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The Achilles tendon is often tested as part of a neurological examination. In this examination, the tendon is hit with a tendon hammer. This tests the S1 and S2 spinal nerves: a normal response is plantar flexion (downward movement) of the foot. [33] Level or portion of tendon affected: [34]
The three tendons, from front to back, that conjoin to form the pes anserinus come from the sartorius muscle, the gracilis muscle, and the semitendinosus muscle. [1] [2] It inserts onto the proximal anteromedial surface of the tibia. [2] The pes anserinus is around 5 cm below the medial tibial joint line. [2]
The two heads of each muscle form a central tendon which passes forwards deep to the deep transverse metatarsal ligament. [1] The tendons are inserted on the bases of the second, third, and fourth proximal phalanges [2] and into the aponeurosis of the tendons of the extensor digitorum longus [3] without attaching to the extensor hoods of the toes.
The superior extensor retinaculum binds down the tendons of extensor digitorum longus, extensor hallucis longus, peroneus tertius, and tibialis anterior as they descend on the front of the tibia and fibula; under it are found also the anterior tibial vessels and deep peroneal nerve. [1]
The flexor hallucis longus is situated on the fibular side of the leg. It arises from the inferior two-thirds of the posterior surface of the body of the fibula, with the exception of 2.5 cm at its lowest part; from the lower part of the interosseous membrane; from an intermuscular septum between it and the peroneus muscles, laterally, and from the fascia covering the tibialis posterior, medially.
Failure most often occurred at the proximal attachment to the calcaneus, which is consistent with the usual location of symptoms (i.e. in plantar fasciitis). Complete rupture or surgical release of the plantar fascia leads to a decrease in arch stiffness and a significant collapse of the longitudinal arch of the foot .
The muscle ends as a tendon of insertion. The tendon passes through a distinct compartment in the inferior extensor retinaculum of foot. It crosses anterior tibial vessels lateromedially near the bend of the ankle. [citation needed] In the foot, its tendon is situated at along the medial side of the dorsum of the foot. [1]
The long plantar ligament is the longest of all the ligaments of the tarsus.It is attached behind to the plantar surface of the calcaneus in front of the tuberosity, and in front to the tuberosity on the plantar surface of the cuboid bone, the more superficial fibers being continued forward to the bases of the second, third, and fourth metatarsal bones.