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Medial plantar muscles of the foot: want to learn more about it?

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Medial plantar muscles of the foot

The plantar muscles of the foot are traditionally studied in either layers or groups. If studying by layers, we can organise these muscles into four primary layers:

The plantar muscles of the foot can alternatively be considered by medial, central and lateral groups.

This article will discuss the medial plantar muscles

Key facts about the medial plantar muscles
Abductor hallucis muscle
Origins: Medial process of calcaneal tuberosity, Flexor retinaculum, Plantar aponeurosis
Insertions: Base of proximal phalanx of great toe
Innervation: Medial plantar nerve (S1-S3)
Functions: Metatarsophalangeal joint 1: Toe abduction, Toe flexion; Support of longitudinal arch of foot
Adductor hallucis muscle
Origins: Oblique head: bases metatarsal bones 2-4, Cuboid bone, Lateral cuneiform bone
Transverse head: plantar metatarsophalangeal ligaments of toes 3-5
Insertions: Lateral aspect of base of proximal phalanx of great toe
Innervation: Lateral plantar nerve (S2,S3)
Functions: Metatarsophalangeal joint 1: Toe adduction, Toe flexion; Support of longitudinal and transverse arches of foot
Flexor hallucis brevis muscle
Origins: Tendon of tibialis posterior, Medial cuneiform bone, Lateral cuneiform bone, Cuboid bone
Insertions: Lateral and medial aspects of base of promixal phalanx of great toe
Innervation: Medial plantar nerve (S1,S2)
Functions: Metatarsophalangeal joint 1: Toe flexion; Support of longitudinal arch of foot
Mnemonic Muscles innervated by the medial plantar nerve can be remembered as LAFF muscles
(stands for: first Lumbrical, Abductor hallucis, Flexor digitorum brevis, Flexor hallucis brevis)

Anatomy and supply

Medial plantar muscles

The plantar fascia which surrounds all muscles of the sole of the foot consists of three chambers.

The muscles lying within the medial group form a bulge referred to as the 'ball' of the big toe. It contributes to the surface anatomy of the medial sole of the foot and is easy to palpate.

The medial plantar muscles are innervated by motor branches of the tibial nerve (L5-S2). 

Abductor hallucis muscle

The abductor hallucis has its origin at the medial process of the calcaneal tuberosity, plantar aponeurosis and the superficial layer of the flexor retinaculum. Its tendon runs distally to the medial sesamoid bone of the great toe and inserts into the base of the proximal phalanx of the big toe.

The muscle is innervated by the medial plantar nerve.

Adductor hallucis muscle

Adductor hallucis is anatomically located in the central compartment of foot, but the muscle is functionally grouped with the medial plantar muscles of foot because it acts on the great toe (hallux). The adductor hallucis has two heads:

  • The transverse head originates at the 3rd to 5th metatarsophalangeal joint and the deep transverse metatarsal ligament.
  • The oblique head arises at the cuboid bone, the lateral cuneiform bone and the bases of the 2nd to 4th metatarsal bones. It may also/alternatively have an attachment to the sheath of the fibularis longus tendon.  To be precise the oblique head does not lie within the medial but central group of the plantar fascia.

Both heads form a common tendon, which runs along the lateral sesamoid bone of the great toe, and inserts at the base of the proximal phalanx of the big toe.

The innervation is supplied by the lateral plantar nerve.

Flexor hallucis brevis muscle

The FHB originates at the lateral cuneiform bone and cuboid bone. It may also have attachments to the medial cuneiform bone, the plantar calcaneocuboid ligament and the tendon of tibialis posterior.

Its insertions are located at the base of the proximal phalanx of the great toe, via the the medial (medial head) and lateral (lateral head) sesamoid bones. 

While the medial head is innervated by the medial plantar nerve, the lateral head is supplied by the lateral plantar nerve (double innervation).

Anatomical relations

In addition to the three above mentioned muscles there are more structures lying in the medial group of the plantar fascia e.g. the tendon of the flexor hallucis longus muscle; blood vessels and nerves of the medial foot sole (medial plantar artery and vein, medial plantar nerve).

Function

The medial muscles of the foot sole have various tasks:

  • First of all they act upon the metatarsophalangeal joint of the big toe,  leading to the abduction (abductor hallucis muscle), adduction (adductor hallucis muscle) and flexion (both flexor hallucis brevis and adductor hallucis muscle) of the big toe. 
Longitudinal arch of the foot (lateral view)
  • Furthermore they actively support the structure of the arches of the foot. While all three muscles stabilize the longitudinal arch, the transverse head of the adductor hallucis muscle is the only muscle securing the transverse arch.

Medial plantar muscles of the foot: want to learn more about it?

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