Ankle and foot kinesiology

What are the 3 major joints we focus on in kinesology?

Talocrural, subtalar, transverse tarsal

Where is the talocrural joint located?

between the tibia/fibula and the talus

Where is the subtalar joint located?

between the talus and calcaneous

Where is the transverse tarsal joint located?

between the talus/calcaneous and the cuboid/cuneiforms

Where is the proximal tibiofibular joint located and what type of joint is it?

head of fibula with proximal tibia; planar/slide, synovial joint

Which way does the fibula glide when DF?

posteriorlaterally

Which way does the fibula glide when PF?

anteromedially

What function does the distal tibiofibular joint have when DF?

it allows for spread of tib-fib so larger anterior side of talus can fit between

Where do high ankle sprains occur?

the distal tib/fib articulation

What typically causes a high ankle sprain?

rotational injury, particularly ER with the talocrural joint in full DF

Where does most of the compressive load occur in the ankle? Between the talus/tibia or between lateral talus/fibula?

talus/tibia

Is the tibia/fibula concave or convex?

concave

Is the talus concave or convex?

convex

What is the CPP of the talocrural joint? What is the LPP?

Max DF; 10 degrees PF, neutral inv/ev

What is the capsular pattern of the talocrural joint?

PF > DF

What are all of the fundamental osteokinematics in the foot/ankle

abduction/adduction, inversion/eversion, dorsiflexion/plantarflexion

What are the actual osteokinematics in the foot/ankle (triplanar motion)? What three individual motions make up each?

Pronation and supination;

pronation: eversion, abduction, dorsiflexion

supination: inversion, adduction, plantarflexion

What is the main osteokinematic component of pronation?

dorsiflexion

What is the main osteokinematic component of supination?

plantarflexion

How many degrees of ROM does the talocrural joint have in dorsiflexion?

10-20 degrees

How many degrees of ROM does the talocrural joint have in plantarflexion?

30-50 degrees

What is the arthrokinematic of ankle dorsiflexion?

anterior roll, posterior slide

What is the arthrokinematic of ankle plantarflexion?

Posterior roll, anterior slide

Which ligaments limit inversion?

Anterior talofibular ligament, posterior talofibular ligament, and calcaneofibular ligament

Which ligament limits eversion?

Deltoid Ligament

What is the CPP of the subtalar joint?

Supination (PF, Inv, Add)

What is the LPP of the subtalar joint?

Mid-range (neutral position)

What is the capsular pattern of the subtalar joint?

Inv (varus) > eversion (valgus)

Which position, STJ supination or pronation, unlocks the MTJ?

Pronation (DF, Ev, Abd)

Which position, STJ supination or pronation, locks the MTJ?

Supination (PF, Inv, Add)

What 3 actions are included in the subtalar joint osteokinematic of distal end free pronation?

Eversion, abduction, dorsiflexion

What 3 actions are included in the subtalar joint osteokinematic of distal end free supination?

inversion, adduction, plantarflexion

What 3 actions are included in the subtalar joint osteokinematic of distal end fixed supination?

calcaneal inversion, talar abduction & DF (talus moves up and out)

What 3 actions are included in the subtalar joint osteokinematic of distal end fixed pronation?

calcaneal eversion, talar adduction & PF (talus moves down and in)

Does the calcaneous move medial or lateral when going into inversion at the subtalar joint?

medial

Does the calcaneous move medial or lateral when going into eversion at the subtalar joint?

lateral

What osteokinematic motions are produced at the talonavicular joint (lil stj)?

Eversion & inversion

What osteokinematic motions are produced at the calcaneocuboid joint (lil tc)?

Dorsiflexion & plantarflexion

What are the joint axis for the midtarsal joints?

longitudinal (talonavicular) and oblique (calcaneocuboid)

What is the primary joint motion of the talonavicular joint?

Eversion and inversion

What is the primary joint motion of the calcaneocuboid joint

pronation: dorsiflexion, abduction

supination: plantarflexion, adduction

Which muscle is the primary supinator of the foot/MTJ?

Tibialis posterior (& it controls pronation eccentrically)

Which ligament is known for supporting the medial longitudinal arch?

Spring ligament

What are the 3 midtarsal joint ligaments?

Spring ligament, short plantar ligament, long plantar ligament

What are the functions of the intertarsal joints?

assist MTJ with supination/pronation & form transverse arch

What two structures make up a "ray" in the foot?

Metatarsal + phalanges

Which TMT joint is the most stable?

2nd- important for gait

Which TMT joint has the greatest adapability?

1st

What happens to the arch when you DF the 1st ray?

arch lowers

What happens to the arch and gait when you PF the 1st ray?

raises arch and stabilizes the foot for push off

What is the medical term for a bunion?

Hallux Valgus

What is the CPP of the IP joints?

Full extension

What is the LPP of the IP joints?

Slight extension

What is the capsular pattern of the IP joints?

Flexion > extension

What are the 3 arches of the foot?

Medial longitudinal arch, lateral longitudinal arch, transverse arch

What is the keystone of the medial longitudinal arch- MLA?

Talonavicular joint

What is the most superficial nonfat structure of the foot?

Plantar fascia

When you bear weight, what kind of force is put on the plantar fascia? (passive/active, tensile/compressive)

passive tension- arch drops

What happens to the plantar fascia and the intrinsic foot muscles as you bear weight if you have a dropped arch?

Plantar fascia and intrinsic muscles get stretched- cant stabilize as well

What is it called when the plantar fascia becomes tight due to GT extension & elevated arch?

Windlass mechanism

What are some disadvantages of a "flat foot"

low med-long arch (overstretched PF/intrinsics),

less MTP extension bc "collapse" of MTJ,

less effective windlass mechanism,

inablility to lock midfoot/forefoot,

bidirectional relationship

What bones make up the transverse tarsal joint?

three cuneiforms, and cuboid

What is the keystone of the transverse tarsal joint?

Intermediate cuneiform

What is the primary function of the transverse arch?

keep all 5 MTs on the ground (distribute weight)

What position is the talocrural joint in when standing on a hill facing downhill?

Plantarflexion

What position is the talocrural joint in when standing on a hill facing uphill?

dorsiflexion

What position is the talocrural joint in when at the bottom of the squat position?

Dorsiflexion

What position is the talocrural joint in when lying in supine, hook lying position?

Plantarflexion

What position is the talocrural joint in when walking just before the heel comes up to swing the leg forward? (foot is behind you)

Dorsiflexion

What is the STJ position when standing with an extremely wide stance?

Inversion

R STJ in standing and turning to look far behind you to the Right?

Inversion

R STJ in standing and turning to look far behind you to the Left?

Eversion

What is the role of the muscles in the anterior compartment of the leg?

Dorsiflexion

What is the role of the muscles in the lateral compartment of the leg?

Eversion

What is the role of the muscles in the superficial posterior compartment of the leg?

Plantarflexion

What is the role of the muscles in the deep posterior compartment of the leg?

Inversion

What is the role of the plantarflexors in weight bearing?

Eccentric force to control/slow the weight shift forward of the tibia

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Rearfoot varus

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rearfoot valgus

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forefoot varus

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forefoot valgus