ANATOMY

Foot

The forefoot includes the five metatarsal bones - the first of which bears most weight - and the toes (phalanges). The first metatarsal provides attachment for several tendons. Near the head of this are two small, oval-shaped bones (sesamoid). The second, third, and fourth metatarsal bones are well protected with only minor tendon attachments and much less important for propulsion.

The midfoot includes five of the seven tarsal bones (the navicular, cuboid, and three cuneiform). The distal row contains the three cuneiforms and the cuboid. The midfoot meets the forefoot at the five tarsometatarsal (TMT) joints. The hindfoot is made up of the calcaneus - the largest tarsal bone which forms the heel - with the talus resting on top of it to form the pivot of the ankle.

Toe joints point the toes towards or away from the ground and allow side to side movements. The foot as a whole (excluding the toes) can move outwards and inwards and all the many joints of the hindfoot and midfoot contribute to these complex movements.

The multiple bones and joints of the foot give flexibility but also must form an arch to support any weight. The foot has three arches: medial, lateral and transverse. These are maintained by the shapes of the bones, by ligaments and by the support of muscles and tendons.