Transcript Kinesiology_files/Foot and ankle

Chapter 11
The Ankle and Foot Joints
Manual of
Structural Kinesiology
The Ankle and Foot Joints
11-1
The Ankle and Foot Joint
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26 bones
19 large muscles
Many small (intrinsic) muscles
More than 100 ligaments
Support & propulsion
– Foot trouble - common ailment
– Poor foot mechanics leads to foot discomfort
– No substitute for adequate muscular development,
strength, & proper foot mechanics
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Structural Kinesiology
The Ankle and Foot Joints
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Bones
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Structural Kinesiology
The Ankle and Foot Joints
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Bones
• Distal malleoli of tibia & fibula
– Enlarged & protrude
horizontally & inferiorly
– Serve as pulley for posterior
tendons to increase mechanical
advantage of muscles in
performing inversion & eversion
actions
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Structural Kinesiology
The Ankle and Foot Joints
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Gastrocnemius Muscle
Plantar flexion of ankle
Flexion of knee
Manual of
Structural Kinesiology
The Ankle and Foot Joints
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Soleus Muscle
Plantar flexion of ankle
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Structural Kinesiology
The Ankle and Foot Joints
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Peroneus Longus (fibularis) Muscle
Eversion of foot
Plantar flexion of ankle
Manual of
Structural Kinesiology
The Ankle and Foot Joints
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Peroneus Brevis (fibularis) Muscle
Eversion of foot
Plantar flexion of ankle
Manual of
Structural Kinesiology
The Ankle and Foot Joints
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Peroneus Tertius (fibularis) Muscle
Eversion of foot
Dorsiflexion of ankle
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Structural Kinesiology
The Ankle and Foot Joints
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Extensor Digitorum Longus Muscle
Extension of four lesser toes
at metatarsophalangeal,
proximal & distal
interphalangeal joints
Dorsiflexion of ankle
Eversion of foot
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Structural Kinesiology
The Ankle and Foot Joints
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Extensor Hallucis Longus Muscle
Dorsiflexion of ankle
Extension of great toe at
metatarsophalangeal
& interphalangeal
joints
Weak inversion of foot
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Structural Kinesiology
The Ankle and Foot Joints
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Tibialis Anterior Muscle
Dorsiflexion of
ankle
Inversion of
foot
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Structural Kinesiology
The Ankle and Foot Joints
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Tibialis Posterior Muscle
Plantar flexion
of ankle
Inversion of
foot
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Structural Kinesiology
The Ankle and Foot Joints
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Flexor Digitorum Longus Muscle
Flexion of 4 lesser toes at
metatarsophalangeal,
proximal & distal
interphalangeal joints
Inversion of
foot
Plantar flexion
of ankle
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Structural Kinesiology
The Ankle and Foot Joints
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Flexor Hallucis Longus Muscle
Flexion of great toe at
metatarsophalangeal
& interphalangeal
joints
Inversion of foot
Plantar flexion
of ankle
Manual of
Structural Kinesiology
The Ankle and Foot Joints
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Muscles
Ankle & foot joint muscles by
function
• Plantar flexors
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Gastrocnemius
Flexor digitorum longus
Flexor hallucis longus
Peroneus (fibularis) longus
Peroneus (fibularis) brevis
Plantaris
Soleus
Tibialis posterior
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Structural Kinesiology
The Ankle and Foot Joints
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Muscles
Ankle & foot joint muscles
by function
• Evertors
– Peroneus (fibularis)
longus
– Peroneus (fibularis) brevis
– Peroneus (fibularis) tertius
– Extensor digitorum longus
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Structural Kinesiology
The Ankle and Foot Joints
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Muscles
Ankle & foot joint muscles
by function
• Dorsiflexors
– Tibialis anterior
– Peroneus (fibularis) tertius
– Extensor digitorum longus
(extensor of lesser toes)
– Extensor hallucis longus
(extensor of great toe)
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Structural Kinesiology
The Ankle and Foot Joints
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Muscles
Ankle & foot joint muscles
by function
• Invertors
– Tibialis anterior
– Tibialis posterior
– Flexor digitorum longus (flexor
of lesser toes)
– Flexor hallucis longus (flexor
of great toe)
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Structural Kinesiology
The Ankle and Foot Joints
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Toe Flexion
• Agonists
– Flexor hallucis longus
– Flexor digitorum longus
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Structural Kinesiology
The Ankle and Foot Joints
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Toe Extension
• Agonists
– Extensor hallucis longus
– Extensor digitorum longus
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Structural Kinesiology
The Ankle and Foot Joints
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The Ankle and Foot Joint
• Walking
– Stance phase
• Heel-strike occurs when
landing on heel, foot should be
in supination
• Midstance immediately follows
with foot moving into pronation
• Toe-off follows midstance,
foots returns to supination prior
to & during push off
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Structural Kinesiology
The Ankle and Foot Joints
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The Ankle and Foot Joint
• Walking
– Swing phase
• occurs when foot
leaves ground & leg
moves forward to
another point of
contact
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Structural Kinesiology
The Ankle and Foot Joints
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The Ankle and Foot Joint
• Problems arise
– foot is too rigid & does not pronate
adequately
– foot remains in pronation past midstance
• Walking
– one foot is always in contact with ground
• Running
– point when neither foot is in contact with
ground
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Structural Kinesiology
The Ankle and Foot Joints
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Muscles
• Painful cramps - acute muscle spasm in
gastrocnemius & soleus
– Occur somewhat commonly
– May be relieved through active & passive
dorsiflexion
• Complete rupture of Achilles tendon
– very disabling injury
• Several ankle & foot muscles produce
more than one movement
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Structural Kinesiology
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Muscles
• Acute & chronic injuries are common
– “Shin splints” - common term describing
painful leg condition often associated with
running activities
• Not a specific diagnosis
• Attributed to a number of different specific
musculotendinous injuries
• Most often involves tibialis posterior, medial
soleus, or anterior tibialis, but may also involve
extensor digitorum longus
• May be partially prevented by stretching plantar
flexors & strengthening dorsiflexors
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Structural Kinesiology
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Joints
• Ankle sprains very common
injury
– Sprains involve stretching or
tearing of one or more
ligaments
– Most common ankle sprain
results from excessive
inversion that causes
damage to lateral
ligamentous structures,
primarily anterior talofibular
ligament & calcaneofibular
ligament
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Structural Kinesiology
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Joints
• Ankle sprains very common injury
– Excessive eversion forces injures deltoid
ligament (medially) - less common
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Structural Kinesiology
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Muscles
• Compartment Syndrome
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Most common in anterior compartment
May be acute or chronic
May occur secondarily to injury, trauma, or overuse
Symptoms include sharp pain, particularly with increased
movement actively or passively, swelling, and weakness in
the muscles of the involved compartment
– Depending on severity, emergency surgery may be indicated
to release the fascia in order to prevent permanent tissue
damage
– Many compartment syndromes may be adequately
addressed with proper acute management
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Structural Kinesiology
The Ankle and Foot Joints
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Web Sites
Wheeless’ Textbook of Orthopaedics
www.wheelessonline.com/
– This site has an extensive index of links to the fractures,
joints, muscles, nerves, trauma, medications, medical topics,
lab tests, and links to orthopedic journals and other orthopedic
and medical news.
Human Anatomy Online
www.innerbody.com/image/musc08.html
– Interactive musculoskeletal anatomy
American Academy of Podiatric Sports Medicine
www.aapsm.org/
– Tips and articles on Patient education for the foot and ankle
Arthroscopy.com
www.arthroscopy.com/sp09000.htm
– Patient information on various musculoskeletal problems of
the lower extremity.
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Structural Kinesiology
The Ankle and Foot Joints
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Web Sites
American Academy of Orthopaedic Surgeons
http://orthoinfo.aaos.org/category.cfm?topcategory=Foot
– Patient education library on the foot and ankle
Joint Healing.com
www.jointhealing.com/pages/foot/foot_anatomy.html
– Foot and Ankle Anatomy
Loyola University Medical Center: Structure of the Human Body
www.meddean.luc.edu/lumen/meded/grossanatomy/index.htm
– An excellent site with many slides, dissections, tutorials, etc.
for the study of human anatomy
The Gait Cycle: A Breakdown of Each Component
www.youtube.com/watch?v=5j4YRHf6Iyo
– A video breakdown of each basic component during gait.
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Structural Kinesiology
The Ankle and Foot Joints
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Web Sites
University of Arkansas Medical School Gross Anatomy for
Medical Students
http://anatomy.uams.edu/anatomyhtml/gross.html
– Dissections, anatomy tables, atlas images, links, etc.
American Orthopaedic Foot and Ankle Society
www.aofas.org
– Numerous patient education brochures regarding foot and
ankle problems are found here.
Virtual Hospital
www.vh.org
– Numerous slides, patient information, etc.
Manual of
Structural Kinesiology
The Ankle and Foot Joints
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