Understanding the Human Foot by James Earls

Author:James Earls
Language: eng
Format: epub
Publisher: North Atlantic Books

As with the musculoskeletal descriptions we have explored so far in this chapter, anatomy texts often condition us to highlight the longitudinal arrangement of musculoskeletal tissues. Longitudinal force transfer is only one part—albeit a significant one—of the story, as force can also transfer horizontally from one muscle to its neighbors and beyond. This relatively new area of investigation by researchers is revealing numerous benefits of the web-like continuity of the fascial tissues, as they appear to play roles in the transmission and amplification of force as well as enhancing proprioception.

Transfer of force beyond the “normal” boundary of a muscle is only surprising because of the separation of tissues we see in anatomy texts. The over-used but informative analogy of an orange gives a different image of anatomical arrangements—cutting across the hemisphere of the orange reveals its integrity and connectivity. Although the pattern reveals the position of orange segments and their “borders” it also shows the continuity of fiber from one segment to the next. Just as individual orange segments are outcomes of their dissection, so too are the muscles of the body.

The ability to transfer force from beyond an MTU, referred to as extramuscular force transmission, relies on that same continuity of fiber. Different sections of tissue vary in function and their constituents are adjusted to fit accordingly, but the change from tendon to ligament and joint capsule, or from epimysium to loose connective tissue (see fig. 1.13), are transitions of interconnected cell types. Barring accidents and surgeries, there are no gaps or separations in the body.

Before venturing into force transfer across muscles we must first address a never-ending issue within anatomy—that of vocabulary. There is an inherent problem in empowering an appreciation of anatomical parts as it gives the impression they act as independent agents. How does one describe the form and function of a muscle without giving the impression of it being a discrete unit? To dissect and to name bestows the power of description from which understanding can come. However, that description simultaneously removes the unit from its environment and its many relationships beyond its apparent borders. As we are trying to emphasize the interaction of the body, especially during movement, we must acknowledge the limiting effect of vocabulary to first allow us to build a larger gestalt. So, while it may be true to say that orange segments do not exist within the orange but are an outcome of manual separation, for the sake of narrative clarity we must accept a descriptive necessity and break the anatomical whole into its functional components.

With the above caveat in mind, the leg can be divided into four compartments4—anterior (tibialis anterior, extensor digitorum longus, and extensor hallucis longus), lateral (fibularis longus and fibularis brevis), posterior (gastrocnemius, soleus, and plantaris), and deep posterior (tibialis posterior, flexor digitorum longus, and flexor hallucis longus)—and the foot is also compartmentalized into four or nine sections, depending on one’s choice of reference (for future reference we will use just four).

The body is all compartmentalized, it

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