Abnormality of the foot

1. Foot Deformity

A foot deformity is a disorder of the foot that can be congenital or acquired. Such
deformities can include hammer toe, club foot, flat feet, pes cavus, etc. To say the main
causes of foot problem are these is difficult; because there are different causes of foot
deformities. It is better to identify it by foot problems symptoms.


1 Causes of feet damage

One perception is that each of these deformities is a distinct abnormality, and their
management and various explanations of cause are offered as though they are
independent of each other. However they are all part of the same process, although one
might appear earlier than another. A ―bunion‖ might be treated successfully, only to be
followed later by a ―claw toe‖, or a ―neuroma‖ might be the first expression, to be later
followed by other changes. These deformities are mainly ―age-related changes‖, and
develop progressively in most people as a factor of time. There is also a strong genetic
component. There appear to be different modes of genetic transmission, of which the
commonest is mother to daughter, but other patterns have become apparent, including
father to daughter, with a different anatomical presentation. There is also a gender bias
towards the female, and although the typical changes do occur in males these are less
frequent. Most foot deformities/abnormalities are minor and have a favorable prognosis.
However, some may be the first sign of a significant problem.

A thorough physical examination of ankle, hind foot and forefoot regarding position,
alignment and flexibility of each segment helps you to identify and distinguish between
the more common deformities. A thorough examination includes assessment of
vascular, dermatologic, and neurologic status of the lower extremities, and observation,
palpation, and evaluation of joint range of motion in both feet. The following shows
various types of foot deformities or abnormalities.

2. Various Types of Abnormalities

1. Blisters

Blister is a soft fluid sacks that form between top layers of skin or a double on the skin
filled with fluid. Although usually painful, its chief danger lies in the possibility of infection
The causes of blister are:
 Friction due to loose-fitted shoes.
 Friction produced by rough seams in shoes or socks.
 Lumps in the sole or inside of a shoe.
 A shoe that is too loose and which clips around on the foot.
 Too loose stockings or heavy seams in stocks or stockings.

2. Corns

These types of abnormalities are caused by misalignment, which causes friction on top
of the toes. It is a hard thickening of the skin, plus a central core or nucleus at a point
where pressure is sevsre. They may be a symptom of hammertoes. Excessive pressure
of friction in the area, short or tight fitting shoes and misalignment of the foot structure
are causes of corns.



3. Bunions

An inflammation and swelling on the side of the joint formed over the metatarsal head of
the big toe. Occasionally it also happens over the little toe. Most bunions are behind the
point of the large toe on the large metatarsal bone. "Bunionettes" are behind the little toe
(the outside of the foot). Misaligned arches are usually the cause of bunions, pronation
or supination. This abnormality also caused by excessive pressure in the joint area will
build up fluid and tissue inflammation in the bursa sac. The joint will build up calcium
deposit in the area. Wearing high heels and shoes with tight toe boxes will exacerbate
the problem. Bunions can be triggered by pronation of the heel. Wearing shoes that
have room in the foot bed will help to relieve pressure or rubbing in the area.

4. Ingrown Toenails

The toe nails grow into the skin and flesh of the toe. It is extremely painful and since the
outer section of the skin is broken, infection can take place. The cause of this
abnormality is pressure on the nails from undue crowing of the toes, or from too short
shoe or hosiery, poor hygiene, Incorrect cutting of nail and Tight shoes. “Deformity of
the toenail” means an abnormality resulting from injury to the nail or nail bed, from
chronic infection (for example, tinea), or from a congenital malformation.

5. Hammer toe

It is a condition in which the first joint of the toe is permanently bent downward.
A hammer toe or contracted toe is a deformity of the proximal interphalangeal joint of
the second, third, or fourth toe causing it to be permanently bent, resembling a hammer.
Mallet toe is a similar condition affecting the distal interphalangeal joint.
Hammer toe most frequently results from wearing poorly fitting shoes that can force the
toe into a bent position, such as excessively high heels or shoes that are too short or
narrow for the foot/narrow pointed shoe. Having the toes bent for long periods of time
can cause the muscles in them to shorten, resulting in the hammer toe deformity. This is
often found in conjunction with bunions or other foot problems. It can also be caused by
muscle, nerve, or joint damage resulting from conditions such
as osteoarthritis, rheumatoid arthritis, stroke, Charcot-Marie-Tooth disease or diabetes

6. High arch /Supination

His arches can be so high that he only walking on his bone structure, heel, ball and
toes; all pressure areas. Stability and shock absorption can be a problem. Neutralizing
the foot by wearing the Corrective Orthotic can help bring down the high arched foot.
Depending on the severity of the arch, two or three increases in the orthotic length. As
the foot neutralizes, the metatarsal arch in the orthotic can move back towards the heel.
Symptoms may reappear and the orthotic will press up into the bone structure in the
middle of the foot, taking it out of the metatarsal arch of the foot.

7. Flat foot/Fallen Arches/Pronation

We are all born with flat feet or muscle pad. Usually between the ages of five or seven,
our arches start to develop or not. Pronation is the process by which you shift your
weight from the outside of your foot to the inside. As your heel hits the ground, your foot
has a rolling in motion, thereby flattening out your foot. This rolling in, pronation, may
also effect your sciatic nerve. A pronated foot can also affect ankles, knees and hips.

2.1.1 Arches and Susceptibility to Injury

The anatomy and shape of a person‘s longitudinal and transverse arch can dictate the
types of injuries that person is susceptible to. The height of a person‘s arch is
determined by the height of the navicular bone. A person with a low longitudinal arch, or
flat feet will likely stand and walk with their feet in a pronated position, where the foot
enverts or rolls inward. This makes the person susceptible to heel pain, arch pain and
plantar fasciitis. Flat footed people may also have more difficulty performing exercises
that require supporting their weight on their toes. People who have high longitudinal
arches or a cavus foot tend to walk and stand in with their feet in a supinated position
where the foot inverts or rolls outward. High arches can also cause plantar fasciitis as it
causes the plantar fascia to be stretched away from the calcaneus or heel bone.
Additionally, high or low arches can increase the risk of shin splints as the anterior
tibialis and must work harder to keep the foot from slapping the ground.

structure of foot (Foot anatomy)

                                 structure of foot 

The human foot is a combined structure of base and lever, supporting and balancing the

body‘s weight while standing, as well as raising and moving the body forward when in
motion. Our feet work for us the whole day, whether we stand, play, run, or walk and in
the process they become the most affected part of our anatomy. Foot Anatomy is the
science, which studies the structure of the feet and the interrelations of its parts. The
important structures of the foot can be divided into several categories.

These include:

a. Bones and joints
b. Ligaments and tendons
c. Muscles
d. Nerves
e. Blood vessels

All of these components work together in union to provide the body with support,
balance and mobility. A structural flaw and malfunction in any one part can result in the
development of problems elsewhere in the body. Conversely, abnormalities in other
parts of the ultimately can lead to problems in the feet.

1. Bones and parts of the foot

The foot is made up of 26 skeletal bones held together by muscles, ligaments and 

tendons. These 26 bones are divided into three groups . These are:Tarsus:

 a.The tarsus is the group at the back of the foot and has seven irregularly 

shaped short bones.

b. Metatarsus: The Metatarsus group consists of five metatarsals (long bones). It is 

slender bones located in the front of the instep.

c. Phalanges: The phalanges are consisting of the fourteen long bones forming the 

toes

Structurally, the foot has three main parts; the forefoot, the mid foot, and the hind 

foot.

1. The forefoot: - is composed of the five toes, collectively called Phalanges, and their 

connecting long bones, the metatarsals.

2. The mid foot: - featuring five irregularly shaped tarsal bones (the navicular, cuboid, 

and three cuneiform). It forms the foot‘s characteristic arch and serves as a shock 

absorber.

3. The hind foot: - The talus and the calcaneus make up the hind foot. The calcaneus is 

the largest tarsal bones.

.
Muscles and tendons:

Muscles of the foot and leg balance the body and control the levers. The muscles in the 

leg provide power for the foot and those in the foot itself are used mainly for balance 

and direction. There are some 20 muscles in the foot. They give the foot its shape by 

holding the bones in position, and expand and control to impart movement to the bones 

and joints. One of the muscles is connected to a bone but at the other end the sheath is 

extended and becomes a tough non-elastic cord called a tendon. This tendon then 

transfers the power of the muscle to the joint on another bone where it is to be applied. 

Tendons are strong inelastic ―ropes‖ which attach the muscles to the bones. They keep 

the dynamic balance and shape of the foot. Tendons are very similar to ligaments the 

difference is that tendons attach muscles to bones, whereas ligaments attach bones to 

bones. Like ligaments tendons are also made up of small fibers of a material called 

Collagen.

 There are four groups of muscles in the leg that act on the foot.

1. The front group. Four muscles in front of and between the tibia and fibula whose 

tendons pass in front of the ankle joint. They raise the foot, turn the sole in and out and 

extend the toes up.

2. The outside group. Two muscles, which join the fibula. The tendons pass behind the 

ankle joint so they bend the foot down and turn the foot out.

3. The surface back group (the calf). One muscle joined to the thigh bone (femur) and 

the other to the tibia and fibula. They pass, via the Achilles tendon, over the back of the 

ankle and bend the foot down.

4. The deep back group. Four muscles under the calf whose tendons pass behind the 

ankle to flex the toe down and turn the foot.

.2 Ligaments:

Ligaments are the soft fibrous tissues that attach bones. They stabilize the joints. The 

longest of these, plantar fascia, forms the arch on the sole of the foot from the heel to 

the toes. By stretching and contracting, it allows the arch to curve or flatten, providing 

balance and giving the foot strength to push off and initiate the act of walking. Medial 

ligaments on the inside and lateral ligaments on the inside and lateral ligaments on 

outside of the foot provide stability and enable the foot to move up and down. The foot 

has 109 ligaments that serve as hinges to keep the bones and joints together. They are 

bands of ―ropes‖. They are fibrous and strong but less elastic than muscles. Ligaments 

hold the bones together, particularly those of the arch by keeping it in a firm, unyielding 

curve when weight is placed upon it. They maintain the static form of the foot.

Joints:

The main joints of the foot are:

1. Ankle Joint-Hinge: The bases of the two bones together from a socket into which 

the talus fits-thus forming the ankle joint.

2. Sub Tales Joint: Gliding: Talus glides on the calcaneus.

3. Mid Tarsal Joint: Gliding and ball and socket: Cuboid glides against the calcaneus.

Arches of the foot:

The human foot is an incredibly complex mechanism that has two very important 

functions:

1. Weight bearing

2. Propulsion (movement)

In order to perform these functions, the foot requires a high degree of stability as well as 

flexibility. The multiple bones and joints of the foot give it the necessary flexibility, but in 

order to fully support any weight, the bones of the foot need to form an arch. The foot 

has three distinct arches. Two "longitudinal" arches (one on each side) run from front to 

back; one "transverse arch" runs across the mid foot from inside to outside.

The arches of the foot are formed by the tarsal and metatarsal bones and, 

strengthened by ligaments and tendons, allows the foot to support the weight of the body