53. Short muscles of foot
Flexor digitorum brevis (medial calcaneus & tubercle to middle phalanx of lateral four toes).
Flexor hallucis brevis (cuboid & third cuneiform to base of proximal phalanx & abductor tendon).
Extensor digitorum/hallucis brevis muscle (upper calcaneus on dorsum of foot distal to sinus tarsi to upper surface of toes).
Abductor hallucis (medial calcaneus to medial base of big toe).
Adductor hallucis (metatarsals & MT joints to lateral base of big toe). Important for the internal strength of the foot.
Interossei (metatarsals to base of proximal phalanx of toes)
Action - adducts toes, flexes proximal & extends distal toes 3-5.
The dome of calcaneus flares outward at it base. The medial tubercle is the weight bearing medial part. As well as serving as the attachment for muscle the medial tubercle serves as the attachment for the plantar aponeurosis. The plantar aponeurosis lies superficially and acts as a tie-beam to support the longitudinal arch of the foot. From the medial calcaneal tuberosity it fans out to attach on the metatarsal heads. The skin is thickened and supported with subcutaneous fibro-fatty tissue.
Heel spurs and plantar fasciitis can develop at or near the medial tubercle and will be tender. The treatment is to correct the biomechanics, which caused the problem and remove any further weight being placed on the spur with an orthotic. The orthotic must have a hole cut out of it for the spur to sit in. The patient should self treat by soaking their foot in a bath of warm water for five or ten minutes and then perform transverse friction over the plantar fascia for five minutes daily.
Technique 1 Kneading of short toe flexor muscles.