ESHS Final Ankle & Foot

walking vs running

walking - one foot is always in contact w/ ground
running - point when neither foot is in contact w/ ground

total # bones in foot/ankle

26 bones
- 7 tarsal bones
- 5 metacarpals
- 5 phalanges (3 phalanxes + 2 phalanxes in big toe)
- 2 sesamoid bones under 1st metatarsophalangeal joint

tarsal bones

talus, calcaneus, navicular, cuboid, medial, intermediate, and lateral cuneiforms

tibiofibular joint
bones + joint type

tibia + fibula by interosseous membrane
syndesmotic amphiarthrodial joint

tibiofibular joint
ligaments

- interosseous ligament (talus + calcaneus)
- interosseous ligament (tibia + fibula)
- anterior + posterior tibiofibular ligaments

ankle joint (talocrural joint)
bones + joint type

talus + leg bones
hinge joint

ankle joint
movements°

plantar flexion 50°
dorsiflexion 15-20°

subtalar joint
bones + joint type

talus + calcaneus
gliding or arthrodial joint

transverse tarsal joint
bones + joint type

Anterior surfaces of talus and calcaneus articulate with posterior surfaces of navicular and cuboid
gliding

subtalar + transverse tarsal joints
movements°

inversion 20-30°
eversion 5-15°

metatarsophalangeal joints (MP)
bones + joint type

distal phalanges + metatarsals
condyloid-type

MP joint
movements°

1st toe:
- flexion 45°
- extension 70°
2-5 toes
- flexion + extension 40°

1st toe interphalangeal (IP)
bones + movements°

1+2 phalanxes
extension 0°
flexion 90°

proximal interphalangeal (PIP)
bones + movements°

proximal + middle phalanxes
extension 0°
flexion 35°

distal interphalangeal (DIP)
bones + movements°

middle + distal phalanxes
extension 30°
flexion 60°

medial longitudinal arch

The highest of the three arches of the foot; composed of the calcaneus, talus, navicular, cuneiforms, and the first three metatarsals.

lateral longitudinal arch

One of the three arches of the foot; composed of the calcaneus, talus, cuboid, and the fourth and fifth metatarsals; lower and flatter than the medial longitudinal arch.

transverse arch

an arch that spans an interior space connecting opposite walls by crossing from side to side; from 1st - 5th metatarsals

compartment syndrome

involves the compression of nerves and blood vessels due to swelling within the enclosed space created by the fascia that separates groups of muscles

ankle plantar flexors

gastrocnemius, soleus, tibialis posterior, plantaris, flexor digitorum + hallucis longus, fibularis (peroneus) longus + brevis

foot evertors

fibularis (peroneus) longus, brevis, + tertius, extensor digitorum longus

ankle dorsiflexors

tibialis anterior, fibular (peroneus) tertius, extensor digitorum longus, extensor hallucis longus

foot invertors

tibialis anterior, tibialis posterior (TOM), flexor digitorum longus (DICK), flexor hallucis longus (HARRY)
(TOM, DICK, HARRY)

anterior compartment muscles

tibialis anterior, extensor hallucis + digitorum longus, fibularis (peroneus) tertius

lateral compartment muscles

fibularis (peroneus) longus, fibularis (peroneus) brevis

deep posterior compartment muscles

tibialis posterior, flexor digitorum longus, flexor hallucis longus
TOM, DICK, HARRY

superficial posterior compartment muscles

gastrocnemius (medial + lateral head) and soleus

gastrocnemius

ankle plantar flexion
knee flexion

plantaris

ankle plantar flexion
knee flexion

soleus

ankle plantar flexion

fibularis (peroneus) longus

foot eversion
ankle plantar flexion

fibularis (peroneus) brevis

foot eversion
ankle plantar flexion

fibularis (peroneus) tertius

foot eversion
ankle dorsiflexion

extensor digitorum longus

2nd-5th toe extension
foot eversion
ankle dorsiflexion

extensor hallucis longus

1st toe extension
weak foot inversion
ankle dorsiflexion

tibialis anterior

foot inversion
ankle dorsiflexion

tibialis posterior (TOM)

foot inversion
ankle plantar flexion

flexor digitorum longus

2nd-5th toe flexion
foot inversion
ankle plantar flexion

flexor hallucis longus

1st toe flexion
foot inversion
ankle plantar flexion

# intrinsic muscles of the foot:
# extrinsic muscles

20 intrinsic
19 extrinsic

extensor digitorum brevis

extends toes 2-4
dorsum foot

intrinsic muscles 1st layer

abductor hallucis, flexor digitorum brevis, abductor digiti minimi

intrinsic muscles 2nd layer

quadratus plantae, lumbricales

intrinsic muscles 3rd layer

flexor hallucis brevis, adductor hallucis, flexor digiti minimi brevis

intrinsic muscles 4th layer

dorsal interossei, plantar interossei

ankle sprains

injuries to the ligaments (1st, 2nd, 3rd degree)

anterior talofibular ligament sprain

- Most common sprain
- Inversion in plantar flexion mechanism of injury

calcaneo-fibular ligament sprain

- severe inversion

posterior talofibular ligament sprain

- severe inversion

plantar fascitis

inflammation of the plantar fascia on the sole of the foot

plantar fasciitis causes

- new or increased activity
- repetitive high impact activity
- prolonged standing on hard surfaces
- anatomy (flat feet or high arch)
- tight calf muscles
- obesity
- age

achilles tendinitis

a painful inflammation of the Achilles tendon caused by excessive stress being placed on that tendon

achilles tendinitis symptoms

swelling, pain, irritation

achilles tendinitis non-insertional

- middle portion of tendon
- fibers break down to tiny tears, causing swelling and thickness
- younger, active people

achilles tendinitis insertional

- lower portion of tendon to heel bone
- damage tendon fibers can cause bone spurs
- runners, calf tightness, stress

plantar calcaneal heel spur

plantar aspect of the calcaneus, often embedded in plantar fasciitis

posterior calcaneal heel spur

posterior heel affecting achilles tendon

bunions

painful swellings of the bursae in the first joints of big toes caused by shoe pressure

Morton's Neuroma

inflammation of the nerve typically between the 3rd and 4th metatarsals

Morton's Neuroma
causes

- unknown (compression)

'high sprain ankle'

injury of the anterior tibiofibular ligament