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The foot has a wide range of motions, including inversion and eversion. Inversion is a movement of the foot that causes the soles to face inwards, and it occurs primarily at the talocalcaneonavicular and subtalar joints. The muscles responsible for inversion of the foot are the tibialis anterior and tibialis posterior. The tibialis anterior is the strongest dorsiflexor of the foot, and it originates from the lateral surface of the tibia, attaching to the base of the big toe. The tibialis posterior, on the other hand, is the deepest-lying muscle in the posterior compartment, originating from the tibia and fibula and attaching to the plantar surfaces of the toes. These muscles play a crucial role in controlling foot movement and maintaining stability.
| Characteristics | Values |
|---|---|
| Inversion of the foot | Movement of the foot which causes the soles of the feet to face inwards |
| Eversion of the foot | Tilting of the foot so the sole faces away from the midline |
| Muscles that cause inversion of the foot | Tibialis anterior, Tibialis posterior |
| Muscles that cause eversion of the foot | Peroneus longus, Peroneus brevis |
| Range of motion for inversion of the foot at the subtalar joint | 25° to 30° |
| Range of motion for inversion of the foot at the transverse tarsal joint | 8° to 10° |
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What You'll Learn
Tibialis anterior
The tibialis anterior muscle is located on the lateral side of the tibia and is the strongest dorsiflexor of the foot. It originates from the upper two-thirds of the lateral surface of the tibia and the adjoining part of the interosseous membrane and deep fascia. The fibres of the tibialis anterior run vertically downward, ending in a tendon that is apparent on the anterior surface of the muscle at the lower third of the leg. This tendon usually passes beneath the extensor retinaculum, which holds it in place. The tibialis anterior is one of the muscles that tend to be inhibited and underactive, which can lead to overactivity of the synergistic muscles: extensor hallicus longus, extensor digitorium longus, and peroneous tertius.
The tibialis anterior muscle aids in any activity that requires moving the leg or keeping the leg vertical. It functions to stabilise the ankle as the foot hits the ground during the contact phase of walking (eccentric contraction) and acts later to pull the foot clear of the ground during the swing phase (concentric contraction). It also helps to maintain the medial arch of the foot and draws up and holds the toe in a locked position. This muscle acts as the main foot dorsiflexor on the talocrural joint, but it also inverses the foot at the subtalar joint. Both actions play important roles in the gait cycle.
The range of motion for inversion of the foot at the subtalar joint ranges from 25° to 30°, while it is considerably less at the transverse tarsal joint, ranging from 8° to 10°. Inversion is a movement of the foot that causes the soles of the feet to face inwards, and it is produced primarily by the tibialis anterior and tibialis posterior muscles. Eversion is the opposite movement, where the sole of the foot faces away from the midline.
Excessive physical activity, especially among runners and military personnel, can result in repetitive microtrauma of the tibialis anterior, causing pain along the anterior edge of the tibia known as anterior shin splints or anterior tibial stress syndrome. This condition generally resolves spontaneously during periods of rest, and nonsteroidal anti-inflammatory drugs (NSAIDs) and ice can be used to relieve symptoms. A tibialis anterior hernia is a rare type of hernia where fat or other material protrudes through a defect in the muscle, often caused by trauma such as an inadvertent kick to the lower leg.
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Tibialis posterior
The tibialis posterior is the deepest muscle of the deep posterior compartment of the lower leg. It is a key stabilising muscle that supports the medial arch of the foot. The muscle is primarily responsible for plantar flexion and inversion of the foot. It originates from the tibia and fibula and attaches to the plantar surfaces of the toes.
The tibialis posterior is a primary inverter of the foot. This inversion happens at two synovial joints of the foot: the midtarsal joint, between the talus and navicular bone, and the subtalar joint, between the talus and calcaneus. The range of motion for inversion of the foot at the subtalar joint ranges from 25° to 30°.
The tibialis posterior tendon (TPT) travels distally, then posterior to the medial malleolus along with the FDL tendons, posterior tibial artery, tibial nerve, and FHL. Once the TPT travels distal to the medial malleolus, it courses along the plantar aspect of the foot, where it splits into three components: primary, plantar, and recurrent. This split allows for the broad attachment site of the tibialis posterior tendon. The main portion inserts primarily onto the navicular bone tubercle, as well as the plantar sections of the medial cuneiform. The plantar portion inserts onto the base of the second, third, and fourth metatarsals, along with the second and third cuneiform and the cuboid.
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Subtalar joint
The subtalar joint, also known as the talocalcaneal joint, is a joint of the foot. It is formed by the meeting of the talus and calcaneus, two of the tarsal bones in the foot. The subtalar joint is structurally a synovial joint and functionally a plane synovial joint, also referred to as a gliding joint. It acts as a hinge, connecting the two bones and allowing for the inversion and eversion of the foot, or the tilting of the foot so that the sole faces towards or away from the body's midline. The subtalar joint has a range of motion for inversion of the foot of 25° to 30°.
The subtalar joint is enclosed by a joint capsule, which is lined internally by a synovial membrane and strengthened externally by a fibrous layer. The capsule is supported by three ligaments: the cervical ligament, the interosseous talocalcaneal ligament, and the extrinsic calcaneo-fibular ligament. There are four additional ligaments that form weaker connections between the talus and calcaneus. The interosseous talocalcaneal ligament is particularly strong and provides the majority of the ligamentous stability to the joint.
The subtalar joint is essential for mobility and is key to functional activities such as walking and running. However, it is prone to degeneration and trauma due to its weight-bearing nature. Damage to the subtalar joint can lead to pain, foot deformity, and gait and mobility issues. The joint is also susceptible to arthritis, especially following sprains or fractures of the calcaneus or talus. Symptoms of subtalar joint arthritis include pain when walking, loss of motion, and difficulty walking on uneven surfaces.
The muscles that cause inversion of the foot at the subtalar joint are the tibialis anterior and tibialis posterior. These muscles produce supination, or the rolling of the foot towards the body's midline. The range of motion for inversion is greater at the subtalar joint than at the transverse tarsal joint, where it ranges from 8° to 10°.
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Talocalcaneonavicular joint
The talocalcaneonavicular joint is a ball-and-socket joint in the foot. It is formed by three tarsal bones: the talus, calcaneus, and navicular bones. The socket of the joint is formed by the concave articular facets of the navicular, calcaneus, calcaneonavicular part of the bifurcate ligament, and the plantar calcaneonavicular ligament (also known as the spring ligament). The ball is formed by the convex talus.
The talocalcaneonavicular joint is considered a functional unit with the subtalar (talocalcaneal) joint, which is located posteriorly. The two joints are often referred to collectively as the subtalar joint in clinical practice due to their simultaneous movement.
The talocalcaneonavicular joint permits gliding and rotational movements, allowing inversion and eversion of the foot. Inversion refers to the movement of the foot that causes the soles of the feet to face inwards, while eversion is the opposite movement. The muscles that cause inversion of the foot are the tibialis anterior and tibialis posterior.
The joint capsule of the talocalcaneonavicular joint is present on the dorsal and proximal aspects of the articulation. The dorsal component of the capsule extends from the neck of the talus to the dorsal margin of the proximal articular surface of the navicular bone. The proximal part of the joint capsule is better developed and is found within the tarsal sinus. This part forms the strong talocalcaneal interosseous ligament, along with the anterior part of the talocalcaneal joint capsule.
There are three principal ligaments associated with the talocalcaneonavicular joint: the dorsal talonavicular ligament, plantar calcaneonavicular ligament, and calcaneocuboid part of the bifurcate ligament. The bifurcate ligament is a Y-shaped structure that runs from the dorsolateral surface of the calcaneus and divides into two separate parts: the calcaneocuboid and the calcaneonavicular parts. The calcaneonavicular part of this ligament is significant for the talocalcaneonavicular joint as it participates in the formation of the acetabulum pedis.
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Ankle injuries
Inversion ankle sprains are particularly common in sports, accounting for about 40% of athletic injuries. They can occur when an athlete steps or lands on another athlete's foot, or due to walking on an uneven surface. Inversion injuries can also be caused by a previous injury, where the ankle has not healed properly, leading to progressive deterioration and ankle instability.
The PRICE (Protection, Rest, Ice, Compression, and Elevation) method is advised in the first 24-48 hours following an ankle injury. This helps to manage symptoms and prevent further damage. Rest involves avoiding activities that may aggravate the injury, allowing the ligaments to heal. Ice is applied for 15-20 minutes every few hours to reduce swelling and pain. Compression with an elastic bandage supports the ankle and further reduces swelling.
If you suspect an ankle injury, it is important to seek medical attention from a qualified professional. They may refer you to a physical therapist to aid in your recovery and prevent future injuries. In severe cases, surgery may be required to reconstruct damaged tissue.
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Frequently asked questions
The muscles that cause inversion of the foot are the tibialis anterior and tibialis posterior.
Inversion of the foot is a movement that causes the soles of the feet to face inwards. The opposite movement is eversion.
The tibialis anterior muscle is located alongside the lateral surface of the tibia and is the strongest dorsiflexor of the foot. The tibialis posterior is the deepest muscle in the posterior compartment. It originates from the tibia and fibula and attaches to the plantar surfaces of the toes.
