Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-1

• 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
11-2

Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-3

• 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
11-4

Plantar flexion of ankle
Flexion of knee
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-5

Plantar flexion of ankle
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-6

Eversion of foot
Plantar flexion of ankle
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-7

Eversion of foot
Plantar flexion of ankle
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-8

Eversion of foot
Dorsiflexion of ankle
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-9

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
11-10

Dorsiflexion of ankle
Extension of great toe at metatarsophalangeal
& interphalangeal joints
Weak inversion of foot
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-11

Dorsiflexion of ankle
Inversion of foot
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-12

Plantar flexion of ankle
Inversion of foot
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-13

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
11-14

Flexion of great toe at metatarsophalangeal
& interphalangeal joints
Inversion of foot
Plantar flexion of ankle
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-15

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
11-16

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
11-17

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
11-18

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
11-19

• Agonists
– Flexor hallucis longus
– Flexor digitorum longus
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-20

• Agonists
– Extensor hallucis longus
– Extensor digitorum longus
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-21

• 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
11-22

• 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
11-23

• 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
11-24

• 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
11-25

• 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
11-26

• 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
11-27

• Ankle sprains very common injury
– Excessive eversion forces injures deltoid ligament (medially) - less common
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-28

• 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
11-29

Wheeless ’ Textbook of Orthopaedics www.wheelessonline.com/
– 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 www.innerbody.com/image/musc08.html
– Interactive musculoskeletal anatomy
American Academy of Podiatric Sports Medicine www.aapsm.org/
– Tips and articles on Patient education for the foot and ankle
Arthroscopy.com www.arthroscopy.com/sp09000.htm
– Patient information on various musculoskeletal problems of the lower extremity.
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-30

American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/category.cfm?topcategory=Foot
– Patient education library on the foot and ankle
Joint Healing.com
www.jointhealing.com/pages/foot/foot_anatomy.html
– Foot and Ankle Anatomy
Loyola University Medical Center: Structure of the Human Body www.meddean.luc.edu/lumen/meded/grossanatomy/index.htm
– An excellent site with many slides, dissections, tutorials, etc. for the study of human anatomy
The Gait Cycle: A Breakdown of Each Component www.youtube.com/watch?v=5j4YRHf6Iyo
– A video breakdown of each basic component during gait.
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-31

University of Arkansas Medical School Gross Anatomy for
Medical Students http://anatomy.uams.edu/anatomyhtml/gross.html
– Dissections, anatomy tables, atlas images, links, etc.
American Orthopaedic Foot and Ankle Society www.aofas.org
– Numerous patient education brochures regarding foot and ankle problems are found here.
Virtual Hospital www.vh.org
– Numerous slides, patient information, etc.
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-32