Your forefoot consistently takes a beating, but nature designed it to handle it. Mess with nature’s design, however, and problems like hammertoe, flat feet and calluses can crop up.
The Bones
Your forefoot contains two sets of bones: the phalanges and the metatarsals. The phalanges are your toe bones. Your big toe has two phalanges while your other toes have three. The phalanges are numbered one to five, starting with the big toe as number one.
The metatarsals are the bones in the ball of your foot. Each foot contains five metatarsals. The metatarsals line up side-by-side, with each metatarsal connected to a corresponding toe bone. Metatarsals are also numbered one to five, starting with the innermost metatarsal as number one.
The Ligaments
A network of ligaments runs lengthwise, widthwise and diagonally throughout your forefoot. The bands and sheets of reinforcing material form a framework that:
- Ties the arches
- Keeps skin connected to bone
- Allows space for nerves, vessels and tendons to pass below the metatarsal heads
- Works in conjunction with fat to insulate and bolster the foot
The Protection
Fat serves as protection throughout the foot, and it’s especially vital in the area directly below the metatarsal heads. Ligaments hold fat deposits in place, forming a cushion beneath each head. These cushions help disperse pressure while protecting underlying nerves and vessels.
In a perfect world, your five metatarsal heads are at an equal distance above the ground. The second metatarsal bone is typically the longest, but the other metatarsal heads share the load under normal conditions.
Abnormalities and detrimental conditions often arise when the structure and functioning of the forefoot is compromised. One example is metatarsal heads that are not equidistant from the ground. Another is ill-fitting shoes that cram the toes together, limit the foot’s ability to act as a lever or subject the metatarsal heads to uneven pressure that impedes their ability to share the load.
REFERENCES:
- Bojsen-Moller F. Anatomy of the Forefoot, Normal and Pathologic. Clin Orthop Relat Res. 1979;142:10-18.