Tendons are flexible, cord-like tissues composed primarily of collagen. They connect muscles to bones, facilitating movement throughout the body. Tendons transmit the force generated by muscle contractions to the skeletal structure, moving bones. This network of tendons in the foot enables a wide range of motions, supports body weight, and maintains stability during activities like walking, running, and balancing.
Tendons on the Top of the Foot (Dorsal)
The top, or dorsal, aspect of the foot houses tendons that contribute to upward foot and toe movements. The Tibialis Anterior tendon is located on the front of the shin and extends to attach to bones in the midfoot, specifically the medial cuneiform and the base of the first metatarsal. This tendon connects the tibialis anterior muscle to these foot bones, enabling dorsiflexion, which is the action of lifting the foot upwards toward the shin.
Adjacent to the tibialis anterior are the Extensor Digitorum Longus and Extensor Hallucis Longus tendons. The Extensor Digitorum Longus originates from a lower leg muscle and its tendon divides to extend the four smaller toes (second through fifth). The Extensor Hallucis Longus tendon, originating from a deeper leg muscle, controls the extension and upward movement of the big toe. Both extensor tendons lift the toes off the ground during walking and prevent the foot from dragging.
Tendons on the Bottom of the Foot (Plantar)
The plantar, or bottom, surface of the foot contains tendons for toe flexion, arch support, and pushing off the ground. The Tibialis Posterior tendon courses behind the medial malleolus (inner ankle bone) and inserts into multiple bones on the bottom of the midfoot, including the navicular, cuneiforms, cuboid, and bases of the metatarsals. This tendon supports the foot’s medial arch, and its function includes inverting the foot (turning the sole inward) and assisting in plantarflexion (pointing the foot downward).
Two other tendons on the plantar side are the Flexor Digitorum Longus and Flexor Hallucis Longus. The Flexor Digitorum Longus originates from a calf muscle and its tendon extends into the sole of the foot, splitting into four smaller tendons that attach to the undersides of the second through fifth toes, enabling their curling or flexion. The Flexor Hallucis Longus, also originating from a calf muscle, controls the flexion of the big toe. Both flexor tendons contribute to gripping the ground and providing propulsion during movement. The plantar fascia, while functionally important for arch support, is a thick ligament-like structure, not a tendon, as it connects bone to bone rather than muscle to bone.
Tendons on the Sides of the Foot (Medial and Lateral)
The sides of the foot are supported by tendons that contribute to ankle stability and movements such as eversion and inversion. On the outer (lateral) side of the ankle, two tendons are the Peroneal (Fibularis) Longus and Peroneal (Fibularis) Brevis. Both originate from muscles in the lateral compartment of the lower leg. The Peroneal Longus tendon passes behind the lateral malleolus and then crosses underneath the foot to insert on the first metatarsal and medial cuneiform. It helps to evert the foot (turn the sole outward) and contributes to plantarflexion, also supporting the foot’s arches.
The Peroneal Brevis tendon, lying deeper and anterior to the Peroneal Longus, also passes behind the lateral malleolus but inserts into the base of the fifth metatarsal on the outer side of the foot. Its main function is to evert the foot and it assists in plantarflexion. These peroneal tendons work together to provide dynamic lateral ankle stability.