The foot’s design is complex and specialised to manage the forces generated by bearing the weight of the body and by the need to propel the body in gait. The talus is at the apex of the main longitudinal foot arch and is held firmly by the ankle mortise. The largest arch is the lengthways or medial arch of the foot which manages the forces involved in moving the body and standing, the spring ligament contributing to this by storing and releasing the energies involved. The outside or lateral arch is less obvious as is the transverse arch at the front of the foot.

The foot arches have a very important role in the function of the foot and without them it would not be the dynamic propulsion system that it is. They absorb the energy and forces involved when body weight is applied to the ground, store it to some degree and release it as the next step is taken. If you watch someone walk with very flat feet and no spring you will be struck by the lack of dynamic movement, the slowness of gait and the lack of balance. Maintaining the health of the foot arches should be an important part of keeping fit and able as we age.

There are two main functions the foot is required to perform: managing the forces generated by the body weight, often magnified by motion, and to absorb and create the propulsion energies needed for gait. The calf muscles reviewed in another article about the ankle contribute towards the maintenance of the foot arches but this is also aided by the toe muscles. The toe long flexor muscles begin in the calf, running under the sole of the foot down to the toes, functioning to grip the ground or curl the toes. The shorter muscles to the toes, having their origin in the feet, are called the intrinsic muscles and function by pulling the toes down onto the ground without any flexion occurring.

In normal gait when the foot hits the ground the heel will hit the surface initially and somewhat on the outside. As the leg rolls over the ankle the talus slides inside the mortise of the ankle and the arches start to bear weight and their ligaments and joints absorb forces. As the step continues the weight moves inwards and forwards to end up on the metatarsal heads of the first and second toes, with the final push off coming from the toe flexor muscles.

Accessory movements, tiny involuntary movements which naturally occur within joints as they move but cannot be done independently, are present in the foot as they are in any bodily motion joint. Normal function of a joint depends at least partly on the presence of accessory movements and will suffer if they are lost or reduced. The foot has a large amount of small bones in very close relationship and constructed into complex anatomy such as the foot arches. Numerous accessory movements occur between the many joints.

The foot arches begin to flatten as the weight of the body is passed through the foot and the tension and elasticity of the foot ligaments counteracts this with the strength of the calf and foot muscles. In moving towards push off the foot is aided by the calf muscles contracting as a sling to maintain the arch, the gripping of the ground by the toe muscles and by the energy recoil of the ligaments. The arch varies in height as the walking cycle continues and this means accessory movements between the many arch bones are constantly occurring so that the bones can slide and glide into the required positions.

The independence of movement between all the many foot bones is vital as the weight causes a spreading of the under surface of the joints and a closing in of the upper joint lines. The foot can accommodate to the circumstances which present themselves in a dynamic fashion at least partly to the individual inter-joint movements. The foot will lose some of its flexibility in responding dynamically to circumstances if accessory movement is lost and the foot changes function from an active system to a passive platform.

Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about Physiotherapists, physiotherapy, physiotherapists in Birmingham, back pain, orthopaedic conditions, neck pain and injury management. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.

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