Ankle Joint

The tibia and the fibula go from the knee to the ankle.

In between is the interosseous membrane which provides muscle attachments.

Ankle Joint

Tibia is the larger bone and the true weight bearing bone of the leg.

Medial and lateral malleoli are at the distal end of the tibia and fibula.

Ankle Joint

Crest of the tibia is the anterior and prominent of the three boarders. It is what we think of as the shin.

Ankle Joint

Head of the fibula is the large proximal end close to the knee joint.

Tarsal Bones

Calcaneus- largest and most posterior tarsal bone. It is also known as the heel bone.

Ankle Joint

Calcaneal tuberosity- projection of poterior side of the calcaneous, where the achilles tendon attaches.

Tarsal Bones

Sustentaculum tali- medial superior part projecting out from the calcaneus, three tendons loop around this projection. It helps them change direction from posterior to plantar foot.

Tarsal Bones

Talus- bone that sits on top of the calcaneus and below the tibia and fibula.

Tarsal Bones

Navicular- medial side of the talus and proximal to the cuniform bones.

Tarsal Bones

Cuboid and Cuniforms-the most distal row of tarsal bones in the foot.

Foot bones

Metatarsals are numbered 1-5.

Normally first and fifth are weightbearing bones and 2-4 are not.

First is the big toe, fifth is the littlest

Foot Bones

Phalanges of the foot have the same position as the hand, they are basically the toes.

Joints of the Ankle/Foot

Talocrural Joint-joint in the ankle found between the tibia, fibula, and talus. Dorsi/plantar flexion

Subtalar Joint-joint in the ankle found between the talus and calcaneus.

Joints of the foot and ankle

Inferior tibiofibular joint is athe syndesmosis joint. This is not a synovial joint, but one covered by a fibrous tissue that holds the joint together.

Basic Anatomy of the Foot and Ankle

Three Arches enable us to absorb forces• Transverse Arch

• Medial Longitudinal

Arch

• Lateral Longitudinal

Arch

The Three Arches

Transverse Arch• Goes across the width

of the foot

• Comprised of the cuneiforms (all three), the cuboid, and the base of the fifth metatarsal.

The Three Arches

Medial longitudinal arch- the highest and most important arch in the foot.• Goes the length of the foot on the medial side.

• Comprised of the calcaneus, talus, navicular, cuneiforms and the first three metatarsals.

The Three Arches

Lateral longitudinal arch- the arch next to the medial one that is flatter and lower.• Goes the length of the foot on the lateral side.

• Comprised of the calcaneus, talus, cuboid, and the forth and fifth metatarsals.

Ligaments

Medial Side• Deltoid Ligament-

support ligament

on medial side of

foot.

• Spring Ligament-

AKA the Plantar Calcaneonavicular ligament.

Ankle Injuries

The most common direction to sprain the ankle is into inversion with the injury to the lateral ligament, specifically the ATF.

Ligaments Lateral Side

• ATF-Anterior Talofibular Ligament

• CF-Calcaneofibular Ligament

• PTF-Posterior Talofibular Ligament

Compartments of the leg

There are four compartments of the lower leg. If there is inflammation in one it will prevent muscles and nerves from work-

ing in that area.

Discuss the different

Motions and results. DF

Muscles of deep lower leg

Extensor Hallucis Longus- fibula and interosseous membrane is the the origin and distal phalanx of great toe is the insertion. Great toe extension is the motion it does.

Muscles of the superficial lower leg

Extensor Digitorum Longus- origin is anterior tibia and lateral condyle of tibia, insertion is distal phalanx of the 2-5 digit. It extends toes and dorsiflexes foot.

Muscles of the Ankle

Peroneus Longus- part of the stirrup of the foot with the tibialis anterior. Starts at lateral fibula, runs behind the lateral maleolli and under the foot to insert onto the plantar surface of the first metatarsal and first cuniform.

Muscles of the Ankle

Anterior Tibialis- part of the stirrup of the foot with the peroneus longus. Origin is on the lateral tibia and interosseus membrane and inserts on the 1st cuniform and 1st metatarsal. Very palpatable muscle on anterior lateral foot. Inversion and dorsiflexion are the main motions.

Muscles of the Ankle

Anterior Tibialis- lateral side of tibia and interosseous membrane, crosses to medial cuneiform and first metatarsal. Makes up anterior lateral leg, dorsiflex and inverts foot.

Anterior Tibialis

Muscles of the Ankle

Posterior Tibialis- This muscles has two origins the interosseous membranes and adjacent tib/fib. Insertion is navicular and tarsals/metat. of palmar side of foot. It’s main motion is inversion, it assists with plantarflexion.

Muscles of the Ankle

Gastrocnemiums- femur to the calcaneus(crosses two joints), the gastroc is the most superficial of the calf muscles. Actions?

Muscles of the Ankle

Soleus- deep calf muscles that runs from posterior tib/fib to calcaneus. Its action is plantarflexion and can be isolated when the knee is in flexion.

Actions with the ankle

Concentric vs. Eccentric• If you go up stairs, which muscles are

concentric with the foot pushing off?

• If you descend a stair which muscles are contracting eccentrically?

Actions with the ankle

Closed vs. Open chain• What is an example of a closed chain

exercise for the ankle?

• What is an example of an open chain exercise for the ankle?