You are currently browsing the tag archive for the ‘Anatomy’ tag.

In some cases, the affects of heel pain may have a different source. As previously mentioned, tight calf muscles can often predispose you to developing plantar fasciitis. A byproduct of this are trigger points. Trigger points are tiny contractions in the muscle fiber which form as a result of over-use, strain, trauma, or shortened and tight muscles. Trigger points refer pain to other areas of the body. In the case of the lower leg, there are several muscles which could be referring pain to the heel and long arch of the foot – the same area where plantar fasciitis pain occurs. Let’s take a look at the first image below.

Soleus TP

This image depicts a trigger point in the middle of the soleus muscle. The soleus is a large calf muscle that plays a major role in plantar flexing your foot. The muscle is accessible half way down your lower leg and attaches itself to the foot via the Achilles tendon. If the muscle is tight, it will keep your foot plantar flexed (toes pointing down) and limit the amount of dorsiflexion (toes pointing up) available. This limitation will invariably put a strain on the muscles and fascia of the foot.

Quadratus Plantae TP

This second image shows a trigger point in the quadratus plantae muscle — a deep intrinsic foot muscle. Pain from a trigger point in this muscle can be a sharp, stabbing pain preventing you from putting your full weight down on your heel.

Gastrocnemius TP

And lastly, another common site of plantar fasciitis pain is along the medial arch of the foot. A trigger point in the medial head of the gastrconemius muscle can often refer pain to this area. Your gastrocnemius muscles are the superficial muscles found on the upper part of the lower leg. These muscles are very strong, powerful muscles which also attach to the foot via the Achilles tendon. They are often recruited in activities such as sprinting and jumping due to their capacity to lift your entire body weight.

It’s important to remember that while true plantar fascitiis takes time to heal, the effects of trigger points in these muscles could perpetuate pain in the area long after the condition has resolved itself. Along with treating the symptoms of referred pain, trigger point therapy has the added benefit of addressing tight calf muscles, which could be contributing to the condition. So whether you’ve been diagnosed with plantar fasciitis or are dealing with foot pain of some kind, in addition to your conventional treatments, trigger point therapy in combination with reflexology should be a part of your recovery plan.


joe-azevedo2Joe Azevedo is a New York State/NCBTMB Licensed Massage Therapist, ARCB Certified Reflexologist, and an Advanced Reiki Practitioner. He is a graduate of the Swedish Institute and is the owner and founder of Brooklyn Reflexology.

We rely on our feet to take us just about everywhere. So if heel pain is causing you to curtail your daily activities, this can be a huge problem. In the first half of this article, we’ll look at the most common form of heel pain — plantar fasciitis.  In the second half, we’ll consider how the effects of trigger points in the lower leg muscles can be a contributing factor and/or the cause of your heel pain!

Plantar fasciitis is a fairly common condition that causes pain and inflammation in the fascia which cover the bottoms of your feet. These tough bands of connective tissue run from your heel bone to your metatarsals and provide a good amount of arch support. Micro-ruptures can form due to repeated pulling, stress, and/or trauma to the area. If not treated properly, the condition can become chronic and lead to the formation of a heel spur, which can then cause further irritation and pain.

Plantar fasciitis typically affects those who have relatively: high arches (pes cavus), flat feet (pes planus), tight calf muscles, or tight, ill-fitting shoes. It can also occur in people who spend most of their day on their feet, those who are overweight, and runners who suddenly increase their activity level. Excessive pronation of the foot, running on sand or uneven surfaces, and inadequate arch support from worn out shoes can also be contributing factors.

The major signs and symptoms include:

– Pain at the heel when weight bearing

– Morning stiffness and pain that decreases with activity

– Tenderness along the medial arch when pressure is applied

– Pain when standing on your toes and /or walking on your heels

– Numbness along the outside of the foot

– Occasional swelling over the heel

– X-rays that reveal bone spurs where the fascia attaches on the heel bone

If you’ve been diagnosed with plantar fasciitis, chances are that most conservative methods should help alleviate the condition in a majority of cases. Such remedies may include:

– Rest, along with an over the counter NSAID to help with pain and inflammation

– Ice and myofascial massage to the affected area

– Orthotics and/or new shoes with good arch support

– Stretches for lower leg and foot muscles

– Night splints

In severe cases when the condition is particularly chronic and debilitating, your doctor may prescribe cortisone shots. While the shots may help to manage the condition, they are not a cure. It is crucial to be proactive and stave off any possible long-term effects by doing your homework. This will help speed up the recovery time significantly.


joe-azevedo2Joe Azevedo is a New York State/NCBTMB Licensed Massage Therapist,  ARCB Certified Reflexologist, and an Advanced Reiki Practitioner. He is a graduate of the Swedish Institute and is the owner and founder of Brooklyn Reflexology.

In part one of Anatomy of the Foot, we covered the basic structure of the foot — from the three sections and three arches, to the bones and their ligaments. In part two, we’ll get into the muscles and tendons that make the foot move.

Tendons

Like the ligaments of the foot, there are numerous tendons that attach the muscles of the lower leg to the foot. Tendons are the cord-like structures that attach muscle to bone. Here are a few key tendons along with some common forms of tendonitis.

Achilles Tendon: One of the most recognizable tendons of the body, the Achilles tendon is located at the back of the heel and attaches the calf muscles of the lower leg to the calcaneous. This tendon helps to flex the foot downward and propel you forward. Achilles tendonitis can result from overuse of the tendon while running or jumping or from a tight shoe, which can put pressure on the back of the heel.

Peroneal Tendons: There are two peroneal tendons which attach the lateral muscles of the lower leg to the foot. These tendons run underneath the lateral malleolus (the boney knob on the outer ankle) and when overused, can often times lead to peroneal tendonitis. The pain is usually felt along the lateral malleolus and heel, and can also be related to a high arch or a supinated (rolled in) foot.

Tibialis Posterior Tendon: This tendon attaches one of the deeper lower leg muscles to the foot. The tendon runs underneath the medial malleolus (the boney knob on the inner ankle) and when overused can lead to posterior tibial tendonitis. Common amongst runners or people with hyper mobile or pronated feet, pain and swelling can occur along the inner part of the ankle.

Anterior Tibial Tendon: The tendon of the anterior tibialis muscle, located in the front of the lower leg, runs over the top of the ankle to attach itself to the bottom of the inside of the foot. Pain and swelling along the top of the ankle and foot could be a sign of anterior tibialis tendonitis. This can result from excessive downhill running.

Bursa and Bursitis: Bursitis is an inflammation of the bursa sacs which lie under tendonous joints and are designed to reduce the friction against bone. One of the most common sites for bursitis on the foot is just behind your heel under the Achilles tendon. Often referred to as a “pump bump,” this bursa lies underneath the Achilles tendon and can be irritated from a tight shoe. Retrocalcaneal bursitis, as it’s called, usually develops over time and is often more acute and localized than the pain associated with Achilles tendonitis.

Muscles

Of the twenty intrinsic muscles found on the foot, only two are located on the dorsal (top) part of the foot. Seven muscles are found on the plantar (bottom) part of the foot. And the other eleven (the interosseous and lumbricals) are found between the metatarsal bones.

Dorsal foot muscles: The extensor digitorum brevis and the extensor hallucis brevis are short toe extensors. The latter extends the big toe and the former extends the other four toes.  The interosseous muscles lie between the metatarsal bones and help to move the toes from side to side and also aid in flexion and extension. There are actually two set of these interosseous muscles. The dorsal component has four muscles and the plantar component has three. Technically these muscles lie between the metatarsals, but because they’re most easily accessible from the top of the foot, they’re usually considered dorsal muscles.

Plantar foot muscles: The plantar surface of the foot is home to three layers of muscle.

First Layer: The first and most superficial layer contains three muscles. First on the list is the flexor digitorum brevis muscle which lies directly in the middle of the foot and attaches the heel to the toes. This muscles aids in flexing (curling) the four smaller toes. The abductor hallucis muscle lies along the medial longitudinal arch and helps to abduct or rather, move the big toe away from the other toes. The abductor digiti minimi muscle, found along the lateral longitudinal arch, helps to move the little toe away from the other toes. These last two toe abductor muscles are crucial in making the minor adjustments necessary to keep your balance.

Second Layer: This layer contains five muscles. The quadratus plantae muscle attaches the heel bone to the tendons of a long flexor muscle. This configuration makes it a strong aid in flexing the toes. The deeper lying lumbricals, of which there are four, lie parallel to the metatarsal bones. These tiny muscles help to flex the 2nd-5th toes.

Third Layer: This third and deepest layer has two big toe muscles and one little toe muscle. The two big two muscles are the adductor hallucis and the flexor hallucis brevis muscles. The adductor muscle moves the big toe closer to the other four toes and the flexor muscle bends the big toe downward. The last muscle in this layer, the flexor digiti minimi brevis muscle, helps to flex the little toe.

Covering all these layers of muscle are two bands of fascia that run for the heel to the ball of the foot. When irritated, it can lead to a fairly common condition called plantar fasciitis – an inflammation of the fascia.

Movements of the Foot

Finally, let’s discuss the four major planes of movement of the ankle and foot. The foot is capable of making numerous adjustments along its 33 joints, all of which are necessary for maintaining balance. For the sake of simplicity, we’ll consider the movements of the ankle joint, which move the foot.

The four major planes of movement are: dorsiflexion, plantarflexion, inversion and eversion. Each of these planes has a degree of movement that is considered part of the normal range of motion (ROM) found at the ankle.

Dorsiflexion: When you lift your foot so that your toes are pointed upward, this is called dorsiflexion. About 20 degrees of dorsiflexion is considered normal.

Plantarflexion: Flexing your foot so that your toes point downward is considered plantarflexion. Typically, 50 degrees of plantarflexion is about average.

Inversion/Supination: When your foot rolls inward so that your toes are pointed toward the midline of the body, this is referred to as a supinated or inverted foot. There tends to be more variability in this plane of movement than the previous two, so a normal range is usually between 45-60 degrees.

Eversion/Pronation: This occurs when your ankle rolls outward and your toes point away from the midline of the body. Similar to inversion, pronation of the foot falls within a normal range, which is typically 15-30 degrees. This is notably less than inversion/supination.

As one can see, there’s quite a bit to consider when discussing the feet. Hopefully this short anatomy lesson will give you some working knowledge and better equip you in making informed decisions about the care of your feet.


joe-azevedo2Joe Azevedo is a New York State/NCBTMB Licensed Massage Therapist, ARCB Certified Reflexologist, and an Advanced Reiki Practitioner. He is a graduate of the Swedish Institute and is the owner and founder of Brooklyn Reflexology.

By Appointment Only

917-514-3175

Location

116 Clinton St, Brooklyn Heights
October 2019
M T W T F S S
« Jun    
 123456
78910111213
14151617181920
21222324252627
28293031  

Reflexology Map