Chapter 10
Ankle & Foot Joints
Ankle & Foot Joints
• 26 bones
• 19 large muscles
• Many small intrinsic muscles
• More than 100 ligaments
Ankle & Foot Joints
Support & Propulsion
• Foot Trouble/Pain: common ailment
• Poor foot mechanics leads to foot discomfort
• No substitute for adequate muscular
development, strength, & proper foot mechanics
Ankle & Foot Joints
Ankle & Foot Joints: Walking
Stance Phase
• Heel-strike occurs when landing on heel, foot should
be in supination
• Midstance immediately follows c/ foot moving into
pronation
• Toe-off follows midstance, foot returns to supination
prior to & during push off
Ankle & Foot Joints: Walking
Swing Phase
• Occurs when foot leaves ground & leg moves
forward to another point of contact
Ankle & Foot Joints
Problems
• Foot is too rigid & does not pronate adequately
• Foot remains in pronation past midstance
Walking
• One foot is always in contact c/ ground
Running
• A point when neither foot is in contact c/ ground
Bones
• Each foot has 26 bones forming an arch
• Body weight is transferred from the tibia to the talus &
calcaneus
• 5other bones in the rear foot & mid-foot, known as
the tarsals
• Navicular: btw/ talus & three cuneiform bones
Bones
• Cuboid: BTW/ calcaneus 4th & 5th metatarsals
• 5 Metatarsals: Anterior to tarsals
• 5 Phalanges: 3 phalanxes in each except 1st toe, which
contains two phalanxes
• 2 Sesamoids: Beneath 1st metatarsophalangeal joint
Bones
Bones
Bones
Pulley for Posterior Tendons
• Peroneus Brevis & Peroneus Longus: Immediately behind
lateral malleolus
• Base of 5th metatarsal serves as an insertion for peroneus
brevis & tertius
Bones
“Tom, Dick, & Harry” muscles immediately posterior to
medial malleolus
• Tibialis Posterior
• Flexor Digitorum Longus
• Flexor Hallucis Longus
Bones
• Tibialis Anterior inserts on inner surface of medial
cuneiform & base of 1st metatarsal
• Peroneus Longus inserts on undersurface of medial
cuneiform & 1st metatarsal
• Tibialis Posterior: Multiple insertions on lower inner
surfaces of navicular, cuneiform, & 2nd through 5th
metatarsal bases
Bones
• Extensor Digitorum Longus inserts on top of 2nd
through 5th distal phalanxes bases
• Flexor Digitorum Longus inserts on undersurfaces of
2nd through 5th distal phalanxes bases
• Extensor Hallucis Longus inserts on top of 1st distal
phalanx base
Bones
• Flexor Hallucis Longus inserts on undersurface of 1st
distal phalanx base
Posterior Surface of Calcaneus
• Prominent & serves as a point of insertion for Achilles
Tendon
Tibiofibular Joint
• Syndesmotic
amphiarthrodial joint
• Joined at proximal &
distal tibiofibular joints
• Ligaments & strong, dense
interosseus membrane
btw/ tibia & fibula shafts
provide support
Tibiofibular Joint
Syndesmosis Joint Sprain
• “High Ankle Sprain”
primarily involves
anterior inferior
tibiofibular lig
Joints
• Most common ankle sprains result from excessive inversion cau/
damage to lateral ligamentous structures, primarily anterior
talofibular & calcaneofibular lig
Joints
Arches
2 Longitudinal Arches
• Medial Longitudinal Arch
• Lateral Longitudinal Arch
1 Transverse Arch
Jump to Joints, 5, Appendix
Arches
Joints
Plantar Fascia / Plantar Aponeurosis
• Assists in stabilizing the medial longitudinal arch & in
propelling body forward during latter part of stance
phase
Plantar Fasciitis
• Common painful condition involving the plantar fascia
Muscles
Muscle groups formed according to location & function
• Anterior Ankle & Foot: Dorsal Flexors
• Posteriorly: Plantar Flexors
• Laterally: Evertors
• Medially: Invertors
Lower Leg Muscles
Lower Leg: Divided into 4 compartments
• Dense Fascia: Tightly surrounds & binds each compartment
• Facilitates venous return & prevents excessive swelling of
muscles during exercise
• Anterior Compartment
• Dorsiflexor Group: Tibialis Anterior, Peroneus Tertius,
Extensor Digitorum Longus, & Extensor Hallucis Longus
• Lateral Compartment
• Peroneus Longus & Peroneus Brevis
Lower Leg Muscles
• Posterior Compartment – Superficial & Deep
• Gastrocnemius, Soleus, & Plantaris (Superficial)
• Deep Posterior Compartment
• Flexor Digitorum Longus, Flexor Hallucis Longus,
Popliteus, & Tibialis Posterior
Lower Leg Muscles
Compartment Syndrome
• Most common in anterior compartment
• May be acute or chronic
• Sx include sharp pain, particularly with increased movement
actively or passively, swelling, & weakness
• Depending on severity, emergency surgery may be indicated to
release fascia in order to prevent permanent tissue damage
Ankle & Foot Joint Muscles by Function
Several ankle & foot muscles
produce more than one
movement
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
Ankle & Foot Joint Muscles by Function
Evertors
• Peroneus / Fibularis Longus
• Peroneus / Fibularis Brevis
• Peroneus / Fibularis Tertius
• Extensor Digitorum Longus
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
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
Ankle & Foot Joint Muscles by Compartment
Anterior Compartment
• Tibialis Anterior
• Extensor Hallucis Longus
• Extensor Digitorum Longus
• Peroneus / Fibularis Tertius
Ankle & Foot Joint Muscles by Compartment
Lateral Compartment
• Peroneus / Fibularis Longus
• Peroneus / Fibularis Brevis
Ankle & Foot Joint Muscles by Compartment
Deep Posterior Compartment
• Flexor Digitorum Longus
• Flexor Hallucis Longus
• Tibialis Posterior
Superficial Posterior
Compartment
• Gastrocnemius / Medial Head
• Gastrocnemius / Lateral Head
• Soleus
Gastrocnemius Muscle
Plantar flexion of ankle
Flexion of knee
Soleus Muscle
Plantar flexion of ankle
Peroneus / Fibularis Longus Muscle
Peroneus / Fibularis Brevis Muscle
Peroneus / Fibularis Tertius Muscle
Extensor Digitorum Longus Muscle
Extensor Hallucis Longus Muscle
Tibialis Anterior Muscle
Tibialis Posterior Muscle
Flexor Digitorum Longus Muscle
Flexor Hallucis Longus Muscle
Ankle Dorsiflexion
Agonists
• Tibialis Anterior
• Extensor Digitorum Longus
• Peroneus / Fibularis Tertius
• Extensor Hallucis Longus
Ankle Plantar Flexion
Agonists
• Gastrocnemius
• Soleus
• Flexor Digitorum Longus
• Flexor Hallucis Longus
• Peroneus / Fibularis Longus
• Peroneus / Fibularis Brevis
• Plantaris
• Tibialis Posterior
Toe Flexion
Agonists
• Flexor Hallucis Longus
• Flexor Digitorum Longus
Toe Extension
Agonists
• Extensor Hallucis Longus
• Extensor Digitorum Longus
Sciatic Nerve
Tibial Division
• Gastrocnemius, soleus, tibialis posterior, flexor digitorum
longus, and flexor hallucis longus
• Medial and Lateral Plantar Nerves: Intrinsic foot muscles
• Medial Plantar Nerve
• Abductor hallucis, flexor hallucis brevis, first
lumbrical, and flexor digitorum brevis
Sciatic Nerve
Tibial Division
• Medial and Lateral Plantar Nerves: Intrinsic foot muscles
• Lateral Plantar Nerve
• Adductor hallucis, quadratus plantae, lumbricals 2,
3, and 4, dorsal interossei, plantar interossei,
abductor digiti minimi, and flexor digiti minimi
Sciatic Nerve
Common Peroneal or Fibular Division
• Superficial Peroneal Nerve
• Peroneus longus and peroneus brevis
• Deep Peroneal Nerve
• Tibialis anterior, extensor digitorum longus, extensor
hallucis longus, peroneus tertius, and extensor
digitorum brevis