Logan Steele
Plantar flexion is the movement that occurs at the ankle when the top of the foot points away from the leg, towards the floor. This movement is used in many daily activities, such as pressing the foot down on a car's gas pedal or standing on tiptoes to reach a high shelf. It is also used in several sports, including ballet, where it is used to dance en pointe, swimming, running, and cycling. Plantar flexion is made possible by several muscles in the ankle, foot, and leg. These include the gastrocnemius, soleus, plantaris, flexor hallucis longus, flexor digitorum longus, tibialis posterior, peroneus longus, and peroneus brevis.
| Characteristics | Values |
|---|---|
| Definition | Plantar flexion is a movement in which the top of the foot points away from the leg. |
| Muscles Involved | Gastrocnemius, Soleus, Plantaris, Flexor Hallucis Longus, Flexor Digitorum Longus, Tibialis Posterior, Peroneus Longus, Peroneus Brevis |
| Function | Standing on tiptoes, pressing the foot down on the gas pedal in a car, standing on the tips of the toes to reach something, ballet dancing en pointe, walking, running, swimming, dancing, and riding a bicycle. |
| Range of Motion | 20 to 50 degrees from the resting position. |
| Injuries | Any injury to the muscles supporting plantar flexion can limit the range of motion and affect the ability to perform activities requiring plantar flexion. Common injuries include ankle sprains and anterior talofibular ligament strain. |
| Prevention | Strengthening exercises, proper footwear, and avoiding high heels can help prevent injuries. |
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What You'll Learn
Gastrocnemius, soleus, and plantaris muscles
Plantar flexion is a movement in which the top of the foot points away from the leg. It is used in many daily activities, such as pressing the foot down on a car pedal, standing on tiptoes to reach something, and riding a bicycle. Several muscles control plantar flexion, including the gastrocnemius, soleus, and plantaris muscles.
The gastrocnemius is a muscle that forms half of what is commonly called the calf muscle. It starts at the back of the knee and attaches to the Achilles tendon at the heel. The gastrocnemius is one of the muscles that does most of the work in plantar flexion. It is a broad and strong muscle that merges with the soleus muscle to create the Achilles tendon at the heel.
The soleus muscle is the other main component of the calf muscle. It is a deep muscle that starts behind the knee and runs beneath the gastrocnemius. The soleus connects to the tibia and fibula (the bones in the lower leg) and, together with the gastrocnemius, helps with activities such as walking, running, and jumping. It is also responsible for pushing the foot away from the ground, making it vital for any movement involving plantar flexion.
The plantaris is a small muscle that runs between the gastrocnemius and soleus down the length of the lower leg. It is sometimes considered an accessory muscle, as it is absent in about 10% of people. The plantaris works in conjunction with the Achilles tendon to flex the ankle and knee. It aids in providing steadiness, which is important for activities such as ballet dancing, where graceful movements require stability during extreme plantar flexion.
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Tibialis posterior
The tibialis posterior is a small muscle located deep in the lower leg, between the flexor digitorum longus and the flexor hallucis longus. It is the most central of all the leg muscles and is a key stabilising muscle, supporting the medial arch of the foot.
The tibialis posterior is involved with plantar flexion and inversion—when you turn the sole of the foot inward toward the other foot. It works with the peroneus longus to keep your ankle stable while you stand on tiptoe. The peroneus longus runs along the side of the lower leg to the big toe and is involved in plantar flexion and eversion, when you turn the sole of the foot outward, away from the other foot.
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. The recurrent portion has a small insertion site at the sustentaculum tali of the calcaneus.
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 tibialis posterior originates from the posterior compartment of the lower leg, so it is also a secondary plantar flexor of the foot, along with the gastrocnemius, soleus, and plantaris muscles.
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Peroneus longus
The peroneus longus, also known as the fibularis longus, is a superficial muscle in the lateral compartment of the leg. It is the longest and most superficial of the three fibularis (peroneus) muscles. At its upper end, it attaches to the head of the fibula, with its "belly" running down along most of this bone. The muscle then becomes a tendon that wraps around and behind the lateral malleolus of the ankle, continuing under the foot to attach to the medial cuneiform and first metatarsal.
The peroneus longus is involved in plantar flexion and eversion of the foot and ankle. In plantar flexion, the foot points down and away from the leg, and the peroneus longus muscle acts to lift the foot upward. In eversion, the peroneus longus tilts the sole of the foot away from the body's midline. This movement is critical to the eversion of the foot and can be injured by forced inversion and dorsiflexion of the ankle in the setting of trauma.
The peroneus longus is susceptible to various pathologies, including tendonitis, dislocation, subluxation, rupture, and chronic tears. Peroneal tendon injuries are common in young, active individuals and those participating in sports such as football, soccer, and running. An injury to the peroneus longus tendon can cause lateral ankle pain and ankle instability.
The anterior tibial artery and peroneal artery supply the peroneus longus muscle. The anterior tibial artery arises from the popliteal artery, which originates from the superficial femoral artery, a branch of the common femoral artery.
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Peroneus brevis
The Peroneus brevis (also known as the fibularis brevis) is a short muscle located in the lateral compartment of the lower extremity below the knee. It is one of the three ankle everters, or fibularis muscles, along with the fibularis longus and fibularis tertius. The fibularis brevis is the strongest abductor of the foot and is responsible for 63% of the power needed to evert the foot. It also assists in plantar flexion, which is the movement of pointing the toes downwards and away from the leg.
The fibularis brevis originates from the distal two-thirds of the lateral fibula, and its tendon passes downwards, looping posterior to the lateral malleolus. The fibularis brevis inserts on the proximal end of the fifth metatarsal. The average length of the fibularis brevis tendon is 79.6mm, with a width of 4.46mm and 14.85mm at its midpoint and insertion, respectively. The tendon of the fibularis brevis is the most commonly dislocated tendon in the ankle, and injuries to this tendon are usually caused by inversion or supination forces.
The fibularis brevis receives innervation from the superficial peroneal nerve, and its arterial supply is provided by muscular branches of the peroneal artery. It is relevant to occupational medicine due to its frequent involvement in lateral ankle sprains.
The fibularis brevis works together with the fibularis longus to steady the leg upon the foot, especially when standing on one leg. They also work together to assist in plantar flexion. An injury to the fibularis brevis may weaken the ability to perform plantar flexion, limiting the range of motion and affecting the ability to perform activities that require plantar flexion.
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Flexor hallucis longus and flexor digitorum longus
Plantar flexion is a movement in which the top of the foot points away from the leg. It is used in many daily activities, such as pressing the foot down on a car's gas pedal, standing on tiptoes to reach something, or riding a bicycle. This movement requires the coordination of several muscles in the ankle, foot, and leg.
The flexor hallucis longus is a powerful muscle located on the posterior aspect of the fibula. It runs down the lower leg to the big toe and helps flex the big toe, allowing people to walk and maintain balance while on their tiptoes. The tendon of the flexor hallucis longus passes downwards, deep to the flexor retinaculum, crossing the posterior ankle joint and connecting to the flexor digitorum longus tendon.
The flexor digitorum longus is another deep muscle in the lower leg. It starts thin and gradually widens as it moves down the leg. It is responsible for the flexion of the second to fifth toes in the foot. The flexor digitorum longus provides the power to flex the toes and aids in balance while standing.
Injuries to the flexor hallucis longus and flexor digitorum longus muscles can affect plantar flexion and limit the range of motion in the foot. Tendonitis of the flexor hallucis longus, for example, is common in ballet dancers, gymnasts, and runners due to excessive use of toe flexion. Rehabilitation for these injuries may include stretching and strengthening exercises, such as walking or running on different surfaces to challenge the function of these muscles.
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Frequently asked questions
Plantar flexion is the movement that occurs at the ankle where the foot is pointed downwards, such as when standing on tiptoes.
Several muscles in the ankle, foot, and leg are involved in plantar flexion. These include the gastrocnemius, soleus, plantaris, flexor hallucis longus, flexor digitorum longus, tibialis posterior, peroneus longus, and peroneus brevis.
An injury to any of the muscles supporting plantar flexion can limit the range of motion and affect the ability to perform activities that require plantar flexion, such as standing on tiptoes.
To prevent injuries, it is important to strengthen the muscles in the ankle, leg, and foot that support plantar flexion. Wearing proper footwear and avoiding high heels can also help reduce the risk of injuries.
