Ankle and Lower Leg Chapter 19

BONES OF THE ANKLE AND LOWER LEG TIBIA MEDIAL MALLEOLUS FIBULA LATERAL MALLEOLUS TALUS CALCANEUS

JOINTS OF THE ANKLE TIBIAL - TALAR SUBTALAR

MAJOR LIGAMENTS OF THE ANKLE Lateral Aspect anterior tibiofibular anterior talofibular lateral talocalcaneal calcaneofibular

LIGAMENTS (cont.) Medial Aspect Posterior deltoid posterior talofibular posterior talocalcaneal

Lateral View of Ankle

Medial View of Ankle

MUSCLES OF ANKLE AND LOWER LEG Gastrocnemius Soleus Peroneus longus Peroneus brevis Anterior tibialis Posterior tibialis Extensor digitorum longus Extensor hallucis longus Flexor digitorum longus Flexor hallucis longus

Anterior Musculature

Deep Posterior musculature

Superficial posterior musculature

LOWER LEG COMPARTMENTS ANTERIOR EDL, EHL, Tibialis anterior, ant. tib. artery LATERAL Peroneus longus muscle, peroneal brevis, fibula DEEP POSTERIOR Tib. Post., FDL, FHL, post. tib. artery SUPERFICIAL POSTERIOR Soleus, gasroc

ADDITIONAL STRUCTURES INTEROSSEOUS MEMBRANE DISTAL TIBIOFIBULAR SYNDESMOSIS BURSAE

PREVENTING INJURY TO LOWER LEG & ANKLE Achilles Tendon Stretching Strength Training Neuromuscular Control Training Footwear Preventive Ankle and Braces

PHYSICAL EXAM Weight bearing status Bilateral comparisons Inspection and Palpation Inspection of lateral structures Inspection of medial structures Inspection of anterior structures Inspection of posterior structures Special tests

SPECIFIC INJURIES OF THE ANKLE AND LOWER LEG - ASSESSMENT Ankle Sprain Ankle Fractures Peroneal Tendon Problems Anterior/Posterior Tibialis Tendonitis Shin Conditions Leg Cramps & Spasm Gastroc / Achilles Strain Stress Fracture Syndrome of Lower Leg

REHABILITATION General Weight Bearing Joint Mobilization Flexibility Strengthening Proprioception Taping and Bracing