The foot and the ankle have 26 bones between them. There are 33 joints in the foot and more than 100 muscles, tendons and ligaments.
It is a mechanically complex structure of immense strength and it can sustain enormous pressure, often much more than the actual body weight, especially over the course of a lengthy run.
The ankle is the main shock absorber and helps to propel you forward. If something goes wrong in the structure of the foot, it often has far-reaching effects on other parts of the body.
The foot is structurally divided into three main parts – the hindfoot, the midfoot and the forefoot.
The hindfoot is made up of three different joints and it also links the midfoot to the ankle. The top of the hindfoot is linked to the two long bones of the calf and this allows the foot to move up and down. The heel bone is the largest bone in the foot. It is called the subtalar joint, where it joins the talus and this enables the foot to move in a circular manner. There is usually a layer of fat underneath the heel, which cushions the impact of the full body weight on the heel.
The midfoot is primarily a shock absorber and has five tarsal bones – all shaped in a slightly different way. Muscles and arch ligaments connect the midfoot to the hindfoot and the forefoot.
The forefoot has five toes. The big toe has two bones and the others each have three The forefoot carries half the body's weight and pressure is balanced on the ball of the foot.
Bone problems in your feet
Overpronation ("Flat feet")
The most common complication of overpronation is so-called "flat feet".
Pronation and supination are the terms used to describe the natural and necessary movements of the feet. There are periods of both through the normal range of movements that take place during the gait cycle.
Pronation allows the foot to absorb shock and adapt to the surface it lands on while supination allows the bones of the foot to lock into place, enabling the foot to bear the body’s weight whilst standing, walking or running.
Overpronation is a common problem seen by podiatrists and can cause a number of complications.
Read more about pronation and so-called "flat feet".
About one in every ten bones that are broken, are foot bones. Seeing as there are 26 bones in the human foot, and the foot often takes quite a pounding when people take part in sport, or simply get on with life, this statistics is not surprising.
Bones usually break when something happens in which the bone is crushed, bent, twisted or stretched. Toes often break when you kick something, and when ankles break or are sprained, some of the metatarsal bones (long bones in the foot) also sometimes break. Bones can either be broken on sudden impact or by means of a stress fracture, in which small cracks form in the bone after repeated exposure to constant stress.
Children's bones fracture more easily than those of adults. Bruising, swelling and an inability to walk are often obvious symptoms of broken bones in the feet. If a fracture is suspected, a doctor will take X-rays of the foot and depending on the type of fracture, will either bandage it, or place it in a cast or a splint. In extreme cases, surgery may be needed to repair the fractured bones.
After a procedure such as this, a patient may be on crutches for several weeks.
Read more about ankle fractures.
A heel spur results from excessive traction or pulling by the tendons or ligaments on their insertion points on the heel bone. The inflammation that results from this stimulates the heel bone to grow a spur at this point.
It appears that the body grows this spur in an attempt to decrease the pulling forces by growing out to meet the tendon or ligament. This is a very painful condition.
Read more about bonespurs.
Metatarsalgia presents as pain in the forefoot associated with increased stress over the metatarsal head region, which is the area from the base of the toes to the middle of the foot, i.e. the front third of the foot.
Metatarsalgia is a common overuse condition, i.e. a history of gradual onset is more common than sudden or acute presentation. Chronic symptoms may appear over a period of six months.
Athletes participating in high impact sports, including running or jumping are at risk.
Read more about metatarsalgia.
South African Podiatry Association (SAPA)