The Ankle and Foot
STRUCTURE AND FUNCTIONOF THE ANKLE AND FOOT
Bones of the ankle
• The distal tibia and fibula
• 7 tarsal
• 5 metatarsals
• 14 phalanges
Ankle (Talocrural) Joint
Characteristics.
• The ankle (talocrural) joint is a synovial hinge joint formed by the mortise (distal end of the tibia and tibial and fibular malleoli) and trochlea (dome) of the talus
STRUCTURAL RELATIONSHIPSAND MOTIONS
Anatomical Characteristics
LegThe tibia and fibula make up the
leg. These two bones are bound
together by an interosseous
membrane along the shafts of
the bones,
STRUCTURAL RELATIONSHIPSAND MOTIONS
FootHindfoot
The talus and calcaneus make up the posterior segment.
STRUCTURAL RELATIONSHIPSAND MOTIONS
FootMidfoot.
The navicular, cuboid, and three cuneiforms make up the middle segment
STRUCTURAL RELATIONSHIPSAND MOTIONS
FootForefoot.
Five metatarsals and 14 phalanges make
up the anterior segment. Each toe has three phalanges except forth large toe, which has two.
Motions of the Foot and Ankle Defined
Primary Plane Motions
Sagittal plane motion around a frontal
Frontal plane motion around a sagittal Plane.
Inversion is inward turning of the foot and eversion is
Outward turning
Triplanar Motions
• Pronation
Pronation is a combination of dorsiflexion,eversion, and abduction.
Triplanar Motions
• Supination.
• Supination is a combination of plantarflexion,inversion, and adduction.
FUNCTIONOFTHEANKLE AND FOOT
Structural Relationships
Arches
• Primary support of the arches comes from the spring ligament
• In the normal static foot, muscles do little to support the arches
FUNCTIONOFTHEANKLE AND FOOT
Structural Relationships
Effect on posture.
• During standing if one foot/ ankle complex is more pronated than the other, the overall effect is a
Frontal plane asymmetry with a “short leg” on that side
FUNCTIONOFTHEANKLE AND FOOT
Structural RelationshipsAbnormal foot postures• A varus deforimity of the calcaneus may compensate by standing with a pronated
(or everted) calcaneus posture• Pes cavus and supinated foot describe a high-arched foot
Muscle Function in the Ankle and Foot
Plantarflexors. PrimaryGastrocnemiusSoleus SecondryTibialis posteriorThe flexor hallucis longusFlexor digitorum longus The peroneus longus
Muscle Function in the Ankle and Foot
Dorsiflexors
• Tibialis anterior
• The extensor hallucis longus and extensor digitorum longus
• Peroneus tertius
THE ANKLE/FOOTCOMPLEXAND GAIT
• During the normal gait cycle, the ankle goes through a ROM of 32deg to 35deg
REFERRED PAINAND NERVE INJURY
Major Nerves Subject to Pressure and Trauma
• Common peroneal nerve.
• Posterior tibial nerve
• Plantar and calcaneal nerves
Common Sources of SegmentalSensory Reference in the Foot