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The foot is made up of many muscles, ligaments, tendons, and bones, which enable movement, flexibility, and stability. Dorsiflexion of the foot occurs at the ankle joint, and several muscles are involved in this movement. These include the tibialis anterior, extensor digitorum longus, extensor hallucis longus, and fibularis tertius. The ankle joint is one of the most valuable structures in the human body due to its intricate surfaces and function in ambulation.
| Characteristics | Values |
|---|---|
| Muscles involved in dorsiflexion | Tibialis anterior, extensor digitorum longus, extensor hallucis longus, fibularis tertius |
| Location of muscles | Anterior compartment of the leg |
| Dorsiflexion occurs at | The ankle joint |
| Dorsiflexion movement | Superior raising of mid- and forefoot while tibia and fibula remain static, causing an upward bend at the ankle joint |
| Nerve involved | Deep fibular nerve |
| Arterial supply | Anterior tibial artery |
| Foot drop | A symptom of neurological, anatomical, or muscular problems, caused by weakness of dorsiflexors |
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What You'll Learn
- The tibialis anterior is the strongest dorsiflexor of the foot
- The extensor digitorum longus lies laterally and deep to the tibialis anterior
- The extensor hallucis longus is positioned deep to the tibialis anterior and extensor digitorum longus
- The fibularis tertius muscle is not present in all individuals
- The posterior compartment muscles assist in plantar flexion and foot propulsion
The tibialis anterior is the strongest dorsiflexor of the foot
The tibialis anterior originates from the lateral surface of the tibia and attaches to the medial cuneiform and the base of metatarsal I. It is innervated by the deep fibular nerve. The eccentric lengthening of the tibialis anterior controls plantar flexion and absorbs the shock of heel strike.
The tibialis anterior is also considered to be part of an exclusive group of muscles in the body that invoke more excitability in the central nervous system and, therefore, produce higher results in resistance training when compared to other muscles. This is according to research by Griffin and Cafarelli in 2007.
Injuries to the tibialis anterior can result in foot drop, a commonly encountered symptom of a neurological, anatomical, or muscular problem. Foot drop is the inability to lift the forefoot due to the weakness of the dorsiflexors of the foot. Foot drop can also be caused by direct injury to the peroneal nerve, which can lead to palsy of the common peroneal nerve, resulting in weakness of the tibialis anterior and other key dorsiflexors of the foot.
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The extensor digitorum longus lies laterally and deep to the tibialis anterior
The extensor digitorum longus is a feather-like muscle of the anterior (extensor) compartment of the leg. This compartment also contains the tibialis anterior, which is the most superficial and anterior-facing muscle. The extensor digitorum longus lies laterally and deep to the tibialis anterior. The anterior tibial artery and vein pass between these two muscles. 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 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 (its most superior part). The part of its origin at the tibial condyle is fused with the originating fibres of the fibularis longus muscle. The muscle passes under the superior and inferior extensor retinaculum of the foot, along with the fibularis tertius. It divides into four slips, which run forward on the dorsum of the foot and are inserted into the second and third phalanges of the four lesser toes.
The primary action of the extensor digitorum longus is to extend the lateral four toes at the metatarsophalangeal joint. When acting independently, it is unable to extend the entire length of the toes, only extending at the metatarsophalangeal joint, while the toes remain flexed at the interphalangeal joints. However, when contracting together with the lumbricals, which are the main extensors of the interphalangeal joints, this muscle contributes to extension at every joint between the bones of the lateral four toes.
Acting in synergy with the tibialis anterior, the extensor digitorum longus participates in dorsiflexion of the foot. Dorsiflexion is the upward bending of the mid- and forefoot at the ankle joint while the tibia and fibula remain static. The other muscles involved in this movement are the fibularis tertius, extensor hallucis longus, and tibialis anterior.
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The extensor hallucis longus is positioned deep to the tibialis anterior and extensor digitorum longus
The extensor hallucis longus is a thin muscle that extends from the middle third of the fibula to the distal phalanx of the big toe. It is a key muscle located in the anterior compartment of the lower leg, alongside the tibialis anterior, extensor digitorum longus, and fibularis tertius muscles.
The main function of the extensor hallucis longus is to extend the big toe, which occurs in both the metatarsophalangeal and interphalangeal joints. This extension is crucial for walking and running, as it helps to prevent losing balance and falling backwards when the foot is fixed on the ground. In addition to its primary function of extending the big toe, the extensor hallucis longus also assists with foot eversion and inversion, and plays a role in dorsiflexion of the foot at the ankle joint.
Weakness of the extensor hallucis longus can lead to issues such as the toe folding under the foot when putting on socks or shoes, and can cause tripping. Hyperextension of the big toe can also result in pain and calluses on the dorsal surface of the interphalangeal joint. Exercises such as big toe lifts and extensions with heel raises can help to strengthen the extensor hallucis longus and improve its range of motion.
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The fibularis tertius muscle is not present in all individuals
The fibularis tertius muscle, also known as the peroneus tertius, is a thin, unipennate skeletal muscle located in the anterior compartment of the leg. It is one of three fibularis muscles, alongside the fibularis longus and fibularis brevis. The fibularis tertius extends from the distal end of the fibula to the base of the fifth metatarsal bone, spanning the talocrural (ankle) and subtalar joints.
The presence of the fibularis tertius muscle varies among individuals and populations. In some individuals, the muscle is absent altogether, while in others, it forms part of the extensor digitorum longus muscle, being described as its ''fifth tendon'. Studies have found that the muscle was present in less than 50% of a Chilean sample population and 63% of a south-western Nigerian sample population.
Despite its absence in some individuals, the fibularis tertius muscle is not essential for normal movement. Its actions can be efficiently completed by other, more powerful muscles. The strength of eversion and dorsiflexion is not compromised in people who lack the fibularis tertius muscle, and it does not appear to provide higher protection against ankle ligamentous injuries.
The fibularis tertius is considered a weak dorsiflexor and evertor of the foot due to its small size and poor mechanical leverage. It receives innervation from the deep fibular nerve, a branch of the sciatic nerve, and arterial blood from several sources, including the anterior tibial artery and the dorsalis pedis artery.
The tendon of the fibularis tertius muscle can be palpated by dorsiflexing the foot and toes against resistance. It can be felt laterally within the shallow depression located anterior to the lateral malleolus. A tear in this tendon can result in pain and swelling over this specific area.
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The posterior compartment muscles assist in plantar flexion and foot propulsion
The foot has two types of muscles: extrinsic and intrinsic. Extrinsic muscles are responsible for gross motor movements like plantar flexion, dorsiflexion, inversion, and eversion. On the other hand, intrinsic muscles are responsible for more fine motor movements like digit flexion, extension, and abduction.
Dorsiflexion of the foot occurs at the ankle joint, with the help of muscles in the anterior compartment of the leg: tibialis anterior, extensor digitorum longus, extensor hallucis longus, and fibularis tertius. The posterior leg muscles, on the other hand, restrict this movement.
The posterior compartment muscles, located at the back of the leg, assist in plantar flexion and foot propulsion. These include the gastrocnemius, soleus, and the triceps surae group of muscles, which include the gastrocnemius, soleus, and their common tendon, the Achilles tendon. The tibialis posterior, flexor digitorum longus, and flexor hallucis longus are also part of the posterior compartment muscles and contribute to plantar flexion.
The plantar fascia, a band of connective tissue that runs along the bottom of the foot, also plays a role in foot propulsion. During the support phase of walking, the plantar fascia elongates and behaves like a spring, assisting in energy conservation. When the toes are dorsiflexed during the propulsive phase of gait, the plantar fascia becomes tense and elevates the longitudinal arch, contributing to forward movement.
In summary, the posterior compartment muscles, including the gastrocnemius, soleus, triceps surae group, tibialis posterior, flexor digitorum longus, and flexor hallucis longus, assist in plantar flexion and foot propulsion during activities such as walking, running, and jumping. The plantar fascia also contributes to foot propulsion by storing and returning energy during the gait cycle.
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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.
Foot drop, or drop foot, is the inability to lift the forefoot due to weakness in the dorsiflexors of the foot. It is not a disease but a symptom of a neurological, anatomical, or muscular problem.
Foot drop can be caused by direct injury or trauma to the dorsiflexors, peripheral nerve injuries, stroke, neuropathies, drug toxicities, or diabetes. It can also be caused by compression of the sciatic nerve between the two heads of the piriformis muscle.
Treatment for foot drop depends on the specific cause and can vary from surgical repair to nerve grafting or the use of an ankle-foot orthosis (AFO) to improve function.
