1. Chapter 11 The Ankle and Foot Joints
Manual of Structural Kinesiology
The Ankle and Foot Joints

2. The Ankle and Foot Joint
26 bones
19 large muscles
Many small (intrinsic) muscles
More than 100 ligaments
Support & propulsion
Foot trouble - common ailment
Poor foot mechanics leads to foot discomfort
No substitute for adequate muscular development, strength, & proper foot mechanics
Manual of Structural Kinesiology
The Ankle and Foot Joints

3. The Ankle and Foot Joints
Bones
Manual of Structural Kinesiology
The Ankle and Foot Joints

4. The Ankle and Foot Joints
Bones
Distal malleoli of tibia & fibula
Enlarged & protrude horizontally & inferiorly
Serve as pulley for posterior tendons to increase mechanical advantage of muscles in performing inversion & eversion actions
Manual of Structural Kinesiology
The Ankle and Foot Joints

5. The Ankle and Foot Joints
Gastrocnemius Muscle
Plantar flexion of ankle
Flexion of knee
Manual of Structural Kinesiology
The Ankle and Foot Joints

6. The Ankle and Foot Joints
Soleus Muscle
Plantar flexion of ankle
Manual of Structural Kinesiology
The Ankle and Foot Joints

7. Peroneus Longus (fibularis) Muscle
Eversion of foot
Plantar flexion of ankle
Manual of Structural Kinesiology
The Ankle and Foot Joints

8. Peroneus Brevis (fibularis) Muscle
Eversion of foot
Plantar flexion of ankle
Manual of Structural Kinesiology
The Ankle and Foot Joints

9. Peroneus Tertius (fibularis) Muscle
Eversion of foot
Dorsiflexion of ankle
Manual of Structural Kinesiology
The Ankle and Foot Joints

10. Extensor Digitorum Longus Muscle
Extension of four lesser toes at metatarsophalangeal, proximal & distal interphalangeal joints
Dorsiflexion of ankle
Eversion of foot
Manual of Structural Kinesiology
The Ankle and Foot Joints

11. Extensor Hallucis Longus Muscle
Dorsiflexion of ankle
Extension of great toe at metatarsophalangeal & interphalangeal joints
Weak inversion of foot
Manual of Structural Kinesiology
The Ankle and Foot Joints

12. Tibialis Anterior Muscle
Dorsiflexion of ankle
Inversion of foot
Manual of Structural Kinesiology
The Ankle and Foot Joints

13. Tibialis Posterior Muscle
Plantar flexion of ankle
Inversion of foot
Manual of Structural Kinesiology
The Ankle and Foot Joints

14. Flexor Digitorum Longus Muscle
Flexion of 4 lesser toes at metatarsophalangeal, proximal & distal interphalangeal joints
Inversion of foot
Plantar flexion of ankle
Manual of Structural Kinesiology
The Ankle and Foot Joints

15. Flexor Hallucis Longus Muscle
Flexion of great toe at metatarsophalangeal & interphalangeal joints
Inversion of foot
Plantar flexion of ankle
Manual of Structural Kinesiology
The Ankle and Foot Joints

16. The Ankle and Foot Joints
Muscles
Ankle & foot joint muscles by function
Plantar flexors
Gastrocnemius
Flexor digitorum longus
Flexor hallucis longus
Peroneus (fibularis) longus
Peroneus (fibularis) brevis
Plantaris
Soleus
Tibialis posterior
Manual of Structural Kinesiology
The Ankle and Foot Joints

17. The Ankle and Foot Joints
Muscles
Ankle & foot joint muscles by function
Evertors
Peroneus (fibularis) longus
Peroneus (fibularis) brevis
Peroneus (fibularis) tertius
Extensor digitorum longus
Manual of Structural Kinesiology
The Ankle and Foot Joints

18. The Ankle and Foot Joints
Muscles
Ankle & foot joint muscles by function
Dorsiflexors
Tibialis anterior
Peroneus (fibularis) tertius
Extensor digitorum longus (extensor of lesser toes)
Extensor hallucis longus (extensor of great toe)
Manual of Structural Kinesiology
The Ankle and Foot Joints

19. The Ankle and Foot Joints
Muscles
Ankle & foot joint muscles by function
Invertors
Tibialis anterior
Tibialis posterior
Flexor digitorum longus (flexor of lesser toes)
Flexor hallucis longus (flexor of great toe)
Manual of Structural Kinesiology
The Ankle and Foot Joints

20. The Ankle and Foot Joints
Toe Flexion
Agonists
Flexor hallucis longus
Flexor digitorum longus
Manual of Structural Kinesiology
The Ankle and Foot Joints

21. The Ankle and Foot Joints
Toe Extension
Agonists
Extensor hallucis longus
Extensor digitorum longus
Manual of Structural Kinesiology
The Ankle and Foot Joints

22. The Ankle and Foot Joint
Walking
Stance phase
Heel-strike occurs when landing on heel, foot should be in supination
Midstance immediately follows with foot moving into pronation
Toe-off follows midstance, foots returns to supination prior to & during push off
Manual of Structural Kinesiology
The Ankle and Foot Joints

23. The Ankle and Foot Joint
Walking
Swing phase
occurs when foot leaves ground & leg moves forward to another point of contact
Manual of Structural Kinesiology
The Ankle and Foot Joints

24. The Ankle and Foot Joint
Problems arise
foot is too rigid & does not pronate adequately
foot remains in pronation past midstance
Walking
one foot is always in contact with ground
Running
point when neither foot is in contact with ground
Manual of Structural Kinesiology
The Ankle and Foot Joints

25. The Ankle and Foot Joints
Muscles
Painful cramps - acute muscle spasm in gastrocnemius & soleus
Occur somewhat commonly
May be relieved through active & passive dorsiflexion
Complete rupture of Achilles tendon
very disabling injury
Several ankle & foot muscles produce more than one movement
Manual of Structural Kinesiology
The Ankle and Foot Joints

26. The Ankle and Foot Joints
Muscles
Acute & chronic injuries are common
“Shin splints” - common term describing painful leg condition often associated with running activities
Not a specific diagnosis
Attributed to a number of different specific musculotendinous injuries
Most often involves tibialis posterior, medial soleus, or anterior tibialis, but may also involve extensor digitorum longus
May be partially prevented by stretching plantar flexors & strengthening dorsiflexors
Manual of Structural Kinesiology
The Ankle and Foot Joints

27. The Ankle and Foot Joints
Ankle sprains very common injury
Sprains involve stretching or tearing of one or more ligaments
Most common ankle sprain results from excessive inversion that causes damage to lateral ligamentous structures, primarily anterior talofibular ligament & calcaneofibular ligament
Manual of Structural Kinesiology
The Ankle and Foot Joints

28. The Ankle and Foot Joints
Ankle sprains very common injury
Excessive eversion forces injures deltoid ligament (medially) - less common
Manual of Structural Kinesiology
The Ankle and Foot Joints

29. The Ankle and Foot Joints
Muscles
Compartment Syndrome
Most common in anterior compartment
May be acute or chronic
May occur secondarily to injury, trauma, or overuse
Symptoms include sharp pain, particularly with increased movement actively or passively, swelling, and weakness in the muscles of the involved compartment
Depending on severity, emergency surgery may be indicated to release the fascia in order to prevent permanent tissue damage
Many compartment syndromes may be adequately addressed with proper acute management
Manual of Structural Kinesiology
The Ankle and Foot Joints

30. The Ankle and Foot Joints
Web Sites
Wheeless’ Textbook of Orthopaedics
This site has an extensive index of links to the fractures, joints, muscles, nerves, trauma, medications, medical topics, lab tests, and links to orthopedic journals and other orthopedic and medical news.
Human Anatomy Online
Interactive musculoskeletal anatomy
American Academy of Podiatric Sports Medicine
Tips and articles on Patient education for the foot and ankle
Arthroscopy.com
Patient information on various musculoskeletal problems of the lower extremity.
Manual of Structural Kinesiology
The Ankle and Foot Joints

31. The Ankle and Foot Joints
Web Sites
American Academy of Orthopaedic Surgeons
Patient education library on the foot and ankle
Joint Healing.com
Foot and Ankle Anatomy
Loyola University Medical Center: Structure of the Human Body
An excellent site with many slides, dissections, tutorials, etc. for the study of human anatomy
The Gait Cycle: A Breakdown of Each Component
A video breakdown of each basic component during gait.
Manual of Structural Kinesiology
The Ankle and Foot Joints

32. The Ankle and Foot Joints
Web Sites
University of Arkansas Medical School Gross Anatomy for Medical Students
Dissections, anatomy tables, atlas images, links, etc.
American Orthopaedic Foot and Ankle Society
Numerous patient education brochures regarding foot and ankle problems are found here.
Virtual Hospital
Numerous slides, patient information, etc.
Manual of Structural Kinesiology
The Ankle and Foot Joints