Foot and Ankle

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Foot and Ankle

• Coach Parker
• Health and Wellness 3

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The Foot

• Made up of 26 Bones
• 3 functional units
• Anterior-forefoot contains 5 MTs, 14 phalanges
• Middle- midfoot 5 tarsals-navicular, cuboid, 3
  cuneiforms
• Posterior-hindfoot talus and calcaneus

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Ligaments

• Approx 100 ligaments in foot ankle
• Lateral side- ATF, PTF, calcaneofibular lig
• Medial side- deltoid lig complex
• Tibiocalcaneal, ant/pos tibiotalar, and
  tibionavicular
• Plantar calcaneonavicular lig- Spring
  lig-supports talus and maintains longitudinal arch

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Arches

• Longitudinal- calcaneal tuberosity to 5 MTs
• Transverse- crosswise from medial to lateral in
  midtarsal region
• Plantar fascia-thick connective tissue that
  provides support for longitudinal arch
• Acts as extension of Achilles tendon of
  plantarflexor muscles

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Joints

• Ankle- synovial, hinge b/t distal tibia, fibula,
  and dome of talus
• Ankle mortise- tight fibrous syndesmosis unites
  all of the above
• Subtalar joint- synovial jt b/t talus and
  calcaneus
• Many others (small) tarsometatarsal,
  intermetatarsal, metatarsophalangeal,
  interphalangeal

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Movements

• Talocrural jt- DF/PF
• Subtalar jt- IV/EV
• Midtarsal/tarsometatarsal-gliding
• MTP and IP jt- flx/ext

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Movements (cont.)

• Pronation and supination- combo mvmts that allow
  foot to maintain contact w/ ground in multiple
  stance or uneven ground
• Pronation- talocrural DF, subtalar, EV, and
  forefoot Abd
• Supination- PF, IV, and Add

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Muscles

• Mainly in lower leg
• Grouped by compartments
• Anterior
• Lateral
• Superficial posterior
• Deep posterior

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Anterior

• Tibialis anterior-DF, inverts foot and ext of 2-5
  digits
• Peroneus tertius-DF, everts the foot
• Extensor digitorum longus-DF, extends 2-5
• Extensor hallucis longus-DF, extends big toe

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Lateral

• Peroneus longus-evert the foot and PF
• Peroneus brevis- evert foot and PF

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Superficial Posterior

• Gastrocnemius-powerful PF, 2 headed, 2 jt muscle
  so flexes knee, more FT fibers than soleus, used
  w/ dynamic, higher force activity
• Soleus- PF, more active during postural/static
  contraction
• 90 knee flx- takes away gastroc
• Plantaris-PF

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Deep Posterior

• Tibialis Posterior, flexor digitorum longus,
  flexor hallucis longus-Tom, Dick, and Harry
• Tib Post- PF and IV
• Popliteus- inverter
• Flex Hall Long- flx big toe
• Flex Digit Long- Flex 2-5 toes

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Injuries

• Ankle sprains-lat more common bc of bony
  structure and lig strength
• ATF-most frequent
• Syndesmotic- high ankle sprain 2x longer tx
• Strains/cramps-dehydration, running, jumping etc
• Achilles tendon rupture-most serious acute
  injury- forceful PF while knee ext

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Injuries (Chronic)

• Plantar fasciitis- chronic inflammatory
  condition px _at_ calcaneal insertion of Plantar
  fascia
• Tight achilles, hyperpronation (flat ft or pes
  planus) obesity
• Bunions, neuromas, tendonitis, bursitis-calc also
  common chronic injuries

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Major Special Tests

• Glide Test-lig sprain
• Compression/Squeeze Test-poss fx
• Valgus/Varus Stress Test-lig sprain in toes
• Navicular Drop Test-hyperpronation
• Ant Drawer Test- ATF lig tear
• Talar Tilt- Calcaneofib lig, poss ATF, PTF, or
  delt
• External Rotation Test-in DFhigh ankle, or delt
• Bump Test-fx
• Thompson Test-Achilles Tendon Rupture