Our feet are made up of 26 bones and more than 33 joints arranged in columns and arches that vary in stiffness and flexibility. Many common problems can occur in this complex structure.
The foot is usually separated into three different parts:
The back of your foot (hindfoot) is made up of your heel bone (calcaneus) and your ankle (talus). They’re joined together by your subtalar joint, which allows your foot to move from side to side.
Your ankle bone is joined to your leg bones (tibia and fibula) at your ankle joint, which acts like a hinge. This allows your foot to bend up and down.
The middle of your foot (midfoot) is made up of five tarsal bones. These form the arch of your foot. Your tarsal bones are connected to the front and back of your foot by muscles and the arch ligament (the plantar fascia). They act as shock absorbers when we’re walking or running.
The front of your foot (forefoot) is made up of your toe bones (phalanges), which are connected to five long bones (metatarsals) by joints. The joints in your toes don’t move very much. Your forefoot takes half of your body’s weight.
The muscles in your lower leg are attached to bones in your feet by tendons, and they control movement that allows us to stand, walk, go on tiptoes and jump. These muscles move your toes and control the position of your foot as it hits the ground, allowing it to become flexible and cushioning the impact. They also make the arches of your feet more rigid to push your body forward when you move.
Your heel bone is connected to the calf muscles in your lower leg by your Achilles tendon, which is the most important tendon for movement. The tibialis posterior tendon, which attaches the underside of your foot to your lower leg, helps supports the arch of your foot and allows you to turn it inward.
The main nerve of your foot controls the muscles in your sole and gives feeling here and to your toes. Other nerves give feeling to the top and outside edge of your foot.
A diagram showing the bones and tendons in the foot and ankle.
Do I need surgery?
Most people with problems in their feet or ankles won’t need surgery. The decision whether to operate depends on a number of factors:
how bad your symptoms are (pain and the effect this has on your life)
your needs
your response to other treatments, including drugs, orthoses and special footwear.
Discuss these with your healthcare professionals, who’ll be able to advise you on whether they think surgery would be a suitable option.
The decision to have foot and ankle surgery is usually based on lifestyle choices and the information given by surgeons rather than being essential in terms of life and death. But if your skin is affected or your feet are quickly becoming deformed, it’s important to get an assessment for urgent surgery to avoid infection and alert your healthcare professionals to possible stress fractures. You’ll always have the final decision on whether to have the operation.
You may feel nervous, stressed or scared if you’ve been told you need surgery. Finding out as much as you can about the operation and understanding the process will help you feel calmer and more in control.