ANTERIOR(TIBIALIS((

STANCE(PHASE(
! Propulsion!"!Begins!to!contract!immediately!before!toe!off!and!has!its!first!peak!of!activity!just!
after!toe!off.!This!assists!in!the!dorsiflexion!of!the!foot!at!toe!off!so!the!toes!can!clear!the!ground.!!
! Contact(period!"!Peak!activity!for!the!tibialis!anterior,!this!is!when!the!anterior!tibialis!exerts!its!
most!profound!effect.!!Decelerates!ankle!joint!plantarflexion!at!heel!strike!and!until!the!forefoot!
is!fully!loaded.!This!helps!to!reduce!posterior!shear!on!the!heel.!!Faster!the!gait!the!more!shear!on!
the!heel,!the!greater!need!for!deceleration.!!Also!supinates!the!forefoot!around!the!L.M.T.J.!or!
inverts!the!forefoot,!the!compensation!for!calcaneal!eversion!in!S.T.J.!pronation.!!As!the!anterior!
tibialis!relaxes!it!allows!for!a!smooth!!loading!of!the!forefoot!from!lateral!to!medial!due!to!a!
!decrease!in!forefoot!inversion!!!
SWING(PHASE(
! Anterior!tibialis!experiences!its!peak!activity!in!swing!phase!after!toe!off.!
! Accelerates!the!foot!at!the!ankle!joint!during!swing.!
! Also!supinates!the!forefoot!at!the!L.M.T.J.!and!dorsiflexes!the!first!ray,!aiding!the!forefoot!in!
clearing!the!ground!in!midswing.!
! Anterior!tibialis!is!a!weak!supinator!of!the!entire!foot!so!it!prevents!the!foot!from!excessive!
pronation!during!the!swing!
ANTERIOR(TIBIAL(MUSCLE(PATHOLOGY(
! If!the!tibialis!anterior!is!not!functioning!we!will!see!foot!slap!at!contact!due!to!the!loss!of!the!
deceleration!of!ankle!joint!plantarflexion.!!
! We!will!also!see!extensor!substitution!as!the!extensors!try!to!decelerate!the!foot!at!this!time.!!
! If!anterior!tibialis!is!weak!we!will!also!see!extensor!substitution.!!
! At!midswing!we!will!see!toe!drag!as!the!foot!is!not!dorsiflexed!and!the!forefoot!is!not!supinated!at!the!L.M.T.J.!and!the!first!ray!is!
not!dorsiflexed.!!
! We!will!also!see!a!pronated!S.T.J.!during!swing!phase.!!
!!
Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

!!
!
 EXTENSOR(HALLUCIS(LONGUS(
CONTACT((
Assists!in!deceleration!of!the!foot!at!heel!strike.!Because!the!tibialis!anterior!is!
dorsiflexing!the!first!ray!the!hallux!is!only!able!to!dorsiflex!20!"!25!degrees.!This!allows!the!
extensor!hallucis!longus!to!aid!in!the!deceleration!at!the!ankle!joint.!!!!
PROPULSIVE(PERIOD((
Provides!extension!stability!along!with!the!!extensor!hallucis!brevis!at!the!first!
!metatarsophalangeal!joint.!!It!also!provides!extension!stability!at!the!!interphalangeal!
joint!with!ground!reactive!forces.!This!turns!the!hallux!into!a!rigid!beam!for!!propulsion.!!
Also!creates!stability!by!compressing!the!!phalanges!of!the!hallux!posteriorly.!!!
SWING(PHASE(((
Peak!function!at!the!beginning!of!swing!phase!and!at!the!end!of!swing!phase.!!The!
strongest!ankle!joint!dorsiflexor!as!the!swing!phase!begins!making!it!most!responsible!for!
the!rapid!ankle!joint!dorsiflexion!needed!for!the!foot!to!clear!the!ground!at!midswing.!
Needs!the!tibialis!anterior!for!extended!strong!ankle!joint!dorsiflexion.!It!is!a!neutral!
dorsiflexor!having!little!effect!on!the!S.T.J.!while!performing!its!function.!!
PATHOLOGY((
Pathology!will!be!similar!to!pathology!!seen!with!tibialis!anterior!failure!or!!weakness.!!
Partial!foot!drop!at!contact!period.!!
Difficulty!in!foot!clearance!during!!midswing.!!!
Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

!!
!
 EXTENSOR(DIGITORUM(LONGUS(
PROPULSIVE(PERIOD((
Begins!to!contract!during!the!last!half!of!the!!propulsive!period.!Contracts!into!the!first!
1/3!of!the!swing!phase.!(Assists!the!lumbricales!in!developing!extensor!!rigidity!of!the!
interphalangeal!joints!during!!propulsion!in!each!lesser!digit.!Assists!in!stabilizing!the!
phalanges!of!the!lesser!!digits!posteriorly!against!each!other!and!the!!corresponding!
metatarsal!head.!Creates!a!rigid!beam!of!the!digits!for!propulsion.!!!
SWING(PHASE((
Peak!activity!at!the!beginning!of!swing!phase!!and!at!the!end!of!swing!phase.!(Assists!in!
dorsiflexing!of!the!foot!for!toe!!clearance!during!the!swing!phase.!(Prevent!excessive!
supination!of!the!foot!during!!the!swing!phase!by!exerting!a!pronatory!force.!(Pronates!
the!S.T.J.!axis!as!well!as!the!midtarsal!!joint!axis.!(Does!not!function!in!midstance.!!
PATHOLOGY((
If!the!extensor!digitorum!longus!is!inactive!or!weak!we!will!see!the!following:!
An!excessively!supinated!subtalar!and!!midtarsal!joints!during!the!swing!phase!!of!gait.!!
Foot!drop!during!midswing!due!to!the!!loss!of!dorsiflexion.!!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

!!
!
!

!!
!
 GASTROCNEMIUS(MUSCLE((
LATE(CONTACT(/(EARLY(PROPULSION((
Gastrocnemius!has!its!origin!on!the!femur!and!insertion!on!the!calcaneus!via!the!
achilles!tendon.!!That!means!it!crosses!three!joints!"!the!knee!joint,!the!ankle!joint!
and!the!subtalar!joint.!So!the!gastrocnemius!will!have!an!effect!on!the!knee!and!
across!the!ankle!joint!and!subtalar!joint.!!!
KNEE(
The!gastrocnemius!muscle!maintains!flexion!tension!on!the!knee!while!the!knee!
extends.!This!is!antagonistic!to!knee!extension!forces!placed!on!the!knee!by!the!other!
calf!muscles.!The!activity!of!the!gastrocnemius!decelerates!the!forward!momentum!
of!the!tibia!as!the!trunk!moves!over!the!foot.!!!!
The!end!result!of!the!gastrocnemius!effect!on!the!knee!is!to!prevent!hyperextension!
of!the!knee.!The!flexory!force!begins!in!late!contact!period!and!continues!into!early!
propulsive!period.!Contributes!to!smooth!knee!extension!to!prepare!for!heel!lift.!!!!
The!gastrocnemius!muscle!assists!the!posterior!tibial!and!soleus!muscles!decelerate!
internal!rotation!of!the!lower!extremity!near!the!end!of!the!contact!period.!The!
gastrocnemius!stops!internal!rotation!of!the!femur!while!the!posterior!tibial!and!
soleus!stop!internal!rotation!of!the!tibia.!This!prevents!internal!torque!from!
developing!at!the!knee.!!!!
The!gastrocnemius!also!externally!rotates!the!femur!once!again!to!prevent!torque!
at!the!knee!while!the!posterior!tibial,!soleus,!and!long!flexors!accelerate!the!lower!
leg!in!external!rotation.!The!gastrocnemius!will!also!assist!the!previously!mentioned!
muscles!(PT,!Soleus,!LF)!in!supinating!the!subtalar!joint!during!midstance!and!early!
propulsion.!!!

!!
!
 The!gastrocnemius!will!flex!the!knee!!and!lift!the!heel!to!initiate!the!propulsive!
period!of!the!stance!phase!of!gait.!This!action!of!the!gastrocnemius!will!also!cause!an!
upward!and!forward!acceleration!of!the!trunk.!!!!
The!gastrocnemius!continues!flexing!the!!knee!in!the!first!half!of!the!propulsive!
period!to!help!with!toe!clearance!during!the!swing!phase!of!gait.!!Also,!it!helps!other!
muscles!that!supinate!the!subtalar!joint!and!midtarsal!joint!and!also!externally!rotate!
the!leg!during!the!propulsive!period.!!
PATHOLOGY(
If!the!muscle!action!or!functional!length!of!the!tendon!is!lengthened!then!heel!lift!
at!the!end!of!midstance!period!and!start!of!propulsive!period!will!be!next!to!
impossible.!!
We!will!see!clawing!of!the!toes!and!plantarflexion!of!the!first!ray.!!
These!are!the!result!of!the!attempt!of!the!flexor!digitorum!longus!and!peroneus!
longus!muscles!to!elicit!heel!lift!without!much!success.!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

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!
 SOLEUS((
EARLY(CONTACT(/(EARLY(PROPULSION(
The!soleus!muscle!will!function!to!stabilize!the!lateral!aspect!of!the!foot!by!plantarflexing!
it!against!the!ground!during!late!contact!period!and!through!midstance!period.!Also,!as!we!
saw!before,!the!soleus!will!aid!the!posterior!tibial!and!gastrocnemius!muscles!in!
decelerating!the!subtalar!joint!pronation!and!internal!tibial!rotation!at!the!end!of!the!
contact!period.!!!!
The!soleus!along!with!the!posterior!tibial!will!decelerate!knee!flexion!at!the!end!of!the!
contact!period.!The!soleus!along!with!the!posterior!tibial,!flexor!hallucis!longus,!and!flexor!
digitorum!longus!muscles!will!extend!the!knee!during!the!midstance!period!by!decelerating!
the!forward!momentum!of!the!tibia.!!!!
While!the!soleus!muscle!is!decelerating!forward!momentum!of!the!tibia!it!is!also!
contributing!to!heel!lift!by!placing!a!plantarflexory!force!at!the!ankle,!which!stops!ankle!joint!
dorsiflexion.!The!soleus!will!also!function!with!the!posterior!tibial!and!long!digital!flexors!to!
accelerate!external!tibial!rotation.!This!also!helps!to!supinate!the!subtalar!joint.!!

POSTERIOR(TIBIALIS(
Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

!!
!
 POSTERIOR(TIBIALIS(
EARLY(CONTACT(/(EARLY(PROPULSION(
The!medial!malleolus!acts!as!a!pulley!for!an!effect!at!the!subtalar!joint!and!the!ankle!joint.!!The!
navicular!tuberosity!acts!as!a!pulley!for!and!effect!on!the!midtarsal!joint.!All!this!makes!the!posterior!tibial!
muscle!and!ankle!joint!plantarflexor,!subtalar!joint!supinator,!and!oblique!midtarsal!joint!supinator.!!
The!posterior!tibial!muscle!serves!to!!decelerate!subtalar!joint!pronation!and!internal!leg!rotation!
during!the!contact!period!with!help!from!the!soleus!muscle.!It!also!assists!the!soleus!muscle!and!long!
digital!flexors!to!decelerate!the!forward!momentum!of!the!leg!during!late!contact!period!and!throughout!
the!midstance!period!producing!knee!extension.!!!
Posterior!tibial!muscle!accelerates!subtalar!!joint!supination!and!external!leg!rotation!during!the!
midstance!period!assisted!by!the!soleus!and!long!digital!flexors.!Posterior!tibial!muscle!maintains!stability!
of!the!midtarsal!joint!by!supinating!the!oblique!midtarsal!joint!axis.!Posterior!tibial!also!maintains!stability!
of!all!the!lesser!tarsal!and!metatarsal!bones,!which!it!is!attached!to!in!a!medial!and!posterior!direction.!!
The!posterior!tibial!muscle!also!assists!in!heel!lift!by!participating!with!the!soleus!and!long!flexors!to!
decelerate!the!forward!motion!of!the!tibia!and!at!the!same!time!stop!ankle!joint!dorsiflexion.!!
PATHOLOGY(
Loss!of!a!pulley!results!in!a!severe!flatfoot!deformity.!!
May!be!caused!by!the!following:!!
Slippage!of!the!posterior!tibial!tendon!!out!of!its!groove!behind!the!medial!!malleolus.!!
Trauma!separating!the!posterior!tibial!!tendon!from!the!navicular!tuberosity!or!from!the!sustentaculum!
tali.!!

(
Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

!!
!
 FLEXOR(HALLUCIS(LONGUS(
END(OF(CONTACT(G(END(OF(PROPULSION((
FHL!assists!the!soleus!and!FDL!muscles!with!deceleration!of!the!
forward!momentum!of!the!tibia!during!the!midstance!period,!
contributing!to!knee!extension.!Pulley!for!FHL!consists!of!the!
medial!malleolus,!sustentaculum!tali,!and!the!talus!"!allows!the!
FHL!to!assist!the!PT,!soleus,!FDL,!and!gastroc!with!acceleration!of!
subtalar!joint!supination!and!external!leg!rotation!during!
midstance!period.!!!!
FHL!assists!the!soleus,!PT,!and!FDL!with!!deceleration!of!the!
forward!momentum!of!the!tibia!contributing!to!heel!lift!initiating!
propulsion.!FHL!maintains!stability!of!the!hallux!against!the!
ground!during!propulsion.!For!this!to!happen!the!hallux!must!
have!been!made!a!rigid!beam!by!the!extensor!mechanism.!
Assists!in!proximal!stabilization!of!the!phalanges!of!the!hallux!
during!propulsion.!First!MPJ!and!sesamoid!apparatus!act!as!
!pulleys.!
FHL!assist!the!gastrocnemius,!FDL,!!and!PT!with!plantarflexion!
of!the!foot!at!the!ankle!joint!during!propulsion.!Assists!the!
abductor!hallucis!and!FDL!with!supination!of!the!oblique!
midtarsal!joint!axis!during!propulsion.!!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

!!
!
 FLEXOR(DIGITORUM(LONGUS((
END(OF(CONTACT(G(MID(PROPULSION((
Pulley!consists!of!medial!malleolus!and!sustentaculum!tali.(Allows!the!FDL!to!function!as!a!
supinator!of!the!STJ!and!a!plantarflexor!of!the!ankle!joint.!A!second!pulley!consists!of!the!deep!
transverse!metatarsal!ligament,!which!allows!the!FDL!to!stabilize!the!digits!plantarly.!!
Functions(of(the(FDL(
Decelerates!subtalar!joint!pronation!and!internal!leg!rotation!during!the!contact!period.!
Decelerates!the!forward!momentum!of!the!tibia!during!midstance!period,!contributing!to!knee!
extension.!Accelerate!subtalar!joint!supination!and!external!leg!rotation!during!midstance!
period.!!!
Decelerates!forward!momentum!of!the!!tibia!and!ankle!joint!dorsiflexion!!contributing!to!heel!
off.!Maintain!stability!of!the!lesser!digits!!against!the!ground!during!propulsion.!To!stabilize!
posteriorly!the!phalanges!of!the!lesser!digits!against!the!lesser!met!!heads!during!midstance!and!
propulsion.!!!
To!assist!with!ankle!joint!!plantarflexion!during!propulsion.!To!assist!with!supination!of!the!
!oblique!midtarsal!joint!during!early!propulsion.!!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

!!
!
 PERONEUS(LONGUS(
MID(MIDSTANCE(G(LATE(PROPULSION((
Pulley!consists!of!the!lateral!malleolus!specifically!the!peroneal!
trochlea.(Also!has!a!pulley!located!on!the!plantar!aspect!of!the!
cuboid.!Functions!consist!of!the!following:!Stabilize!the!first!ray.!
Stabilizes!the!first!ray!!transversely!and!posteriorly!against!the!
lesser!tarsus,!plantarly!stabilizes!the!first!metatarsal!head!firmly!
against!the!ground!during!late!midstance!and!propulsive!periods.!
Pronator!of!the!longitudinal!midtarsal!joint.!!!!
Abduction!force!exerted!on!the!first!ray!resists!!adduction!force!
of!the!posterior!tibial!muscle!on!the!lesser!tarsus!and!metatarsal!
bases,!this!causes!the!development!of!stability!in!these!bones.!
Transfer!weight!from!the!lateral!to!the!medial!side!of!the!forefoot!
and!on!to!the!opposite!foot!during!early!propulsion.!Soleus!
relaxes!making!cuboid!unstable!pulley.!Lifts!as!peroneus!longus!
contracts!causing!lateral!to!medial!loading.!Weakly!assists!in!
deceleration!of!ankle!joint!dorsiflexion!and!aid!in!heel!lift.!Weakly!
assist!in!ankle!joint!plantarflexion!during!propulsion.!!!
PATHOLOGY(
If!the!foot!is!pronated!during!late!midstance!and!the!propulsive!
periods!the!peroneus!longus!loses!its!ability!to!stabilize!the!first!ray.!!
First!ray!will!become!unstable!during!propulsion!or!becomes!
hypermobile.!!
Results!in!subluxation!of!the!1st!metatarsophalangeal!joint.!Caused!
by!flexor!hallucis!longus!trying!to!stabilize!the!first!hallux!against!the!
unstable!first!met.!!
Eventually!can!lead!to!hallux!abducto!valgus!or!hallux!limitus!/!rigidus!deformities!!
!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

!!
!
 PERONEUS(BREVIS(
MIDDLE(MIDSTANCE(G(MIDDLE(PROPULSION(
Pulley!consists!of!lateral!malleolus!peroneal!trochlea.!Strong!
pronator!of!the!subtalar!joint.!!Weak!pronator!of!the!oblique!
!midtarsal!joint.!Weak!ankle!joint!plantarflexor.!!!
FUNCTIONS((
Assists!in!developing!abduction!stabilizing!force!on!the!lesser!
tarsus!during!midstance!and!propulsion.!Provides!an!antagonistic!
pronation!force!at!the!subtalar!joint!to!resist!supination!of!the!foot!
and!external!leg!rotation!by!the!calf!muscles.!Assists!in!transferring!
weight!from!the!lateral!forefoot!to!medial!forefoot!and!on!to!the!
opposite!foot.!!
Exerts!a!pronatory!force!at!the!subtalar!joint!and!at!the!midtarsal!
joint!to!antagonize!the!muscles,!which!supinate!these!joints.!!
PATHOLOGY(
When!the!peroneus!brevis!muscle!goes!into!spasm,!this!can!
cause!a!pronation!at!the!subtalar!joint.!!
Usually!occurs!in!an!effort!by!the!body!to!splint!the!rearfoot!and!
limit!motion!in!response!to!painful!motion!about!the!subtalar!
joint.!!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

!!
!
 EXTENSOR(DIGITORUM(BREVIS((
EARLY(MIDSTANCE(G(LATE(PROPULSION(
Originates!from!dorsal!and!lateral!surfaces!of!the!anterior!aspect!of!the!
calcaneus,!dividing!into!tendon!slips,!which!insert!into!the!2nd,!3rd,!and!4th!
toes.!Stance!phase!muscle.!!
FUNCTIONS(
Stabilize!the!midtarsal!joint!by!pronating!the!oblique!axis!in!the!early!
propulsive!period.!Reinforce!the!extensor!expansion!by!assisting!the!
lumbricale!and!EDL!muscles!as!they!extend!the!2nd,!3rd,!and!4th!toes!during!
propulsion.!
Stabilize!the!2nd,!3rd,!and!4th!metatarsals!against!the!lesser!tarsus!
posteriorly.!Assist!with!posterior!stability!of!the!2nd,!3rd,!and!4th!toes!against!
the!respective!metatarsal!heads,!and!the!phalanges!posteriorly!during!
propulsion.!!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

!!
!
 EXTENSOR(HALLUCIS(BREVIS((
EARLY(MIDSTANCE(G(LATE(PROPULSION(
Originates!from!the!most!medial!portion!of!the!EDB.!Tendon!slip!inserts!into!
the!dorsum!of!the!base!of!the!proximal!phalanx!of!the!hallux.!Stance!phase!
muscle.!!
FUNCTIONS(
Stabilize!posteriorly!the!first!metatarsal!against!the!lesser!tarsus!during!
midstance!and!early!propulsive!periods.!!
Stabilize!posteriorly!the!hallux!against!the!first!metatarsal!during!propulsion.!!
Assist!in!developing!adduction!stability!of!the!hallux!at!the!first!MPJ!during!
propulsion.!!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

!!
!
 LUMBRICALE((
MID(MIDSTANCE(G(MID(PROPULSION(
Stance!phase!muscles.!Work!in!concert!with!the!
FDL!muscle.!Origin!from!the!tendon!slips!of!the!FDL!
in!the!area!of!its!bifurcations!where!the!FDL!
receives!insertion!from!the!quadratus!plantae!
muscle.!
Tendon!of!each!lumbricale!(4)!passes!beneath!the!
deep!transverse!metatarsal!ligament.!Tendon!
passes!from!plantar!"!medial!to!dorso!"!lateral!
inserting!dorso!"!lateral!on!the!shaft!of!the!distal!
phalanx.!!
FUNCTION(
Extend!the!intermediate!and!distal!interphalangeal!joints!of!the!lesser!toes!during!midstance!and!
propulsive!periods.!Assist!in!stabilizing!the!proximal!phalanx!of!the!lesser!toes!in!a!plantarflexed!
direction!against!vertical!ground!reactive!forces!during!the!propulsive!period.!!!
Provide!slight!adduction!stability!of!the!proximal!phalanx!of!the!lesser!digits!resisting!abduction!
force!of!ground!reactive!forces!during!propulsive!period.!!
PATHOLOGY(
Lumbricales,!in!concert!with!the!EDB!extend!the!interphalangeal!joints!to!prevent!buckling!as!the!FDL!contracts.!Absence!of!
lumbricale!function!in!midstance!will!probably!result!in!hammer!digit!syndrome!(HAMMER!TOE).!
May!serve!as!antagonistic!muscle!to!EDL!muscle!activity!during!the!swing!phase!of!gait.!!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

!!
!
 INTEROSSEI(!
LATE(MIDSTANCE(G(LATE(PROPULSION(
Stance!phase!muscles.!Seven!interossei!muscles!"!4!dorsal,!3!plantar.!1st!and!2nd!
dorsal!insert!into!the!medial!and!!lateral!sides!of!the!2nd!proximal!phalanx.!3rd!and!
4th!dorsal!insert!into!the!lateral!side!of!!the!3rd!and!4th!proximal!phalanx.!1st!and!
2nd!plantar!insert!into!the!medial!3rd!and!!4th!proximal!phalanx!while!the!3rd!
plantar!inserts!into!the!medial!5th!proximal!phalanx.!!
FUNCTION(
Stabilize!the!bases!of!the!lesser!four!proximal!phalanges!posteriorly!against!the!
corresponding!met!heads.!Stabilizes!the!bases!of!the!proximal!phalanges!
transversely,!providing!adductor!/!abductor!stability!at!the!MPJ.!May!assist!in!the!
function!of!the!extensor!expansion!in!some!people.!!
Tendons!insert!into!the!plantar!plate.!Will!apply!a!plantarflexory!force!on!the!
proximal!phalanx.!!
PATHOLOGY(
Once!again!hammer!digit!syndrome!"!abnormal!contracture!of!the!digits.!
Weak!resistance!to!abnormal!transverse!plane!pathology!placed!on!the!lesser!
digits.!!
*Interossei!m.!and!Lumbricale!m.!are!the!only!muscles!that!plantarflex!at!the!
proximal!phalanx.!When!we!lose!one,!we!usually!lose!the!other!as!well.!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

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 ABDUCTOR(HALLUCIS(
LATE(MIDSTANCE(G(END(OF(PROPULSION(
Stance!phase!muscle.!Originates!from!the!medial!plantar!
!tubercle!of!the!calcaneus.!Forms!a!conjoin!tendon!with!the!
medial!!tendon!of!the!FHB,!encloses!the!tibial!sesamoid!and!
inserts!into!the!inferior!medial!side!of!the!base!of!the!proximal!
phalanx!of!the!hallux.!!!
FUNCTIONS((
Stabilize!the!hallux!in!adduction.!Assist!with!posterior!stability!
of!the(proximal!phalanx!of!the!hallux!against!the!ground!in!
propulsion.!!
Stabilize!the!OMTJ!axis!during!propulsion!by!supinating!the!
forefoot!about!the!axis.!*Plantarflex!the!first!ray!and!stabilize!
the!first!met!head!against!the!ground!during!propulsion.!!!
PATHOLOGY(
Pronation!of!the!foot!during!propulsion!moves!the!abductor!
hallucis!closer!to!the!1st!ray!axis.!!
Shortens!the!lever!arm!and!diminishes!ability!to!plantarflex!the!1st!met.!!
Contributes!to!hypermobility!of!the!first!ray.!!!
Abducted!gait!"!person!will!role!medially!off!of!the!hallux!during!propulsion.!!
Ground!reactive!forces!put!an!abduction!force!on!the!hallux!"!causing!abductor!hallucis!to!cramp.!!
Cramp!results!in!hallux!valgus!"!adduction!/!plantarflexion!of!the!hallux.!Cramp!also!can!result!in!arch!pain.!!
Strain!or!damage!to!the!abductor!hallucis!can!also!result!in!arch!pain.!
Always!keep!as!part!of!your!differential!diagnosis!when!looking!at!medial!arch!pain.!!
!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

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 ADDUCTOR(HALLUCIS((OBLIQUE(HEAD)((
LATE(MIDSTANCE(G(PROPULSION(
Stance!phase!muscle.!Originates!from!the!bases!of!the!2nd,!3rd,!and!4th!
mets.!Tendon!blends!with!the!lateral!tendon!of!the!FHB!at!the!fibular!
sesamoid,!covers!the!fibular!sesamoid!and!inserts!into!the!lateral!inferior!
surface!of!the!proximal!phalanx!of!the!hallux.!
FUNCTIONS(
Stabilize!the!hallux!in!abduction.!Help!stabilize!the!proximal!phalanx!of!the!
hallux!posteriorly!against!the!first!met!head.!Plantarflex!the!base!of!the!
proximal!phalanx!stabilizing!the!hallux!against!ground!reactive!forces!during!
propulsion.!Fibular!sesamoid!serves!as!a!pulley.!
PATHOLOGY(
Hypermobility!of!the!first!ray!allows!the!sesamoids!to!become!laterally!
displaced.!!
This!creates!an!imbalance!giving!the!adductor!hallucis!an!advantage.!!
Adductor!hallucis!pulls!the!base!of!the!proximal!phalanx!of!the!hallux!
laterally!on!the!first!met!head.!
Transverse!subluxation!is!the!first!stage!of!HAV!(HALLUCIS!ABDUCTO!
VALGUS).!
!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

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 FLEXOR(HALLUCIS(BREVIS((
MID(MIDSTANCE(G(PROPULSION(
Stance!phase!muscle.!Originates!from!the!medial!
plantar!portion!of!!the!cuboid!and!from!the!3rd!
cuneiform.!It!divides!into!2!muscle!bellies!and!ends!in!2!
tendons.!The!medial!tendon!contains!the!tibial!
sesamoid!and!inserts!into!the!plantar!medial!base!of!
the!proximal!phalanx!of!the!hallux.!The!lateral!tendon!
contains!the!fibular!!sesamoid!and!inserts!into!the!
plantar!lateral!!base!of!the!proximal!phalanx!of!the!
hallux.!!
FUNCTIONS((
Stabilizes!the!base!of!the!proximal!phalanx!of!the!hallux!against!the!ground!during!
propulsion.(Stabilizes!the!base!of!the!proximal!phalanx!of!the!hallux!posteriorly!against!the!
first!met!head!during!propulsion.!Primary!flexor!of!the!proximal!phalanx!at!the!1st!ray.!
Assists!the!FHL!to!stabilize!the!hallux!against!the!ground!during!propulsion.!Assists!with!
posterior!stability!of!the!1st,!2nd,!and!3rd!metatarsals!against!their!respective!cuneiforms.!
Also,!may!provide!some!transverse!stability!to!the!central!metatarsals!during!propulsion.!!!
During!midstance!period!the!FHB!provides!mostly!posterior!stabilization!due!to!the!small!
pulley!available!at!the!1st!MPJ.!During!propulsion!the!FHB!provides!a!more!plantarflexory!
force!on!the!hallux!due!to!increased!pulley!at!the!1st!MPJ.!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

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 FLEXOR(DIGITORUM(BREVIS((
PROPULSION(
Contracts!at!heel!lift!and!throughout!propulsion.!Stance!phase!muscle.!Originates!
from!the!medial!plantar!tuberosity!of!the!calcaneus.!!
Divides!into!four!tendon!slips,!each!of!which!inserts!into!one!of!the!four!lesser!
digits.!Tendon!inserts!into!medial!and!lateral!sides!of!the!shaft!of!the!intermediate!
phalanx.!
FUNCTIONS(
Stabilizes!the!oblique!axis!of!the!midtarsal!joint!by!supinating!it!against!ground!
reactive!forces!directed!against!the!lesser!met!heads.!Stabilizes!the!2nd,!3rd,!4th,!
and!5th!rays!posteriorly!and!plantarly.!!
Assists!the!FDL!in!maintaining!stability!of!the!lesser!digits!against!the!ground!
during!propulsion.!Stabilizes!the!intermediate!phalanx!of!each!toe!posteriorly!
against!the!proximal!phalanx,!and!the!proximal!phalanx!against!its!metatarsal!
head.!
!
*Only!muscle!to!have!its!activity!
( solely!in!one!period!of!the!stance!
phase!of!the!gait!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

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 TRANSVERSE(PEDIS((
LATE(MIDSTANCE(G(LATE(PROPULSION(
More!commonly!called!the!transverse!head!of!the!
adductor!hallucis.!Stance!phase!muscle.!Originates!from!
the!lateral!plantar!base!!of!the!proximal!phalanx!of!the!
hallux.!Muscle!fibers!end!up!in!the!3rd,!4th,!and!
!sometimes!5th!metatarsophalangeal!joint!ligaments.!!
FUNCTIONS(
Prevent!elongation!of!the!deep!transverse!
intermetatarsal!ligament.!Provide!transverse!stabilization!
to!the!forefoot!at!the!level!of!the!metatarsophalangeal!
joints!during!propulsion.!!
PATHOLOGY(
Loss!of!advantage!of!muscle!due!to!hypermobile!first!
ray.!!
Pulls!on!fibular!sesamoid!and!hallux!laterally!starting!
HAV.!!
Leads!to!splay!foot!or!widening!of!the!forefoot!while!the!rearfoot!remains!the!same.!!
If!attachment!is!missing!at!the!5th!met!head,!then!splaying!if!the!5th!ray!only!will!be!seen.!
5th!becomes!hypermobile!and!subluxes!resulting!in!a!tailors!bunion.!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

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 QUADRATUS(PLANTAE((
EARLY(MIDSTANCE(G(MID(PROPULSION(
Stance!phase!muscle.!Origin!from!two!heads:!Medial!head!originates!from!the!
medial!surface!of!the!body!of!the!calcaneus.!Lateral!head!from!the!inferior!
calcaneal!surface!on!its!lateral!side.!Inserts!by!a!wide!tendon!along!the!sheath!of!
the!FDL!just!proximal!to!its!bifurcation.!!
FUNCTIONS((
Stabilize!the!midtarsal!joint!in!a!supination!motion!about!the!OMTJ!axis!during!
midstance!and!propulsion.!
Provide!stability!to!the!FDL!tendon!slips!to!the!toes!while!simultaneously!
providing!stability!to!the!origin!of!the!lumbricales!during!propulsion.!
Provides!posterior!and!lateral!tension!on!the!FDL!tendon!slips!neutralizing!the!
natural!posterio!"!medial!pull!of!the!FDL!tendon.!Allows!a!straight!posterior!pull!
on!the!digits.!Assists!with!posterior!stabilization!of!the!lesser!mets,!2nd!and!3rd!
cuneiforms,!and!cuboid!during!midstance!and!!propulsion.!

Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

((

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ADDUCTOR(MUSCLE(GROUPS((
Contract!isotonically!accelerating!or!creating!motion.!Assist!in!creating!transverse!plane!motion!of!the!pelvis!and!thigh,!and!
create!some!sagittal!plane!motion!of!the!thigh.!Creating!stability!at!the!hip!joint!is!a!secondary!function.!!
STANCE(PHASE(
Origin!and!insertion!changes!with!flexion!and!extension!of!the!thigh!"!so!function!changes!with!the!position!of!the!femur.!
Heel(contact!"!stabilizes!the!femur!on!the!pelvis!at!the!hip!joint!along!with!the!abductors,!hamstrings,!and!quadriceps.!Heel(
contact!"!initiates!internal!rotation!of!the!pelvis!and!opposite!thigh!around!the!stance!phase!hip!joint.!
SWING(PHASE(
At!toe!off!the!adductors!initiate!flexion!of!the!hyperextended!swing!phase!thigh.!At!toe!off!the!adductors!assist!with!internal!
rotation!of!the!externally!rotated!thigh.!!
Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

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ABDUCTOR(MUSCLE(GROUP(
Function!is!primarily!isometric!"!making!them!a!hip!stabilizer.!Stabilizes!primarily!in!the!frontal!plane.!!
Prevents!frontal!plane!tilt!of!the!pelvis!toward!the!non"weight!bearing!side.!!
Functions!from!the!end!of!swing!phase!through!the!midstance!period.!!
Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

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QUADRATUS(FEMORIS(
Heel(contact!"!primarily!stabilizes!the!knee!joint!and!secondarily!the!hip!joint.!
Prevents!excess!knee!flexion!at!heel!contact,!also,!assists!with!knee!extension!during!the!contact!period.!!
Propulsion(G(toe(off!"!assists!the!adductor!group!in!flexing!the!thigh!on!the!pelvis!at!the!hip!joint.!!
This!muscle!group!is!very!important!in!climbing!stairs,!squatting,!and!sitting!!!
Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

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!

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HAMSTRINGS(
Functions!both!isometrically!and!isotonically!producing!both!positive!and!negative!work.!!
Heel(contact(G!decelerates!extension!of!the!!tibia!at!the!knee!joint!just!prior!to!heel!!contact.!!
After!heel!contact!it!stabilizes!the!knee!joint!!primarily,!at!the!hip!joint!the!hamstrings!will!cause!extension!secondarily.!!!
Toe(off(G(Propulsion(G!Assist!the!gastrocnemius!muscle!with!knee!flexion.!
Contact!Period! Midstance!Period! Propulsive!Period! Swing!Phase! PATH!

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