Jake Allen + Krissy LaPointe + Drew Spicer Ankles of Action! Jake Allen + Krissy LaPointe + Drew Spicer

Bones & Joints BONES: Fibula Talus Tibia Calcaneus JOINTS: Talofibular Tibiofibular Tibiotalar

Ligaments

Muscles

Movements Dorsiflexion Plantarflexion Inversion Eversion “Women with increased tibial varum and calcaneal eversion range of motion are at greater risk of suffering ankle ligament trauma, while men with increased talar tilt are at greater risk.” (Medline Plus, 2011)

Restrictions Structures Limiting Movements Dorsiflexion (ROM) 0° - 20° Ligaments: Medial Ligament of Ankle, Calcaneofibular, Posterior Talofibular, Posterior Joint Capsule Contact of Talus w/ Tibia Tension of Plantarflexors of Ankle Plantarflexion 0° - 50° Ligaments: Anterior Talofibular, Anterior Part of Medial Ligament of Ankle, Anterior Joint Capsule Contact of Talus w/ Fibula Tensions of Dorsiflexors of Ankle Inversion 0° - 35° Ligaments: Lateral Ligament of Ankle, Talocalcaneal Ligament, Lateral Joint Capsule Tension of Evertor Muscles of Ankle Eversion 0° - 25° Ligaments: Medial Ligament of Ankle, Medial Talocalcaneal Ligament, Medial Joint Capsule Tensions of Tibialis posterior, Flexor Hallucis Longus, Flexor Digitorum Longus Contact of Talus w/ Calcaneus Moore: Table 5.16 (pg 387) & Table 5.17 (pg 390) Dorsiflexion limited to 20 degrees. The Posterior Tibiotalar, Tibionavicular and Tibiocalcaneal Ligaments of the Deltoid Ligament along with the Calcaneofibular, Posterior Talofibular and the Posterior aspect of the joint capsule. As well as neck of the Talus bumping into the anterior inferior aspect of the Tibia and the Plantar Flexors. All of these structures limit Dorsiflexion. Plantar Flexion limited to 50 degrees. The last Deltoid Ligament, Anterior Tibiotalar, the Talofibular, and the Anterior aspect of the joint capsule. As well as the Dorsiflexors and the Talus. During plantar flexion, the talus internally rotates as a result of its conical and wedged shape it also supinates slightly causing posterolateral wedging between the posterolateral trochlea and lateral malleolus. Together these structures limit Plantar Flexion. Inversion limited to 35 degrees. Lateral ligaments of the ankle, Lateral Talocalcanneal ligament and the Lateral aspect of the joint capsule, along with the Evertor Muscles limit Inversion. Eversion limited to 25 degrees. The Deltiod, Medial Talocalcaneal Ligaments, and the Medial aspect of the joint capsule. Tibialis Posterior, Flexor Hallucis Longus, and Flexor Digitorum Longus also act to limit Eversion. And due to the abnormal shape of the Subtalar joint the contact between the Talus and the Calcaneus also limit Eversion.

Assess the Ankle Actions

References Medline Plus, National Institutes of Health. (2011, March). Ankle Ligament Injury Risk Factors: a prospective study of college athletes. Retrieved September 29,2014, from http://www.ncbi.nlm.nih.gov/pubmed/11347693 Moore, Keith L., Agur, Anne M.R., and Dalley, Arthur F. (2015). Essential Clinical Anatomy (5th ed). Baltimore, MD: Lippincott Williams & Wilkins. Netter, Frank H. (2014). Atlas of Human Anatomy. 6th ed. Philadelphia, PN: Saunders. Pro Active Physical Therapy. (2011). Ankle Impingement Problems. http://www.proactivept.com/Injuries-Conditions/Ankle/Ankle-Issues/Ankle- Impingement-Problems/a~120/article.html Rehabilitation: Merck Manual Professional. (2013, August). Normal Values for Range of Motion of Joints: Ankle. Retrieved October 3, 2014, from http://www.merckmanuals.com/professional/special_subjects/rehabilitation/physical_ therapy_pt.html