Metatarsal dysfunction

Many authors describe a number of transverse arches (Fig. 95-10). With the exception of the metatarsal heads, these arches do not transmit forces to the ground. The anterior metatarsal transverse arch consists of the five metatarsal heads, with the second metatarsal as its highest point. With weight-bearing, this arch is flattened. Depression of the anterior metatarsal transverse arch increases the weightbearing burden of the metatarsal heads, creating dysfunction. A second, posterior metatarsal arch consists of the bases of the five metatarsals. A third, tarsal arch has been described, consisting of the navicular, cuneiform, and cuboid bones. This arch assists in flexibility and the rotation motions of the foot. Diminution or absence of the tarsal arch is evident in pes planus (flat feet). 

FIG. 100-6 High-velocity, low-amplitude thrusting technique for metatarsal somatic dysfunction. 

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