Anatomy clinical correlates: Foot

The foot is the most distal part of our lower limbs - and while it represents only a small part of the body, its unique structure allows for walking, running, and dancing, but is also an unfortunate vulnerable point for being tickled.

Laughing aside, let's kick off this video which will focus on the clinical conditions affecting the foot.

First, let's talk about plantar fasciitis. Plantar fasciitis describes inflammation of the deep plantar fascia, also called the plantar aponeurosis. The deep plantar fascia is a thick, pearly-white band of tissue that attaches to the medial process of the calcaneal tuberosity and extends to the toes and supports the medial longitudinal arch of the foot.

Excessive training, particularly those who frequently run, jog, or walk,

can cause repetitive microtrauma.

This leads to inflammation of the plantar fascia particularly at its attachment point to the calcaneus.

Additionally, individuals who undergo high impact exercise like jumping in volleyball or frequently train in bare feet may also experience plantar fasciitis.

Risk factors for plantar fasciitis include obesity, prolonged standing or working on hard surfaces, and pes planus, which is “flat feet” defined by the loss of the medial longitudinal arch of the foot where it contacts the ground

Diagnosis of plantar fasciitis is often clinical, and it commonly presents in middle aged adults. Individuals typically present with unilateral or bilateral heel pain that is worse in the morning and after prolonged rest, and gradually lessens with activity.

The pain is typically palpated over the medial process of the calcaneal tuberosity,

but can be felt along the length of the sole of the foot,

while pain can also be felt on passive dorsiflexion of the toes.

Heel spurs often coexist with plantar fasciitis, but it is also unclear whether they can cause plantar fasciitis, or represent a secondary response to an inflammatory reaction.

Let's talk a bit more about pes planus, also known as ‘flat feet ', and is a term used to describe loss of the foot's medial longitudinal arch.

Flatfeet can be classified as either flexible, meaning they have normal appearance at rest but flatten with weight bearing, or rigid, which appear flat even when not weight bearing and has a reduced range of motion at the tarsal and subtalar joints.