When I was visiting the “Late Renoir” exhibit at the Philadelphia Museum of Art recently, I marveled at the paintings and sculptures the artist made late in his career. Of course while I was walking from painting to painting, I studied the shape of the foot and ankle in those artworks and I recalled what someone said to me years ago: “The foot and the hand are the most difficult to draw.”
Those of us who treat the maladies of the lower extremity are experts in surface anatomy and pathology. However, I considered what it would be like to not have the intimate knowledge our profession gives us and how difficult it would be to recreate, for example, the fifth toe in a drawing. Would it be an overlapping toe, an adductovarus toe or an underlapping toe? How is the foot traditionally represented in art?
After some research, I found a fascinating article from 1897 by E.H. Bradford, MD, who discussed the various representations of the foot in sculpture.1 He compared the shape of feet in art in shoe wearing and non-shoe wearing societies. He described three foot types that were seen in sculptures and paintings.
There was the Egyptian perspective in which the toes are poker straight and no hallux valgus deformity is evident. There is the classical (Greek and Roman) view, which is best represented by the foot of Hermes by Praxiteles (http://ubiqx.org/~crh/Photos/GeekCruise04/Katakolon/PA120074.JPG  ). In the classical view, the great toe is separated from the second, the middle three toes are parallel but diverge 30 degrees from the axis of the foot, and the fifth toe is in adductovarus.
Then there is the modern perspective in which the foot is copied from the classical type with the fifth toe being “distorted” and set back more proximally. Figure 1 is a photo I took from the Rodin Museum in Philadelphia. Beyond what Dr Bradford observed and wrote, today’s artists are able to create the lower extremity anatomy of the human body with astonishing detail (http://www.pteropus.co.uk/gymnast_page.html  ).
Going one step further (no pun intended), I thought about the shoe and its representation in art. In my mind, shoes are art and the best place to see not only the history of footwear, but also its role in society is the Bata Shoe Museum in Toronto. If you would like to stay stateside, then make an appointment to see 250 of the 900 shoes in the Temple University School of Podiatric Medicine’s Shoe Museum. This will give you a whole new appreciation of the craftsmanship and the culture involved in making the devices to shelter the already deformed looking fifth toe.
So when I am able to return to the sculpture halls of the Louvre, the British Museum or the Metropolitan Museum of Art again someday, I know I will be focusing on that sculpted fifth toe all thanks to Dr Bradford.
1. Bradford EH. The human foot in art. JBJS Am 1897; s1-10:148-161.
2. http://ubiqx.org/~crh/Photos/GeekCruise04/Katakolon/PA120074.JPG 
3. http://www.pteropus.co.uk/index.html 
4. http://www.batashoemuseum.ca/index.html 
5. http://podiatry.temple.edu/pages/about/shoe_museum/shoe_museum.html