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Embarrassing Question on the Medial Column

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Robertisaacs, Jul 28, 2010.

  1. Members do not see these Ads. Sign Up.
    This is one of those "I've always thought everyone else knew so I never asked" type questions.

    The medial column.

    I've always understood it to be the hallux, 1st met, medial cuniform, and navicular. However when I tried to confirm this I struggled to find a definative reference. Some said it was all three cuniforms and the 3 medial mets, others just the medial ones.

    Who coined the expression and what is the correct definition?

    Regardless of whether it is 1-3 or just the medial most, the bones are attatched end on end.

    I'm looking at an excel spreadsheet. The columns go up and down. The rows go side to side.

    Why is it medial column, not medial row :eek:.
  2. Good question. When I was taught in podiatry school many years ago, the medial column was the navicular, cuneiforms, metatarsals 1-3 and digits 1-3. The lateral column was the cuboid, metatarsals 4-5 and digits 4-5. I believe this terminology is likely a century old, but don't know exactly who first originated it.

    Roman architectural columns are 2,000 years old. How old are Excel spreadsheet columns?
  3. This may help....

  4. This may not ? ;)

    Medial Column foot systems : an innovative tool for improving posture

  5. Why you little...



    Thanks Kevin. So it is 1-3 not just the medial most structures then.

    About 20 glorious years I think. But the Roman columns

    Go up and down not side to side (unless they've fallen over.)

    Sorry. I'ts probably irrelevant. But you're the one who instilled the desire for good terminology in me so you have no one to blame but yourself. The medial column does not transmit weight through compression. If the medial column were the tibia, the talus, and the calc, that I could understand.

    I think too much. This is going to bug me now.
  6. Since when??
  7. Unless you're a ballet dancer en pointe?

    I may need you (or somebody else clever) to help me out a bit with this one. I can see how there could be some compressive force between, say, the medial cuniform and the 1st met. After heel raise, when they are on top of each other. But for the most part the bones of the medial column sit next to each other, not on top of each other. When is there weight transmitted through compression between the proximal phalanx and the metatarsal? Compression from muscles, ligaments and the windlass, yes. But its not a
    unless, as I said, one is en pointe.

  8. Robert:

    Bones are the main "compression-force-transmitters" within the foot and lower extremity since tendon, ligament and muscle are poor at tranmitting compresson forces and are much better at transmitting tension forces. Bone may transmit torsional and tension forces as well. Cartilage transmits compression forces also like bone, but is not stiff enough to resist the torsional forces required for structural integrity in the beam-like structural elements of the body.

    Any time ground reaction force (GRF) is applied to the plantar aspect of the medial column at the 1st, 2nd and 3rd metatarsal heads, this GRF is a combination of a compression force component along with a shearing force component. When the medial metatarsal heads are weightbearing, the tensile forces from the plantar fascia, plantar intrinsics that insert onto digits 1-3, flexor hallucis longus and flexor digitorum longus will increase the compression force between the proximal phalanx bases and the medial metatarsal heads. These compression forces are transmitted simultaneously to the metatarsal-cuneiform joints, cuneiform-navicular joints and talo-navicular joint.

    Without the bones of the medial forefoot being able to resist these resulting internal compression stresses, then the foot would be more like a bowl of Jello, rather than a variable-rigidity structural unit that is optimized for the purpose of being the prime-terrestrial interface organ for the human species. Therefore, the bones of the medial forefoot form a column of compression elements....transmitting compression forces from one element to another...and thus the term "medial column".

    Asking good questions is never a bad thing.:drinks

  9. efuller

    efuller MVP

    To add a slightly different take to what Kevin said:

    The ground applies a vertical force to the met head. When there is tension in the fascia the proximal phalanx applies a distal to proximal force to the met head. When you add those to forces together you get axial compression of the metatarsal. That could explain, evolutionarily, why the met cuneiform joints and the cuneiform navicular joints are perpendicular to the long axis of the metatarsal bones.

    Don't let the terminology get in the way of reality. Let's talk about rays instead of columns.



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