The bones and joints in the feet experience wear and tear, so conditions that cause damage to the foot can directly affect its health.
This article outlines the basic anatomy of the foot bones, along with some of the most common conditions affecting these bones.
Foot bones and anatomy
The human foot consists of 26 bones. These bones fall into three groups: the tarsal bones, metatarsal bones, and phalanges.
Tarsal bones
The tarsal bones are a group of seven bones that make up the rear section of the foot.
Tarsal bones include:
- The talus, or ankle bone: The talus is the bone at the top of the foot. It connects with the tibia and fibula bones of the lower leg.
- The calcaneus, or heel bone: The calcaneus is largest of the tarsal bones. It sits below the talus and plays an essential role in supporting body weight.
- The tarsals: These five bones form the arch of the midfoot. They are the medial, intermediate, and lateral cuneiforms, the cuboid, and the navicular.
Metatarsal bones
The metatarsal bones are a group of five tubular bones in the middle of the foot. They connect to the tarsal bones and the phalanges.
The metatarsals sit in a row, and doctors number them one to five. The first one sits closest to the arch of the foot, and number five sits at the outer edge of the foot.
Phalanges
The phalanges are the bones in the toes. The second to fifth toes each contain three phalanges.
From the back of the foot to the front, doctors call them the proximal, middle, and distal phalanges.
The big toe or hallux contains only two phalanges, which are proximal and distal.
The metatarsal phalangeal joints are the joints between the metatarsals and the proximal phalanx of each toe. These joints form the ball of the foot.
The first metatarsal phalangeal joint sits in line with the big toe. It is a common area for foot pain and other problems.
A bunion is a prominent bump on the inside of the foot, near the base of the big toe.
Bunions develop when the bone at the base of the toe — the first metatarsal — begins to separate from the bone at the base of the second toe — the second metatarsal.
As the first metatarsal drifts outwards, it causes the big toe to drift toward the other toes. These processes cause the bunion to become more prominent.
A person with a bunion may experience pain and discomfort at the site of the bunion or underneath the ball of the foot. These symptoms may worsen when walking or standing.
People who develop bunions tend to compensate by carrying more weight on the second toe, which can cause calluses to develop.
Gout
Gout is a type of inflammatory arthritis. Although it can affect almost any joint in the body, it most commonly affects the joint at the base of the big toe.
Gout usually occurs due to a high concentration of uric acid in the blood.
Uric acid is a chemical that usually dissolves in the blood and leaves the body through the urine. In people with gout, excess uric acid begins to accumulate and form crystals in the joints.
Uric acid crystal deposits can trigger an extreme inflammatory reaction, which causes pain and swelling in the affected area.
Hammer toes
A hammer toe is a condition that usually affects toes other than the big toe. Instead of pointing straight out in front, these toes point downward, forming a claw shape.
In most cases, the condition develops with age. It is usually the result of a muscle imbalance when the long muscles of the lower leg overpower the smaller muscles of the foot. This imbalance causes the toes to bend inward.
A hammer toe may cause the following symptoms:
- pain and calluses on the tops of the toes due to friction with shoes
- pain on the tips of the toes due to toes pressing into the sole of a shoe
- metatarsalgia, or pain in the joints at the base of the toes
- a sensation that feels like walking on marbles
Heel spurs and plantar fasciitis
Heel spurs are bony growths that develop on the heel bone, or calcaneus. Although they may cause some discomfort, they are rarely painful.
However, heel spurs often develop as a result of a condition called plantar fasciitis, which can cause pain.
Plantar fasciitis refers to inflammation and thickening of the plantar fascia, which is the ligament that supports the arch of the foot.
The following factors can increase the risk of developing plantar fasciitis:
- tight calf muscles that reduce the foot’s ability to flex upward
- a very high arch in the foot
- repetitive impact from some sports
- obesity
Plantar fasciitis can cause pain in the heel or bottom of the foot when standing or walking.
People who develop heel spurs without plantar fasciitis are unlikely to experience painful symptoms.
Heel spurs affect up to one in 10 people. Of these, only half will experience any pain.
According to the American College of Foot and Ankle Surgeons, a person may wish to see a doctor if they experience any of the following:
- a foot injury, such as a sprain or broken toe
- changes in the appearance of the foot or ankle
- pain in the foot, ankle, or lower leg
- pain or discomfort after standing
- heel pain in the morning
- impaired ability to perform certain activities
- an abnormal growth on the foot
- a medical condition that can affect the feet, such as diabetes or arthritis
Summary
The anatomy of the foot is highly intricate, consisting of many bones, joints, and ligaments.
Some health conditions, injuries, and general wear and tear can all cause or contribute to conditions affecting foot bones.
People who experience persistent foot pain or notice changes in the appearance of their feet may wish to see a doctor.
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