Article

Multiple intrinsic and extrinsic soft tissue structures that apply
forces and support the medial longitudinal arch have been implicated in pes
planus. These structures have common functions but their interaction in pes
planus is not fully understood. The aim of this study was to compare the
cross-sectional area (CSA) and thickness of the intrinsic and extrinsic foot
muscles and plantar fascia thickness between normal and pes planus feet. METHODS:
Forty-nine adults with a normal foot posture and 49 individuals with pes planus
feet were recruited from a university population. Images of the flexor digitorum
longus (FDL), flexor hallucis longus (FHL), peroneus longus and brevis (PER),
flexor hallucis brevis (FHB), flexor digitorum brevis (FDB) and abductor hallucis
(AbH) muscles and the plantar fascia were obtained using a Venue 40 ultrasound
system with a 5-13 MHz transducer. RESULTS: The CSA and thickness of AbH, FHB and
PER muscles were significantly smaller (AbH -12.8% and -6.8%, FHB -8.9% and
-7.6%, PER -14.7% and -10%), whilst FDL (28.3% and 15.2%) and FHL (24% and 9.8%)
were significantly larger in the pes planus group. The middle (-10.6%) and
anterior (-21.7%) portions of the plantar fascia were thinner in pes planus
group. CONCLUSION: Greater CSA and thickness of the extrinsic muscles might
reflect compensatory activity to support the MLA if the intrinsic foot muscle
function has been compromised by altered foot structure. A thinner plantar fascia
suggests reduced load bearing, and regional variations in structure and function
in feet with pes planus.
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