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Dorsiflexion is the backward bending and contracting of the foot at the ankle joint. The muscles that enable this movement are located in the anterior compartment of the leg and include the tibialis anterior, extensor digitorum longus, extensor hallucis longus, and fibularis tertius. The posterior leg muscles, on the other hand, restrict dorsiflexion. Injuries to the dorsiflexors can result in a condition known as foot drop, where the foot slaps the ground during walking.
| Characteristics | Values |
|---|---|
| Muscles that dorsiflex the foot | Tibialis anterior, extensor digitorum longus, extensor hallucis longus, and fibularis tertius |
| Location of muscles | Anterior compartment of the leg |
| Dorsiflexion | Backward bending and contracting of the foot |
| Dorsiflexion occurrence | At the ankle joint |
| Dorsiflexion range | 0-16.5o to 0-25o |
| Dorsiflexion function | Lifting the foot and toes to prevent them from dragging along the ground |
| Dorsiflexion and the tibia | The tibia remains static during dorsiflexion |
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What You'll Learn
Tibialis Anterior
The tibialis anterior muscle is a fusiform muscle found in the anterior part of the leg. It is the most superficial and anterior-facing muscle in the anterior compartment of the leg. The tibialis anterior is thick and fleshy above and tendinous below, with fibres that run vertically downward. It is inserted into the medial and inferior surface of the medial cuneiform bone and the adjacent portion of the first metatarsal bone. The muscle is innervated by the deep fibular nerve, and recurrent genicular nerve (L4).
The tibialis anterior muscle plays a crucial role in stabilising the ankle joint as the foot makes contact with the ground during the contact phase of walking. It helps to absorb the shock of the heel strike by controlling plantar flexion. It also aids in pulling the foot clear of the ground during the swing phase of walking. This muscle is responsible for dorsiflexion and inversion of the foot, which is the upward bending of the mid- and forefoot while the tibia and fibula remain static. The tibialis anterior is the primary dorsiflexor of the ankle, with the synergistic action of the extensor hallucis longus, extensor digitorum longus, and peroneous tertius.
The tibialis anterior is essential for maintaining the medial longitudinal arch of the foot. It helps to draw up and hold the toe in a locked position, which is important for activities such as toe-kicking a ball. The muscle also contributes to balance by stabilising the talus and other tarsal bones, allowing the leg to remain vertical even when walking on uneven ground.
Injuries to the tibialis anterior can result in a condition known as "shin splints" or medial tibial stress syndrome (MTSS). This is characterised by pain along the anterior edge of the tibia and is commonly seen in runners and military personnel due to excessive physical activity. Treatment for shin splints typically involves rest, with nonsteroidal anti-inflammatory drugs (NSAIDs) and ice used to relieve symptoms.
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Extensor Digitorum Longus
The extensor digitorum longus (EDL) is a pennate muscle located in the anterior (extensor) compartment of the leg, alongside three other muscles: the tibialis anterior, extensor hallucis longus, and fibularis (peroneus) tertius. The EDL is the most lateral muscle in the anterior compartment, situated at the lateral part of the front of the leg.
The extensor digitorum longus originates from the inferior part of the lateral tibial condyle, the proximal half of the medial surface of the fibula, and the anterior surface of the interosseus membrane. The muscle then descends inferiorly and, just above the ankle, gives off a tendon that passes under the superior and inferior extensor retinaculum of the foot. Within the inferior extensor retinaculum, the tendon splits into four smaller tendons that are all wrapped together in a synovial sheath. These tendons run forward on the dorsum of the foot and are inserted into the second, third, and fourth phalanges of the four lesser toes.
The extensor digitorum longus is innervated by the deep fibular nerve (L5, S1), a branch of the common fibular nerve. The leg portion of the muscle is supplied by two arteries of the leg: the proximal part is supplied by the anterior tibial artery, while the distal part receives blood from the fibular artery. The tendons of the muscle are vascularized by the anterior lateral malleolar, lateral tarsal, metatarsal, plantar, and digital arteries.
The extensor digitorum longus is one of the muscles that dorsiflex the foot, along with the tibialis anterior, extensor hallucis longus, and fibularis tertius. As the EDL crosses the subtalar, metatarsophalangeal, and interphalangeal joints of the foot, it also everses the foot and extends the toes.
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Extensor Hallucis Longus
The extensor hallucis longus (EHL) is a thin skeletal muscle located in the anterior compartment of the lower leg. It is one of four muscles in this compartment, alongside the extensor digitorum longus, tibialis anterior, and fibularis tertius muscles. The EHL is situated between the tibialis anterior and the extensor digitorum longus.
The EHL originates from the anteromedial aspect of the fibula, extending to the anterior aspect of the interosseous membrane of the leg, which is located between the fibula and tibia. The muscle then runs inferomedially towards the foot, ending in a tendon. The tendon passes through a distinct compartment in the inferior extensor retinaculum of the foot. It crosses the anterior tibial vessels laterally near the bend of the ankle. In the foot, the tendon is situated along the medial side of the dorsum of the foot. The tendon gives off a thin prolongation on either side, covering the surface of the metatarsophalangeal joint. An expansion from the medial side of the tendon is usually inserted into the base of the proximal phalanx.
The EHL's main function is to extend the big toe (hallux), which occurs at both the metatarsophalangeal and interphalangeal joints. This extension is crucial for walking and running. Additionally, the EHL assists with foot eversion and inversion and dorsiflexion of the ankle.
Weakness of the EHL can cause the toe to fold under the foot when putting on socks or shoes and can lead to tripping. Hyperextension of the great toe can also cause pain and calluses, or corns, on the dorsal surface of the interphalangeal joint. Exercises such as big toe lifts, big toe extension with heel raises, and short foot exercises can help improve isolation, range of motion, and strength of the EHL.
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Fibularis Tertius
The fibularis tertius (also known as the peroneus tertius) is a muscle in the anterior compartment of the leg. It is one of the three fibularis muscles, alongside the fibularis longus and fibularis brevis. The fibularis tertius is the most superficial muscle in the anterior compartment of the leg.
The fibularis tertius arises from the lower third of the front surface of the fibula, the lower part of the interosseous membrane, and the septum (or connective tissue) between it and the fibularis brevis. The septum is sometimes called the intermuscular septum of Otto. The muscle passes downward and ends in a tendon that passes under the superior extensor retinaculum and the inferior extensor retinaculum of the foot in the same canal as the extensor digitorum longus muscle. The tendon inserts into the medial part of the posterior surface of the shaft of the fifth metatarsal bone. The fibularis tertius is located anterior to the fibularis brevis muscle and the anterior lateral malleolar artery.
The fibularis tertius is supplied by the deep fibular nerve, a branch of the sciatic nerve. In rare cases, it may also be supplied by the common fibular nerve. The fibularis tertius receives arterial blood from the anterior tibial artery, the dorsalis pedis artery and its branches, the posterior tibial artery, and more.
The fibularis tertius acts to tilt the sole of the foot away from the midline of the body (eversion) and to pull the foot upward toward the body (dorsiflexion). It is considered a weak dorsiflexor and evertor of the foot due to its relative small size and poor mechanical leverage. The fibularis tertius has a role in the gait cycle, acting with other foot dorsiflexors during the swing phase to clear the foot and toes off the ground. It also has supporting functions for the ankle joint, preventing excessive inversion of the foot during physical activities.
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Fibularis Brevis
The fibularis brevis, or peroneus brevis, is a short muscle that, along with the fibularis longus, forms the group of lateral leg muscles. It is one of the three ankle everters known as the fibularis muscles, the others being the fibularis longus and fibularis tertius. The fibularis brevis is the strongest abductor of the foot.
The fibularis brevis originates from the distal two-thirds of the lateral surface of the fibula and the adjacent part of the anterior intermuscular septum. The muscle fibres course inferomedially along the lateral border of the fibula, forming a fusiform muscle belly. The tendon of the fibularis brevis passes downwards and loops posterior to the lateral malleolus, before inserting on the styloid process at the proximal end of the fifth metatarsal.
The main function of the fibularis brevis is to evert the foot at the subtalar joint, which helps to restore the foot to its anatomical position after it has been inverted. This is particularly important when running or walking on uneven terrain, as it may also prevent the body from falling to the opposite side when balancing on one leg. The fibularis brevis also assists in plantar flexion, extending the foot downward away from the body at the ankle.
The most common injuries to the fibularis brevis are to the tendon, including tendinopathy, dislocation/subluxation, sprain, and splitting. The tendon is susceptible to injury, and tears are a common source of lateral ankle pain. Inversion or supination forces can cause tendon injuries, and a lateral ankle sprain can result in a tear and cause swelling at the lateral ankle.
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Frequently asked questions
The muscles that dorsiflex the foot are the tibialis anterior, extensor digitorum longus, extensor hallucis longus, and fibularis tertius.
These muscles are located in the anterior compartment of the leg.
Dorsiflexion is the backward bending and contracting of the foot at the ankle joint.
