Chapter 19: ankle and foot

ROM of talocrural joint: dorsiflexion

0-20 degrees

ROM of talocrural joint: plantarflexion

0-50 degrees

open chain of talocrural joint

convex talus on concave tibia

closed chain of talocrural joint

concave distal tibia on convex talus

arthrokinematic motion at talocrural joint: dorsiflexion (open kinetic chain)

• Convex surface of talus rolls anteriorly and glides posteriorly on concave tibia.

arthrokinematic motion at talocrural joint: plantarflexion (open kinetic chain)

• Convex surface of talus rolls posteriorly and glides anteriorly on concave tibia.

ROM of subtalar joint: inversion (subtalar joint)

0-35 degrees

ROM of subtalar joint: eversion

0-15 degrees

Plane of motion of talocrural joint

sagittal plane and frontal axis

arthrokinematics of subtalar joint

mainly glide

plane of motion of subtalar joint

frontal plane and sagittal axis

arthokinematics of transverse tarsal joint

gliding motions

transverse tarsal joint divides what?

• divides hindfoot and midfoot

• movement occurs in conjunction with subtalar joint (inversion/eversion and minor abduction/adduction)

what are the ankle joint composite movements?

supination and pronation

what are the triplanar movements of the ankle joint?

• abduction/adduction

• dorsiflexion/plantarflexion

• inversion/eversion

ankle joint is in what plane of motion?

• transverse plane

• oblique axis at subtalar and transverse tarsal joints

closed chain mechanics: pronation

combination of:

• calcaneal eversion

• talar plantarflexion

• talar adduction

• tibial internal rotation

closed chain mechanics: supination

combination of:

• Calcaneal inversion

• Talar dorsiflexion

• Talar abduction

• Tibial external rotation.

open chain mechanics: pronation

combination of:

• Eversion

• Abduction

• Dorsiflexion.

open chain mechanics: supination

combination of:

• Inversion

• Adduction

• Plantarflexion.

Foot ROM: plantar flexion

30-50 degrees (sagittal plane)

Foot ROM: dorsiflexion

10-20 degrees (sagittal plane)

Foot ROM: inversion

30-35 degrees (frontal plane)

Foot ROM: eversion

15-20 degrees (frontal plane)

Foot ROM: adduction/abduction

minimal movement (transverse plane)

what are the metatarsophalangeal joint (MTP) planes of motion?

• flexion/extension

• abduction/adduction

what is the point of reference on the toes?

2nd toe

IP joint characteristics

• hinge joint

• one degree of freedom

  • flexion/extension

• sagittal plane and frontal axis

what are the 3 arches of the foot?

• medial longitudinal arch

• lateral longitudinal arch

• transverse arch

medial longitudinal arch

medial longitudinal arch

transverse arch

transverse arch

lateral longitudinal arch

lateral longitudinal arch

what is red (medial view)?

posterior tibiotalar ligaments

what is orange (medial view)?

anterior tibiotalar ligaments

what is blue (medial view)?

tibionavicular ligament

what is yellow (medial view)?

tibocalcaneal ligament

what is purple (medial view)?

spring ligament

what is orange (lateral view)?

posterior talofibular ligament

what is red (lateral view)?

anterior talofibular ligament

what is yellow (lateral view)?

calcaneofibular ligament

gastrocnemius

• o: posterior medial and lateral condyles of femur

• I: posterior calcaneus via the calcanea (achilles) tendon

• A: knee flexion, ankle plantar flexion

• n: tibial nerve

soleus

• O: posterior interosseous membrane, tibia, fibula

• I: posterior calcaneus via calcaneal tendon

• A: ankle plantar flexion

• N: Tibial nerve

plantaris

• o: lower part of lateral supracondylar ridge of femur

• I: posterior calcaneus via calcaneal tendon

• a: knee flexion, ankle plantar flexion

• n: tibial nerve

superficial posterior group of muscles:

• gastrocnemius

• soleus

• plantaris

deep posterior group of muscles:

• tibialis posterior

• flexor hallucis longus

• flexor digitorum longus

• tibialis posterior

• o: interosseous membrane, adjacent tibia and fibula

• I: navicular and most tarsals and metatarsals

• a: ankle plantar flexion and foot inversion

• n: tibial nerve

• flexor hallucis longus

• o: posterior fibular, interosseous membrane

• I: plantar surface on base of distal phalanx of great toe

• a: ankle plantar flexion, foot inversion, and great toe flexion

• n: tibial nerve

• flexor digitorum longus

• O: posterior tibia

• I: distal phalanx of the 4 lesser toes

• a: ankle plantar flexion, foot inversion, lesser 4 toes MTP and IP joint flexion

• n: tibial nerve

anterior group of muscles:

• tibialis anterior

• extensor hallucis longus

• extensor digitorum longus 

• tibialis anterior

• o: proximal lateral tibia, interosseous membrane

• I: first cuneiform and first metatarsal

• a: ankle dorsiflexion and foot inversion

• n: deep fibular nerve

• extensor hallucis longus

• o: proximal anterior fibula, interosseous membrane

• I: dormsum of base of distal phalanx of great toe

• a: ankle dorsiflexion, foot inversion, 1st toe MTP and IP joint extension

• n: deep fibular nerve

• extensor digitorum longus 

• o: proximal anterior fibular, interosseous membrane, anterior lateral condyle of tibia

• I: dorm of distal phalanx of the 4 lesser toes

• a: ankle dorsiflexion, lesser 4 toes MTP and IP joint extension

• n: deep fibular nerve

lateral group of muscles:

• fibularis longus

• fibularis brevis 

• fibularis tertius

• fibularis longus

• o: head of fibular and interosseous membrane

• I: plantar surface medial cuneiform and first metatarsal

• ankle plantar flexion and foot eversion

• n: superficial fibular nerve

• fibularis brevis 

• o: middle lateral fibula

• I: lateral surface of tuberosity on base of 5th metatarsal

• a: ankle plantar flexion and foot eversion

• n: superficial fibular nerve

• fibularis tertius

• o: distal medial fibular and interosseous membrane

• I: dorsal surface of tuberosity on base of 5th metatarsal

• a: ankle dorsiflexion and foot eversion

• n: deep fibular nerve

intrinsic foot muscles: superficial (1st plantar layer)

• flexor digitorum brevis

• abductor hallucis

• abductor digiti minimi

intrinsic foot muscles: 2nd plantar layer

• lumbricales

• quadratus planea

intrinsic foot muscles: 3rd plantar layer

• flexor hallucis brevis

• adductor hallucis

• flexor digiti minimi

intrinsic foot muscles: 4th plantar layer

• plantar interossei

• dorsal interossei

intrinsic muscles of the dorsum:

• extensor hallucis brevis

• extensor digitorum brevis

what is pink?

first cuneiform

what is black?

second cuneifrom

what is green?

third cuneiform

what is blue?

cuboid

what is purple?

talus

what is red?

calcaneus

what is orange?

phalanges

what is dark blue?

metatarsals

what is yellow?

navicular

what is purple?

• Sustentaculum tali

where is navicular tuberosity?

navicular tuberosity

what is purple?

crest of tibia

subtalar (talocalcaneal) joint is between which bones?

• talus and calcaneus

transverse joint is between which bones?

• mid foot (metatarsals) and hind foot (talus and calcaneus)