Anatomy Of The Foot

Because they are so complicated, human feet can be especially prone to injury. Strains, sprains, tendonitis, torn ligaments, broken bones, fallen arches, bunions, corns, and plantar warts can all occur. Here we will talk more about the anatomy of the human foot and its many moving parts.

Foot

The foot is a part of vertebrate anatomy which serves the purpose of supporting the animal’s weight and allowing for locomotion on land. In humans, the foot is one of the most complex structures in the body. It is made up of over 100 moving parts – bones, muscles, tendons, and ligaments designed to allow the foot to balance the body’s weight on just two legs and support such diverse actions as running, jumping, climbing, and walking.

Because they are so complicated, human feet can be especially prone to injury. Strains, sprains, tendonitis, torn ligaments, broken bones, fallen arches, bunions, corns, and plantar warts can all occur. Here we will talk more about the anatomy of the human foot and its many moving parts.

The complexity of the human foot may stem from the fact that it evolved from hand-like, grasping feet like those we see in apes today. Our ancient ancestors were tree-dwellers, and needed to be able to hang onto branches tightly with all four limbs. This caused them to evolve extraordinarily intricate hands and feet, which were capable of grasping, rotating, and gripping with dexterity that engineers are still trying to replicate in fields like robotics today.

Scientists are not sure why our ancestors eventually developed to walk upright, which caused the “fingers” of our feet to fuse and create a flat surface for walking on. It may have been because our ancestors began living on treeless grasslands, where standing tall to be able to see over the grass was more important than climbing. It could also have been because, as we began using tools, the ability to walk on two feet while using our hands to carry items became important.

Feet are present in other species too; especially mammals, birds, reptiles, and amphibians. Invertebrates such as mollusks and insects may have “feet” that they use to walk or move, but these are not complex bony structures like those found in vertebrates.

Here we will discuss the anatomy of the human foot, and some things that can go wrong to cause injuries or disorders.

These descriptions are meant for informational purposes only. You should always see a doctor if foot injury is suspected, as prompt and proper treatment can make for a faster, easier recovery! It is especially important to see a doctor if a suspected foot injury involves numbness, bleeding, or inability to move the foot, as these may be signs of serious complications.

Proper diagnosis and treatment takes a trained professional; improper diagnosis and treatment may lead to longer-lasting problems!

Foot Anatomy

The foot contains 26 bones, 33 joints, and over 100 tendons, muscles, and ligaments. This may sound like overkill for a flat structure that supports your weight, but you may not realize how much work your foot does!

The foot is responsible for balancing the body’s weight on two legs – a feat which modern roboticists are still trying to replicate. This requires strong, subtle muscles which can keep the foot standing firm even as we move our body’s weight around at different positions and angles.

The many bones work together to allow to allow this fine, delicate movement by subtly shifting inside the foot. They also allow us to perform intricate actions such as standing, climbing, and “grasping” at the ground with our feet on moving or uneven surfaces.

Here we will discuss the most important parts of the anatomy of the foot, and some injuries and disorders that can occur when these parts are damaged.

Of note, here we will make general statements about how different foot injuries and disorders may be treated by doctors. This is not a substitute for medical advice.

See a doctor about any suspected foot injury or disorder, as prompt diagnosis and treatment can make for a faster, easier recovery, while improper treatment may lead to long-term damage.

Foot Bones

There are 26 bones in the foot. These include:

The phalanges, which are the bones in your toes
The metatarsals, which run through the flat part of your foot
The cuneiform bones, the navicularis, and the cuboid, all of which function to give your foot a solid yet somewhat flexible foundation
The calcaneus, which is the bone in your heel
The talus, which is the bone in your ankle
The talus connects to the tibia, which is the main bone in your lower leg

While you may not notice these bones in action every day, you’ll notice quickly if something is wrong with one of them. These bones allow your feet to execute the delicate shifts which enable you to keep your balance while walking, running, jumping, climbing, dancing, and playing sports!

Injury to a bone in the foot often results in a sharp or throbbing pain, especially when you move in a way that causes your weight or a nearby muscle to put pressure on the bone.

The most common broken bones in the foot are broken toes, which may occur after hitting a toe on a hard or sharp surface while walking, running, swimming, or playing sports.

Broken bones in the foot usually call for rest, ice, compression, and elevation to reduce any swelling. It is helpful to remember the acronym “RICE” for Rest, Ice, Compression, and Elevation. This combination of at-home treatments is a good first-line response for many leg and foot injuries.

Supportive wraps or protective casts may be used to reduce pain and keep bones properly aligned. Sometimes, crutches or other means of keeping weight off the foot entirely might be prescribed. In rare cases where a bone breaks into two or more pieces and these pieces become misaligned, surgery may be required to move the pieces back into alignment so they can heal.

Physical therapy may also be suggested to help regain healthy use of the muscles after the injury.

Another possible problem with bones in the foot is the problem of bunions, or bone spurs.

Bone spurs occur when extra bone growth occurs, usually near the end or joint of a bone. This can be caused by chronic irritation of the joint, such as rubbing against another bone or joint. The most common types of bone spurs in feet occur in the big toe, and these are called “bunions.”

Bunions and bone spurs can cause significant pain. Internally, they can rub against other bones, muscles, and nerves beneath the skin. Externally, they can change the shape of the foot, resulting in pain and discomfort from wearing normal shoes.

Mild bunions can be treated by wearing more comfortable shoes or shoe inserts, taking over-the-counter anti-inflammatory medications, applying rest, ice, compression, and elevation, and taping, or splinting the affected area. All of these measures might reduce swelling and prevent the bunion from causing pain.

If pain is not relieved by these activities, surgery may be required to remove some of the bunion tissue.

The risk for bunions is increased if you wear tight, narrow shoes, which may force bones to rub against each other. The risk is also increased if you have arthritis or a history of injuries to the foot.

Foot Ligaments

Ligaments are bands of very strong, flexible tissue that perform the important job of connecting bones together. Ligaments are very strong and difficult to injure, but ligament injuries can be serious when they do occur. This is because ligaments do not receive much blood flow like bones and muscles, so they are slow to repair themselves.

There are a lot of bones in the foot, so you might guess correctly that there are a lot of ligaments. In fact there are so many ligaments that we need three different diagrams to show them all to you!

This diagram shows the sole of the foot. You can see the toes on the top and the heel on the bottom, while the arch and sole of the foot are made up of a thick web of ligaments holding the bones together:

This diagram shows the “medial aspect” of the foot. This term comes from the terms “medial,” meaning “center,” or “in the middle,” and “aspect,” meaning “face.” In other words, this is the “face” that the foot shows to the center of the body. It is the side of the foot that faces inward.

This diagram shows the heel on the right, while the toes reach off the screen to the left.

Here you can see that the ankle is also a thick web of ligaments, where the tibia is connected to the bones of the ankle and the core of the foot. You can also see the bands of ligaments where the metatarsals and phalanges are connected to each other.

Lastly, this diagram shows the “lateral aspect” of the foot, with “lateral” meaning “to the side.” This is the view of the foot from the side of the body, then; the view of the part of the foot that faces outward.

On the left side of the image, above the heel, you can see the delicate leg bone called the fibula. The fibula is smaller than the tibia and runs alongside it. Having two separate bones instead of one connecting the foot to the leg gives the foot and leg extra balance and maneuverability.

You can also see the thick web of ligaments on the top of the foot, where the bones of the foot’s core are connected on the top side.

Now you can begin to see why the middle of your foot feels solid, even though it’s made up of many bones. The many bones are bound together tightly by strong, flexible ligaments, which allow the center of your foot to shift subtly while remaining solid and stable.

Although ligaments are strong, they can be injured – especially in an area like the ankle, where the whole weight of your body hinges on a single joint.

Sprains occur when a body part is wrenched or twisted, resulting in damage to a ligament. Such damage can cause swelling and significant pain. Because ligaments do not receive much nourishing blood flow from the body, sprains can take a long time to heal, and long-term damage can result from continued stress on a sprained ligament.

Like broken bones, sprains are often treated with rest, ice, compression, and elevation; and a supportive wrap or cast to take stress off the sprained area. Sometimes, crutches or other means of keeping weight off the foot entirely might be prescribed.

Physical therapy can be especially helpful in the case of sprains, where it can ensure that the injured ligament is strengthened gradually and is properly supported by surrounding muscles.

A torn ligament occurs when the foot is wrenched or twisted so violently that the ligament actually snaps. This condition can be serious as ligaments which are completely torn may not heal themselves the way a bone or muscle would.

Torn ligaments can sometimes be treated in the same way as strains, but may require surgery if the tear is severe or if there is lasting damage to foot function. With surgery, doctors can join the two ends of a damaged ligament together, or replace a damaged ligament with a healthy one from another part of the body.

Foot Muscles

Just as there are many bones and ligaments of the sole of the foot, there are also many muscles. These can be divided up into four major groups:

The central muscles of the sole of the foot
The lateral muscles of the sole of the foot
The medial muscles of the sole of the foot
The muscles of the dorsum (top) of the foot

You can learn more about each individual group of muscles in the foot using this table:

If muscles are overworked or overstressed, they can become torn or strained. Strains usually manifest as pain, especially with movement or pressure.

Mild strains often go away in days or weeks if the muscle is rested and not subjected to further stress. More serious muscle tears, however, may take months.

It is a good idea to see a doctor if a severe strain is suspected, as severe muscle strains can lead to serious complications.

The most severe form of muscle overuse – rhabdomyolysis – occurs when muscles are so stressed that their cells rupture and release toxic chemicals. This can actually be fatal if left untreated.

Rest, ice, compression, and elevation to reduce swelling are recommended to treat mild to moderate strains. Supportive wraps or casts and crutches or braces may be recommended if the strain is especially severe.

Physical therapy may also be suggested to help regain healthy use of the muscles after the injury.

Foot Tendons

Tendons are thick bands of tissue that connect muscles to bones. By connecting our rigid bones to our powerful muscles, tendons allow us to move. Movement occurs when our muscles pull on our bones, relocating them.

The following diagram shows the tendons of the lateral aspect of the foot – that is, the aspect that faces outward, away from your body:

Foot Arches

Normally, tendons in the foot pull the bones of the foot in toward each other, resulting in distinctive arches between the heel and toes, and between the inner and outer toes. This arch is important for ensuring that weight is properly distributed among the strongest muscles of the leg and foot, and to ensure we can shift our weight as needed to keep our balance or move quickly.

Fallen arches, or “flat feet,” can occur when the tendons of the foot do not pull the foot’s bones together with a normal amount of strength. This results in the foot becoming “flat,” which can lead to pain, balance problems, and tiredness in the leg or foot.

Flat feet can occur as a result of injury, or some people’s tendons simply never pull together properly. Rarely, other health problems such as arthritis or problems with the nerves going to the feet can cause flat feet.

Flat feet may ache and tire easily. Back pain and leg pain may also result as muscles in the back and legs may work to overcompensate for the normal balancing functions of the arch.

Treatment for flat feet may depend on the cause. If you believe you have flat feet, see a doctor to find out what is the best treatment for you!

Skin and Toenails

The internal parts of the foot are not the only important parts! The skin on the bottom of our feet protects our muscles, bones, tendons and ligaments from injury. It also prevents infection.

Toenails protect the top of our toes, which, as we all know, can sometimes be vulnerable to being stubbed, stepped on, or having things dropped on them.

However, there are things that can go wrong with each of these and lead to problems.

Plantar warts – Plantar warts are growths that appear on the bottom of the foot, and may become painful. They are caused by a strain of human papillomavirus that infects skin of the feet and causes unusual growth of skin and blood vessels.

The strain of human papillomavirus that causes plantar warts and other warts is very common in the environment. It is not known why some people develop warts and others don’t. Avoiding sharing shoes and socks with people who have plantar warts may help protect against them, but many people develop plantar warts with no known instances of person-to-person transmission.

If plantar warts remain small, they might not cause pain, and no treatment may be needed. If they become painful, however, they may need to be removed. Several options exist for doing this, including over-the-counter applications, and procedures to freeze the wart tissue which can be performed by a doctor.

Corns and calluses are hard areas of skin which build up as a result of frequent friction against the skin. The body creates corns and calluses to “toughen” the skin against repeated stress.

People who work with their hands such as carpenters, gardeners, and musicians often develop calluses on their hands in areas where they frequently rub against their instruments. People who walk often or whose feet rub against the insides of their shoes may develop corns and calluses on their feet.

People with conditions that cause fragile skin or impaired blood flow to the feet, such as diabetes, should talk with their doctor as soon as corns or calluses develop. This may be a sign of an underlying problem, and treatments that are appropriate for healthy people may cause harm to people with these conditions.

For people who do not have such health conditions, over-the-counter corn-removal and exfoliation treatments can help relieve discomfort caused by corns and calluses. Changing one’s shoes or walking habits may also prevent them from forming in the future.

Once, human toenails served a similar function to those of fingernails or animals’ claws. However, the foot has undergone some important changes in evolutionary history. Toenails have not always kept up.

Ingrown toenails occur when a toenail inappropriately curves, causing it to stab into the flesh of the toe. This is a painful condition, and may become serious if injury and infection occur.

Ingrown toenails can sometimes be managed at home through frequent clipping. But in serious cases, medical attention may be necessary to avoid dangerous infections.

See your doctor immediately if an ingrown toenail causes severe pain, or if a toe with an ingrown toenail becomes red and swollen.

Quiz

1. Why is it important to see a doctor if a foot injury is suspected?
A. Because different types of injuries such as broken bones, sprains, and strains may have similar symptoms but require different treatments
B. Because prompt treatment can make for a slower, easier healing process than if an injury is ignored or treated improperly at first
C. Because doctors can prescribe helpful devices like supportive wraps, casts, and crutches that decrease pain and help with healing
D. All of the above

Answer to Question #1
D is correct. All of the above are reasons to consult a doctor if a foot injury occurs.

2. Which of the following is NOT a bone found in the foot?
A. The calcaneus
B. The cuboid bone
C. The metacarpals
D. The phalanges

Answer to Question #2

C is correct. The metaCARPals sound similar to the metaTARSals, which are found in the foot. But metacarpals are found in the hands, not the feet. You can remember this because “carpal” refers to the same anatomy as “carpal tunnel syndrome,” which is a disease of the hands and wrists.

3. Which of the following is not a foot-related health problem?
A. A broken toe
B. An Achilles tendon injury
C. A sprained ankle
D. Carpal tunnel syndrome

Answer to Question #3
D is correct. Carpal tunnel syndrome occurs in the wrists and hands, not in the feet or ankles.

References

Hoffman, M. (n.d.). Picture of the Feet. Retrieved July 05, 2017, from http://www.webmd.com/pain-management/picture-of-the-feet#1
Gray, H. (2012). Anatomy of the human body. London, England: Bounty.
Foot Injuries | Foot Disorders | MedlinePlus. (n.d.). Retrieved July 05, 2017, from https://medlineplus.gov/footinjuriesanddisorders.html
Topographic anatomy of the lower extremity, part II: knee, leg, ankle, and foot.[Video file]. (n.d.).
Muscles of the foot. (n.d.). Retrieved July 05, 2017, from https://www.kenhub.com/en/videos/muscles-foot
Calluses and Corns – Topic Overview. (n.d.). Retrieved July 05, 2017, from http://www.webmd.com/skin-problems-and-treatments/tc/calluses-and-corns-topic-overview#1

Picture of the Feet

The feet are flexible structures of bones, joints, muscles, and soft tissues that let us stand upright and perform activities like walking, running, and jumping. The feet are divided into three sections:

The forefoot contains the five toes (phalanges) and the five longer bones (metatarsals).
The midfoot is a pyramid-like collection of bones that form the arches of the feet. These include the three cuneiform bones, the cuboid bone, and the navicular bone.
The hindfoot forms the heel and ankle. The talus bone supports the leg bones (tibia and fibula), forming the ankle. The calcaneus (heel bone) is the largest bone in the foot.

Muscles, tendons, and ligaments run along the surfaces of the feet, allowing the complex movements needed for motion and balance. The Achilles tendon connects the heel to the calf muscle and is essential for running, jumping, and standing on the toes.

Feet Conditions

Plantar fasciitis: Inflammation in the plantar fascia ligament along the bottom of the foot. Pain in the heel and arch, worst in the morning, are symptoms.
Osteoarthritis of the feet: Age and wear and tear cause the cartilage in the feet to wear out. Pain, swelling, and deformity in the feet are symptoms of osteoarthritis.
Gout: An inflammatory condition in which crystals periodically deposit in joints, causing severe pain and swelling. The big toe is often affected by gout.
Athlete’s foot: A fungal infection of the feet, causing dry, flaking, red, and irritated skin. Daily washing and keeping the feet dry can prevent athlete’s foot.
Rheumatoid arthritis: An autoimmune form of arthritis that causes inflammation and joint damage. Joints in the feet, ankle, and toes may be affected by rheumatoid arthritis.
Bunions (hallux valgus): A bony prominence next to the base of the big toe that may cause the big toe to turn inward. Bunions may occur in anyone, but are often caused by heredity or ill-fitting footwear.
Achilles tendon injury: Pain in the back of the heel may suggest a problem with the Achilles tendon. The injury can be sudden or a nagging daily pain (tendinitis).
Diabetic foot infection: People with diabetes are vulnerable to infections of the feet, which can be more severe than they appear. People with diabetes should examine their feet daily for any injury or signs of developing infection such as redness, warmth, swelling, and pain.
Swollen feet (edema): A small amount of swelling in the feet can be normal after prolonged standing and common in people with varicose veins. Feet edema can also be a sign of heart, kidney, or liver problems.
Calluses: A buildup of tough skin over an area of frequent friction or pressure on the feet. Calluses usually develop on the balls of the feet or the heels and may be uncomfortable or painful.
Corns: Like calluses, corns consist of excessive tough skin buildup at areas of excessive pressure on the feet. Corns typically have a cone shape with a point, and can be painful.
Heel spurs: An abnormal growth of bone in the heel, which may cause severe pain during walking or standing. People with plantar fasciitis, flat feet, or high arches are more likely to develop heel spurs.
Ingrown toenails: One or both sides of a toenail may grow into the skin. Ingrown toenails may be painful or lead to infections.
Fallen arches (flat feet): The arches of the feet flatten during standing or walking, potentially causing other feet problems. Flat feet can be corrected with shoe inserts (orthotics), if necessary.
Nail fungal infection (onychomycosis): Fungus creates discoloration or a crumbling texture in the fingernails or toenails. Nail infections can be difficult to treat.
Mallet toes: The joint in the middle of a toe may become unable to straighten, causing the toe to point down. Irritation and other feet problems may develop without special footwear to accommodate the mallet toe.
Metatarsalgia: Pain and inflammation in the ball of the foot. Strenuous activity or ill-fitting shoes are the usual causes.
Claw toes: Abnormal contraction of the toe joints, causing a claw-like appearance. Claw toe can be painful and usually requires a change in footwear.
Fracture: The metatarsal bones are the most frequently broken bones in the feet, either from injury or repetitive use. Pain, swelling, redness, and bruising may be signs of a fracture.
Plantar wart: A viral infection in the sole of the foot that can form a callus with a central dark spot. Plantar warts can be painful and difficult to treat.
Morton’s neuroma: A growth consisting of nerve tissue often between the third and fourth toes. A neuroma may cause pain, numbness, and burning and often improves with a change in footwear.

Feet Tests

Physical exam: A doctor may look for swelling, deformity, pain, discoloration, or skin changes to help diagnose a foot problem.
Feet X-ray: A plain X-ray film of the feet can detect fractures or damage from arthritis.
Magnetic resonance imaging (MRI scan): An MRI scanner uses a high-powered magnet and a computer to construct detailed images of the foot and ankle.
Computed tomography (CT scan): A CT scanner takes multiple X-rays, and a computer constructs detailed images of the foot and ankle.

Feet Treatments

Orthotics: Inserts worn in the shoes can improve many foot problems. Orthotics may be custom-made or standard-sized.
Physical therapy: A variety of exercises can improve flexibility, strength, and support of the feet and ankles.
Feet surgery: In some cases, fractures or other problems with the feet require surgical repair.
Pain medicines: Over-the-counter or prescription pain relievers such as acetaminophen (Tylenol), ibuprofen (Motrin), and naproxen (Aleve) can treat most foot pain.
Antibiotics: Bacterial infections of the feet may require antibacterial drugs given orally or intravenously.
Antifungal medicines: Athlete’s foot and other fungal infections of the feet can be treated with topical or oral antifungal medicines.
Cortisone injection: An injection of a steroid may be helpful in reducing pain and swelling in certain foot problems.

Show Sources

Canale, S. Campbell’s Operative Orthopaedics, Mosby Elsevier, 2007.

Goldman, L. Cecil Medicine, Saunders Elsevier, 2008.

Foot Anatomy and Common Foot Problems

Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics.

Yaw Boachie-Adjei, MD, is a board-certified, double-fellowship Orthopedic Surgeon.

Table of Contents
Table of Contents

The anatomy of the foot and its function can predispose to common foot problems.

Common causes of foot pain include plantar fasciitis, bunions, flat feet, heel spurs, mallet toe, metatarsalgia, claw toe, and Morton’s neuroma. If your feet hurt, there are effective ways to ease the pain This article provides an overview of foot anatomy and foot problems that come from overuse, injury, and normal wear and tear of the foot.

Foot Anatomy

Each of your feet has 28 bones, 30 joints, and more than 100 muscles, ligaments, and tendons. These structures work together to carry out two main functions:

Weight-bearing
Propulsion (forward movement)

Plus, the foot must be flexible to adapt to uneven surfaces and remain stable.

The foot has three sections: the forefoot, midfoot, and hindfoot. There are bones, joints, muscles, tendons, and ligaments in each of these sections.

Bones

Forefoot Bones

Phalanges : These are the toes. They are made up of a total of 14 bones: two for the big toe and three for each of the other four toes.
Metatarsals : These are five long bones that extend from the base of each toe to the midfoot. The first metatarsal bone leads to the big toe and plays an important role in propulsion (forward movement). The second, third, and fourth metatarsal bones provide stability to the forefoot.
Sesamoid bones: These are two small, oval-shaped bones beneath the first metatarsal on the underside (plantar surface) of the foot. It is embedded in a tendon at the head of the bone (the part nearest to the big toe). Its role is to reinforce and reduce stress on the tendon.

Midfoot Bones

The midfoot contains five irregularly shaped bones called the tarsals. Together, the tarsals form the arch of the foot. The arch plays a key role in weight-bearing and foot stability.

These bones include:

Navicular
Cuboid
Medial cuneiform
Intermediate cuneiform
Lateral cuneiform

Hindfoot

Calcaneus : This is the large bone at the heel of the foot, also known as the heel bone. Its main function is to transfer most of the body weight from the legs to the ground.
Talus : This is the bone that sits between the calcaneus and the two bones of the lower leg (the tibia and fibula). It helps transfer weight and pressure across the ankle joint.

Joints

Joints are where two bones meet. In the feet, each big toe has two joints: the metatarsophalangeal joint at the base of the toe and the interphalangeal joint just above it.

The other four toes have three joints each: the metatarsophalangeal joint at the base of the toe, the proximal interphalangeal joint in the middle of the toe, and the distal phalangeal joint closest to the tip of the toe.

Muscles

The muscles that control the movements of the foot start in the lower leg and are attached to the bones in the foot with tendons.

These are the main muscles that facilitate movement in the foot:

Tibialis posterior: The muscle that supports the foot’s arch
Tibialis anterior: The muscle that allows the foot to move upward
Peroneus longus and brevis : The muscles that control movement on the outside of the ankle
Extensors: The muscles that raise the toes to make it possible to take a step
Flexors: The muscles that stabilize the toes and curl them under

Tendons

Tendons are fibrous connective tissues that attach muscles to bones. There are three major tendons that help facilitate foot movement, including flexion (forward bending of the foot) and dorsiflexion (backward bending of the foot):

Achilles tendon: This is the most notable tendon of the foot which runs from the calf muscle to the heel. It is the strongest and largest tendon in the body that makes it possible to run, jump, climb stairs, and stand on your toes.
Tibialis posterior: This tendon attaches the calf muscle to the bones on the inside of the foot and supports the arch of the foot.
Tibialis anterior: This runs from the outer bone of the lower leg to the tarsals and first metatarsal which enables dorsiflexion.

Ligaments

Ligaments are fibrous connective tissues that connect bone to bone. These are the primary ligaments of the foot:

Plantar fascia : This is the longest ligament of the foot that runs from the heel to the toes to form the arch. The plantar fascia provides strength for walking and assists with balance.
Plantar calcaneonavicular : This is a ligament that connects the calcaneus to the talus. Its role is to support the head of the talus.
Calcaneocuboid : This is the ligament that connects the calcaneus to the tarsal bones. It helps the plantar fascia support the arch of the foot.

Common Foot Problems

The average person has walked about 75,000 miles by age 50. Given how many moving parts there are in the foot, it’s not surprising how vulnerable it is to injury or overuse.

Nine conditions specific to the foot can cause pain, restrict the movement of the foot, or lead to foot instability.

Plantar Fasciitis

Plantar fasciitis is caused by microtears in the thick fibrous tissue on the underside of the foot, usually due to overstretching. Symptoms include pain in the heel and arch that is often worse in the mornings. Plantar fasciitis is common among-distance walkers or runners.

Bunions

A bunion is a bony protrusion on either the inside edge of the foot or the pinkie toe side. Bunions form gradually when the bones in the foot become misaligned, often due to wearing shoes that don’t fit well or that squeeze the toes together tightly.

The big toe can bend so far inward that it actually crosses under or over the adjacent toe, causing a secondary misalignment called a hammertoe. Usually, a painful callous will form on top of the second toe.

Flat Feet

Pes planus (flat feet) is when the arc of the foot straightens out, often so completely that the entire sole comes in contact with the floor.

Flat feet can cause pain in the midfoot area as well as swelling of the ankle and arch. The imbalance can also lead to hip, knee, or lower back pain.

Pes planus can be congenital (meaning you are born with it), but more often it is a result of age or injury. Between 20% and 30% of people have some degree of flat-footedness.

Heel Spurs

As the largest bone in the foot, the calcaneus (heel) is prone to injury caused by faulty foot biomechanics (meaning problems with your gait).

One of the more common is the development of bony overgrowth called heel spurs that cause severe pain when standing or walking. Also known as calcaneal spurs, heel spurs are most common in people who have plantar fasciitis, flat feet, or high arches.

Mallet Toe

With a mallet toe, the joint in the middle of a toe becomes permanently bent to the extent that it points downward.

Mallet toes develop because of an imbalance in the muscles, tendons, or ligaments that hold the bones straight. As with bunions and hammertoe, mallet toe often forms as a result of wearing ill-fitting shoes, although it can also be caused by trauma or certain diseases.

Metatarsalgia

Metatarsalgia is pain under the ball of the foot. It is often the result of pressure caused by high heel shoes or from conditions such as arthritis, nerve compression, or fractures or tears in ligaments that support the ball of the foot.

Claw Toe

A claw toe is a deformity in which a toe bends downward from the middle joints and can sometimes even curl under the foot entirely. When this happens, callouses or corns will form on top of the affected toe. Sometimes, a corn can place pressure on nerves in the foot, causing pain.

Morton’s Neuroma

This is a common problem in which compression on a nerve in the ball of the foot causes burning, tingling, and pain near the third and fourth toes. High heels are most often the culprit. Morton’s neuroma can make you feel like you have a pebble in your shoe or on a fold in your sock.

Medical Conditions That Can Cause Foot Problems

The feet are subject to a variety of medical problems, including:

Sprains and strains
Ruptured tendon or ligament
Bone fractures
Tendinitis (tendon inflammation)
Osteoarthritis (“wear-and-tear arthritis”)
Rheumatoid arthritis (autoimmune arthritis)
Diabetes
Gout
Athlete’s foot
Onychomycosis (nail fungal infection)

Diagnosis

To diagnose problems related to the anatomical structures in the foot, your healthcare provider or an orthopedic specialist will look at your foot to look for signs of swelling, deformity, skin growth, or misalignment.

They will review your symptoms and medical history and ask you to walk around to look for abnormalities in your gait (referred to as a gait analysis).

Imaging tests are often central to the diagnosis and can include:

X-ray: This standard imaging test involves low-level radiation and is suitable for detecting things like bone fractures, dislocations, or arthritis damage.
Computed tomography (CT): This imaging technology combines multiple X-rays to create a more three-dimensional representation of the foot structure.
Magnetic resonance imaging (MRI): This imaging technique uses a powerful magnet and radio waves to create highly detailed images without radiation. It is especially good at imaging soft tissues.

Treatment

The treatment for a foot problem will depend on the underlying cause.

Foot pain from any cause can often be relieved with over-the-counter painkillers such as Tylenol (acetaminophen), Advil (ibuprofen), or Aleve (naproxen).

More severe cases may require steroid injections to reduce joint inflammation or prescription pain relievers like Celebrex (celecoxib) to relieve chronic arthritis pain.

For foot problems caused by anatomical deformities, foot orthotics (inserts worn inside the shoes) can help compensate for these problems and reduce pain. Standard versions are available in pharmacies, but often a doctor will order custom-made orthotics or custom-fitted shoes.

Physical therapy can improve the strength and flexibility of the feet and ankles. Sometimes conditions like a displaced fracture, bunions, or hammertoe will require surgery if they are causing severe pain or disability.

Summary

The foot is a complex structure comprised of bones, joints, muscles, ligaments, and tendons. It is vulnerable to injury both from trauma and overuse, as well as diseases and infections. Among some of the more common structural foot problems are bunions, claw toes, flat feet, hammertoes, heel spurs, mallet toes, metatarsalgia, Morton’s neuroma, and plantar fasciitis.

The diagnosis of a structural foot problem may involve a physical exam, a review of your symptoms and medical history, a gait analysis, and an imaging test such as an X-ray, CT scan, or MRI scan.

The treatment can vary based on the condition but may involve over-the-counter or prescription painkillers, foot orthotics, custom-fitted shoes, physical therapy, or surgery.

Frequently Asked Questions

What is the bottom of your foot called?

The bottom of the foot is known as the sole. The padded area on the bottom of the foot is known as the plantar aspect.

What is the top of your feet called?

The top of your foot above the arch is known as the instep. In medical terms, the top of the foot is the dorsum or dorsal region. The back of the hand is also known as the dorsal region.

What are common foot problems in older adults?

Foot pain
Peripheral neuropathy (nerve damage)
Arthritis
Plantar fasciitis
Metatarsalgia
Hallux rigidus (degenerative disease of the first metatarsal)
Lesser toe deformities
Hyperkeratosis
Plantar heel pain

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Bito T, Tashiro Y, Suzuki Y, et al. Forefoot transverse arch height asymmetry is associated with foot injuries in athletes participating in college track events.J Phys Ther Sci. 2018;30(8):978–983. doi:10.1589/jpts.30.978
Freedman BR, Gordon JA, Soslowsky LJ. The Achilles tendon: fundamental properties and mechanisms governing healing.Muscles Ligaments Tendons J. 2014;4(2):245–255. PMID: 25332943
American Podiatric Association. Winter foot care: Tips to keep feet warm and cozy all winter long.
Petraglia F, Ramazzina I, Costantino C. Plantar fasciitis in athletes: diagnostic and treatment strategies. A systematic review.Muscles Ligaments Tendons J. 2017;7(1):107–118. doi:10.11138/mltj/2017.7.1.107
Pita-Fernandez S, Gonzalez-Martin C, Alonso-Tajes F, et al. Flat Foot in a Random Population and its Impact on Quality of Life and Functionality.J Clin Diagn Res. 2017;11(4):LC22–LC27. doi:10.7860/JCDR/2017/24362.9697
Park SY, Bang HS, Park DJ. Potential for foot dysfunction and plantar fasciitis according to the shape of the foot arch in young adults.J Exerc Rehabil. 2018;14(3):497–502. doi:10.12965/jer.1836172.086
Rodríguez-Sanz D, Tovaruela-Carrión N, López-López D, et al. Foot disorders in the elderly: A mini-review. Dis Mon. 2018;64(3):64-91. doi:10.1016/j.disamonth.2017.08.001
Muchna A, Najafi B, Wendel CS, Schwenk M, Armstrong DG, Mohler J. Foot problems in older adults: associations with incident falls, frailty syndrome, and sensor-derived gait, balance, and physical activity measures. Journal of the American Podiatric Medical Association. 2018;108(2):126-139. doi:10.7547/15-186

Additional Reading

American Academy of Orthopaedic Surgeons. Posterior Tibial Tendon Dysfunction.
Arthritis Foundation. Anatomy of the Foot.
Mayo Clinic. Hammertoe and Mallet Toe.

By Elizabeth Quinn
Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics.

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Foot

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