PT Crab 🦀 Issue 158 - Footy

This week, we’re talking feet again because I can’t get enough of those weird little guys. They’re so complicated but they almost always work! It’s just crazy. Hands are cool too but I know a lot of PTs don’t believe those exist, so we’ll avoid them for now.

For feet, we’re looking into an overview of the anatomy of intrinsic foot musculature, non-surgical treatments for hallux valgus, and a case report on treating Morton’s Neuroma. Straight to the point.

With that, let’s dive in!

Let’s look inside the foot

The Gist - How often do you think about the intrinsic muscles of the foot? Not often, I’d guess. This piece from the journal Physical Therapy in Sport takes a deep dive into them. Did you know there are 22? Like, I learned that, but definitely forgot. I think we all remember that there are 4 layers though. Overall, it’s a well-written, easy to understand piece that goes into the anatomy, biomechanics, and function of the muscles while also talking a bit about how we strengthen them when needed.

Let’s start where we should start, with evaluation. There aren’t gold standard assessments of foot intrinsic strength, but there are some ways to go after it. You can check toe flexion strength with MMT, toe grip strength with a dynamometer, toe flexion ability with the paper test (which we’ll get to), and the “intrinsic positive test” checks out intrinsic strength overall. The last two may be new to you, so let’s look at them.