The Ankle and Foot
The ankle region is an area in which the lower leg meets the foot and is the articulation of the tibia and fibula (shin bones) and the talus (ankle bone) of the foot. Each ends of these bones are covered in articular cartilage.
It is another area that is complex as it is made up of 3 different joints working together to provide movement and stability, thus foot and ankle physiotherapy is often needed. The main ankle joint is known as the talo-crural joint that exists between the tibia and talus of the foot and allows up and down movement of the ankle. The sub-talar joint that sits underneath allows us to move the foot inwards and outwards.
These ankle joints are held together by strong ligaments that attach mainly on the outside (lateral) and inside (medial); it is the lateral ligaments that are notoriously involved with ankle sprains.
There is a whole list of important muscles crossing the ankle region: at the back, the gastrocnemius and soleus which then blend into the Achilles tendon to attach onto the calcaneum (heel bone). Other numerous muscles plantarflex (point) the toes and pass around the back of the ankle. At the front, the tibialis anterior and the extensor muscles extend the ankle (pull it up towards the face), whilst the peroneal muscles turn the foot outwards and originate from the fibula bone on the outside of the lower leg. Foot and ankle physiotherapy can be used to treat all kinds of injuries associated with this anatomy.
Our Foot and Ankle Physiotherapy
The foot is comprised of 26 different bones – both feet make up nearly a quarter of all the bones in the body. As a result, movement of the ankle and foot involves 30 joints and 30 tendons of the lower leg.
The foot can be divided into 3 parts: the hind foot which is the talus (ankle bone) and the calcaneus (heel bone), the mid foot and the fore foot.
There are 2 arch systems within the foot: The longitudinal (medial) arch which runs from the calcaneus to the big toe and is supported by the plantar ligament which maintains the arch shape. The transverse arch is formed by the heads of the metatarsals and runs across the width of the foot.
Many muscles mentioned above insert into different bones of the foot, also much smaller muscles, known as Intrinsic muscles, connect the bones of the foot to allow for finite movement to occur – like scrunching up the toes.
Common Ankle Problems
- Muscle strains
- Ligament sprains
- High ankle/syndesmosis sprains
- Achilles tendinitis/tendinopathy
- Sever’s Disease
- fractures: tibia, fibula, talus, calcaenous
- Post operatively:
- Ankle ligament surgery
- Ankle replacements
- Osteochondral defects
- Syndesmosis repairs
Common Foot Problems
- Pronating feet (flat feet)
- Morton’s Neuroma
- Fat pad syndrome/impingement
- fractures: tarsal, metatarsal, phalange
- Post operatively:
- Bunion surgery
Check out our VLOG on how to best to treat ankle sprains here.