Long and short plantar ligaments; plantar aponeurosis acts as tie-beam.
Muscles:
Flexor digitorum brevis, abductor digiti minimi, and flexor digiti minimi brevis (tie-beams).
Peroneus longus, brevis, and tertius maintain arch height
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.Lies in coronal plane at the heads of metatarsals.
Complete arch, which flattens slightly during weight-bearing.
Heads of all five metatarsals.
Supported by:
Intermetatarsal ligaments and deep transverse metatarsal ligament.
Transverse head of adductor hallucis binds metatarsal heads together.
Peroneus longus tendon acts as sling from lateral to medial side
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.Lies across bases of metatarsals and distal tarsals (cuneiforms, cuboid).
Incomplete (half-dome) — completed by opposite foot when together.
Navicular, three cuneiforms, cuboid, bases of metatarsals
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.Intertarsal and tarsometatarsal ligaments, dorsal interossei, flexor hallucis brevis, and peroneus longus tendon sling maintain the curvature
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.Shape of bones — wedge-shaped cuneiforms and metatarsal bases provide bony configuration.
Intersegmental ties — ligaments joining adjacent bones (spring, long, and short plantar ligaments).
Tie-beams — plantar aponeurosis and intrinsic muscles hold ends together.
Slings — tendons like tibialis posterior, peroneus longus, tibialis anterior pull the arch upward
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.Distribute body weight over heel and toes.
Act as springs and shock absorbers during locomotion.
Protect soft tissues of the sole from pressure.
Provide resiliency (medial arch) and rigidity (lateral arch)
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.Flat Foot (Pes Planus): Collapse of longitudinal arches → clumsy gait, pain, neuralgia due to pressure on plantar nerves and vessels.
Pes Cavus: Exaggerated arches; seen in spastic or neurological conditions.
Clubfoot (Talipes Equinovarus): Congenital deformity with inversion and plantar flexion of foot
The arches of the foot are maintained by bony, ligamentous, and muscular mechanisms which act together for stability and elasticity.
Transverse arch: Maintained by wedge-shaped tarsal and metatarsal bones — the apex of wedge points downward.
Bony factor is less important for longitudinal arches but contributes to the foot’s concavity.
Ligaments connecting segments of the arch prevent separation:
Spring ligament (plantar calcaneonavicular): Maintains the medial longitudinal arch.
Long and short plantar ligaments: Maintain the lateral longitudinal arch.
Interosseous ligaments and intermetatarsal ligaments: Support transverse arches.
Structures that connect the two ends of the arch and resist flattening:
Plantar aponeurosis: Prevents flattening of longitudinal arches.
Muscles of the first layer of sole (abductor hallucis, flexor digitorum brevis) act as tie-beams.
Adductor hallucis (transverse head): Acts as tie-beam for transverse arch.
Muscular tendons that pull the arch upwards:
Medial longitudinal arch:
Tibialis posterior, flexor hallucis longus, and flexor digitorum longus.
Lateral longitudinal arch:
Peroneus longus and peroneus brevis.
Both arches:
Tibialis anterior and peroneus longus act like a stirrup, pulling the midfoot upward.
Transverse arches:
Maintained by peroneus longus (running across the sole) and tibialis posterior.
Weight Distribution:
Transfers body weight to heel and heads of metatarsals (mainly 1st and 5th).
Lateral border bears lesser weight due to its arch shape.
Spring Action:
Medial longitudinal arch acts like a spring aiding in walking and running.
Shock Absorption:
Cushions the impact of stepping and jumping.
Protection:
Concavity of the sole protects soft tissues, vessels, and nerves.
Functional Differences:
Medial arch: Resilient and elastic.
Lateral arch: Rigid and stable.
The foot arches include two longitudinal (medial and lateral) and two transverse (anterior and posterior).
The medial longitudinal arch is the most prominent and clinically significant — affected in pes planus (flat foot) and pes cavus (high arch).
Ligamentous and muscular supports are essential for maintaining the arches during weight-bearing and locomotion.
| Feature | Medial Longitudinal Arch | Lateral Longitudinal Arch |
|---|---|---|
| Height & Mobility | Higher, more mobile, resilient | Lower, rigid, transmits weight |
| Function | Acts as shock absorber | Provides stability for weight transmission |
| Bones | Calcaneus, talus, navicular, three cuneiforms, 1st–3rd metatarsals | Calcaneus, cuboid, 4th–5th metatarsals |
| Keystone | Head of talus | Cuboid |
| Anterior End | Heads of 1st–3rd metatarsals | Heads of 4th–5th metatarsals |
| Posterior End | Medial tubercle of calcaneum | Lateral tubercle of calcaneum |
| Main Joint | Talocalcaneonavicular joint | Calcaneocuboid joint |
| Ligamentous Support | Spring ligament | Long and short plantar ligaments |
| Tie-Beams | Plantar aponeurosis (medial part), abductor hallucis, flexor digitorum brevis (medial part) | Plantar aponeurosis (lateral part), abductor digiti minimi, flexor digitorum brevis (lateral part) |
| Muscular Slings | Tibialis posterior, FHL, FDL | Peroneus longus and brevis |
| Suspension (Stirrup) | Tibialis anterior + Peroneus longus | Tibialis anterior + Peroneus longus |
| Character | Elastic and spring-like | Stable and weight-bearing |
Definition: Collapse or loss of the medial longitudinal arch → sole becomes flat and touches the ground.
Types:
Congenital: Due to tarsal bone malformation.
Acquired: Common; results from weakening of ligaments and intrinsic foot muscles (especially plantar aponeurosis).
Causes:
Excessive standing, obesity, rickets, pregnancy, poorly fitting shoes, or paralysis of tibialis posterior.
Features:
Medial border of foot touches the ground.
Foot appears broader and everted.
Pain and fatigue after walking or standing.
Complications:
Strain on ligaments, callosities on sole, valgus deformity of heel.
Treatment:
Arch supports, proper footwear, physiotherapy, surgical correction in severe cases.
Definition: Exaggerated height of the medial longitudinal arch.
Causes:
Neurological disorders (spastic paralysis, poliomyelitis, Charcot–Marie–Tooth disease).
Features:
Toes are flexed, heel and metatarsal heads bear excessive weight.
Painful callosities under metatarsal heads.
Clinical importance:
Loss of normal shock absorption → frequent ankle sprains.
Definition: Congenital deformity where the foot is plantarflexed (equinus), inverted (varus), and adducted.
Cause:
Abnormal intrauterine position or defective muscle balance between invertors and evertors.
Features:
Sole faces medially; child walks on the lateral border of foot.
Treatment:
Early manipulation, plaster correction, or surgical release.
Definition: Hyperextension at metatarsophalangeal joints with flexion at interphalangeal joints.
Cause:
Weakness or paralysis of small muscles of foot (as in leprosy, diabetic neuropathy).
Clinical Feature:
Toes resemble claws; difficulty in walking.
Treatment:
Orthopedic correction and physiotherapy.
Definition: Lateral deviation of the great toe at the metatarsophalangeal joint.
Cause:
Tight footwear, genetic predisposition, flat foot.
Clinical Importance:
Medial deviation of first metatarsal, formation of bunion (bursa) over the joint → painful swelling.
Treatment:
Corrective footwear or surgical correction.
Plantar Fasciitis: Inflammation of plantar aponeurosis → severe heel pain, especially on first step in morning.
Calcaneal Spur:
Bony outgrowth at calcaneal tuberosity where aponeurosis attaches.
Often accompanies chronic plantar fasciitis.
Treatment:
Rest, heel padding, physiotherapy, corticosteroid injection.
Due to fatty cushion masking the arch; usually corrects by age 6–7 years as intrinsic muscles strengthen.
Seen in teachers, soldiers, or waiters due to prolonged standing.
Chronic pain over the sole; managed with arch supports and exercises.
The foot acts as a spring and shock absorber, distributing weight during locomotion.
There are two longitudinal arches (medial and lateral) and two transverse arches (anterior and posterior).
The medial longitudinal arch is the highest, most mobile, and most important.
The lateral longitudinal arch is lower and rigid, transmitting weight to the ground.
Talus acts as the keystone of the medial arch; cuboid acts as the keystone of the lateral arch.
Spring ligament supports the head of talus and maintains medial arch.
Long and short plantar ligaments maintain lateral arch.
Plantar aponeurosis acts as a tie-beam for both longitudinal arches.
Tibialis anterior and peroneus longus form a stirrup sling supporting both arches.
The transverse arches are maintained by wedge-shaped bones, ligaments, interosseous muscles, and peroneus longus tendon.
Flat foot results from collapse of the medial arch due to ligament and muscle weakness.
Pes cavus is the exaggerated form of the medial arch, commonly neurological in origin.
The arches protect plantar vessels, nerves, and muscles from direct pressure.
Resiliency of the medial arch and rigidity of the lateral arch provide both spring and stability.
During walking, arches flatten slightly during stance and recoil during toe-off, ensuring smooth locomotion.
The transverse arch is completed by both feet when standing together.
Children’s flat foot is often physiological and self-correcting.
Adults’ flat foot may lead to pain, valgus deformity, and fatigue.
Arch supports and strengthening exercises are key to management of foot deformities.
Proper footwear and posture are essential for maintaining normal arch structure.
A young adult was disqualified from army recruitment because of flat feet.
Questions:
What are flat feet?
Name the factors maintaining the medial longitudinal arch of the foot.
Answer:
When the medial border of the foot fails to show its normal upward concavity, the condition is termed a flat foot (pes planus).
If such a person places a wet foot on the ground, the entire sole makes an imprint — unlike the arched footprint of a normal foot.
A flat foot person cannot run efficiently because of reduced elasticity and shock absorption in the sole. Hence, such individuals are often unfit for military service, where running performance is essential
Volume 2, BD Chaurasia’s Human …
.Factors maintaining the medial longitudinal arch:
Shape of bones:
Specially the talus and calcaneus, which form the bony configuration of the arch.
Ligamentous supports:
Spring (plantar calcaneonavicular) ligament
Deltoid ligament
Plantar aponeurosis acting as a tie-beam
Short muscles:
Abductor hallucis
Flexor hallucis brevis
Dorsal interossei
Long tendons:
Flexor hallucis longus (FHL)
Tibialis posterior
Tibialis anterior
Peroneus longus
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Clinical Relevance:
In flat foot, loss of arch support causes pain, muscle fatigue, and valgus deformity of the heel.
Arch supports, physiotherapy, and corrective footwear can relieve symptoms.
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