Morphological and mechanical properties of plantar fascia and intrinsic foot muscles in individuals with and without flat foot

Tas S., Unluer N. O., KORKUSUZ F.

JOURNAL OF ORTHOPAEDIC SURGERY, vol.26, no.3, 2018 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 26 Issue: 3
  • Publication Date: 2018
  • Doi Number: 10.1177/2309499018802482
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Keywords: flat foot, foot muscles, plantar fascia, stiffness, thickness, ultrasound, STIFFNESS, RELIABILITY, ULTRASOUND, VALIDITY, KNEE, STRENGTH, SYSTEM, ARCH
  • Hacettepe University Affiliated: Yes


Purpose: Many musculoskeletal disorders are associated with over-pronated foot and decreased medial longitudinal arch (MLA) height. Foot intrinsic muscles and plantar fascia (PF) are the primary structures that support MLA. An important reason for the over-pronated foot and the reduction in the MLA height may be the morphological characteristics of the foot intrinsic muscles and PF as well as changes in their mechanical properties. The aim of the present study is to investigate the morphologic structure and mechanical properties of PF, flexor hallucis brevis (FHB), flexor digitorum brevis (FDB), and abductor hallucis (AbH) muscles in individuals with flat foot and to compare the results with those of healthy individuals. Methods: The study included 80 participants, 40 with flat foot and 40 with normal foot posture. The foot posture of the participants was assessed using the Foot Posture Index. PF, FHB, FDB, and AbH thickness and stiffness were measured with an ultrasonography device using a linear ultrasonography probe. Results: Individuals with flat foot had higher AbH thickness compared to individuals with normal foot posture (p < 0.001), whereas both groups were similar in terms of PF (p = 0.188), FHB (p = 0.627), and FDB (p = 0.212) thickness. Stiffness values of the assessed tissues were similar in both groups (p > 0.05). Conclusion: AbH thickness was higher in individuals with flat foot; however, PF, FHB, and FDB thickness were similar in both groups. In addition, our results suggest that foot posture is not related to the stiffness of the assessed tissues.