1. The Ankle and Foot

2. STRUCTURE AND FUNCTION OF THE ANKLE AND FOOT Bones of the ankle The distal tibia and fibula 7 tarsal 5 metatarsals 14 phalanges

3. Ankle (Talocrural) Joint Characteristics. The ankle (talocrural) joint is a synovial hinge joint formed by the mortise (distal end of the tibia and tibial and fibular malleoli) and trochlea (dome) of the talus

4. STRUCTURAL RELATIONSHIPS AND MOTIONS Anatomical Characteristics Leg The tibia and fibula make up the leg. These two bones are bound together by an interosseous membrane along the shafts of the bones,

5. STRUCTURAL RELATIONSHIPS AND MOTIONS Foot Hindfoot The talus and calcaneus make up the posterior segment.

6. STRUCTURAL RELATIONSHIPS AND MOTIONS Foot Midfoot. The navicular, cuboid, and three cuneiforms make up the middle segment

7. STRUCTURAL RELATIONSHIPS AND MOTIONS Foot Forefoot. Five metatarsals and 14 phalanges make up the anterior segment. Each toe has three phalanges except forth large toe, which has two.

8. Motions of the Foot and Ankle Defined Primary Plane Motions Sagittal plane motion around a frontal

9. Frontal plane motion around a sagittal Plane. Inversion is inward turning of the foot and eversion is Outward turning

10. Triplanar Motions Pronation Pronation is a combination of dorsiflexion,eversion, and abduction.

11. Triplanar Motions Supination. Supination is a combination of plantarflexion,inversion, and adduction.

12. FUNCTIONOFTHE ANKLE AND FOOT Structural Relationships Arches Primary support of the arches comes from the spring ligament In the normal static foot, muscles do little to support the arches

13. FUNCTIONOFTHE ANKLE AND FOOT Structural Relationships Effect on posture. During standing if one foot/ ankle complex is more pronated than the other, the overall effect is a Frontal plane asymmetry with a “short leg” on that side

14. FUNCTIONOFTHE ANKLE AND FOOT Structural Relationships Abnormal foot postures A varus deforimity of the calcaneus may compensate by standing with a pronated (or everted) calcaneus posture Pes cavus and supinated foot describe a high-arched foot

15. Muscle Function in the Ankle and Foot Plantarflexors. Primary Gastrocnemius Soleus Secondry Tibialis posterior The flexor hallucis longus Flexor digitorum longus The peroneus longus

16. Muscle Function in the Ankle and Foot Dorsiflexors Tibialis anterior The extensor hallucis longus and extensor digitorum longus Peroneus tertius

17. THE ANKLE/FOOT COMPLEXAND GAIT During the normal gait cycle, the ankle goes through a ROM of 32deg to 35deg

18. REFERRED PAINAND NERVE INJURY Major Nerves Subject to Pressure and Trauma Common peroneal nerve. Posterior tibial nerve Plantar and calcaneal nerves

19. Common Sources of Segmental Sensory Reference in the Foot