Abductor hallucis muscle and arch support

NewsBot · Jun 15, 2007

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Influence of the abductor hallucis muscle on the medial arch of the foot: a kinematic and anatomical cadaver study.
Wong YS.
Foot Ankle Int. 2007 May;28(5):617-20.

BACKGROUND: Most studies of degenerative flatfoot have focused on the posterior tibial muscle, an extrinsic muscle of the foot. However, there is evidence that the intrinsic muscles, in particular the abductor hallucis (ABH), are active during late stance and toe-off phases of gait. The purpose of this study was to analyze the kinematic effect of a simulated contraction of the abductor hallucis muscle on a cadaver lower limb specimen.

METHODS: Eight below-knee cadaver specimens were prepared. The abductor hallucis muscle was exposed and the entire muscle-tendon unit excised. A suture secured to the calcaneal origin of the muscle and tendon was passed through a pulley at the ABH sesamoid attachment. The specimen was mounted on an experimental rig in a 'standing' position. Motions in the first metatarsal, tibia, and calcaneus were tracked using the 'Flock of Birds' motion analysis system (Ascension Technology, Burlington, VT). Muscle contraction was simulated by applying tension on the suture.

RESULTS: All eight specimens showed an origin from the posteromedial calcaneus and an insertion at the tibial sesamoid. All specimens also demonstrated a fascial sling in the hindfoot, lifting the abductor hallucis muscle to give it an inverted 'V' shaped configuration. Simulated contraction of the abductor hallucis muscle caused flexion and supination of the first metatarsal, inversion of the calcaneus, and external rotation of the tibia, consistent with elevation of the arch.

CONCLUSIONS AND CLINICAL RELEVANCE: The abductor hallucis muscle acts as a dynamic elevator of the arch. Understanding this mechanism may change the way we understand and treat pes planus, posterior tibial tendon dysfunction, hallux valgus, and Charcot neuroarthropathy.
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Admin2 · Jun 15, 2007

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efuller · Jun 16, 2007

NewsBot said:

Influence of the abductor hallucis muscle on the medial arch of the foot: a kinematic and anatomical cadaver study.
Wong YS.
Foot Ankle Int. 2007 May;28(5):617-20.
RESULTS: All eight specimens showed an origin from the posteromedial calcaneus and an insertion at the tibial sesamoid. All specimens also demonstrated a fascial sling in the hindfoot, lifting the abductor hallucis muscle to give it an inverted 'V' shaped configuration. Simulated contraction of the abductor hallucis muscle caused flexion and supination of the first metatarsal, inversion of the calcaneus, and external rotation of the tibia, consistent with elevation of the arch.
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Well it's nice to have experimental results that confirm your model's predictions. Let's here it for the free body diagram. The attachment of the medial slip of the plantar fascia is almost identical. The external rotation of the tibia is consistant with STJ supination predicted with the windlass model. It's a shame they didn't run across one of those really flat feet where those forces cause internal leg rotation for the exception proves the rule.
Sorry I don't have the site for the paper that predicts the above results.

Regards,

Eric Fuller

Craig Payne · May 30, 2015

I just stumbled on this thread from 2007 while looking for something else:

NewsBot said: ↑

Understanding this mechanism may change the way we understand and treat pes planus, posterior tibial tendon dysfunction, hallux valgus, and Charcot neuroarthropathy.
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Had to have a bit of a laugh at that. That was 8yrs ago ... nothing has changed.

NewsBot · Feb 20, 2019

H-reflex in abductor hallucis and postural performance between flexible flatfoot and normal foot
Tzu-HuiHuangaLi-WeiChoubCheng-YaHuangaShun-WaWeibYi-JuTsaicYu-JenChena
Physical Therapy in Sport; 19 February 2019

Highlights
•AbH H-reflex was lowered in participants with flexible flatfoot.
•Flexible flatfoot participants demonstrate higher muscle activity.
•CoP displacements were larger in the flexible flatfoot group.
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Objective
Morphological changes of the abductor hallucis muscle (AbH) in flexible flatfoot (FF) individuals influence regulations of the medial longitudinal arch (MLA). Prolonged and repeated stretching of AbH in flexible flatfoot may cause changes in muscle reflex properties and further influence postural performance. However, AbH muscle reflex under different postural conditions have never been examined. The purpose of this study was to investigate differences in AbH H-reflex and postural performance between individuals with normal foot (NF) alignment and FF under prone, double-leg stance (DLS), and single-leg stance (SLS) conditions.

Design
Cross-sectional study.

Setting
University laboratory.

Participants
Individuals with FF (n = 12) and NF (n = 12).

Main outcome measures
AbH H-reflex, AbH EMG and center of pressure (CoP) displacement.

Results
Under all postural conditions, AbH H-reflex was significantly lower in the FF group (P < .05). Under the SLS condition, AbH EMG was significantly higher in the FF group (P < .05), and CoP displacement for the medial-lateral and anterior-posterior directions were significantly higher in the FF group (P < .05).

Conclusions
With increased postural demand, FF individuals maintained their postural stability by recruiting greater AbH activities than through automatic stretch reflex, but FF individuals still showed inferior posture stability.
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