©2010 Primal Pictures

Ankle joint – dorsi and plantar flexion

Articulations of the subtalar joint –

inversion, eversion, supination, pronation

Figure 3a: Dorsiflexion

stopping excess dorsi-flexion. For the rest of the article we will consider both joints as a single joint acting together together.

Figure 2: Main joints of the ankle and the movements associated with those joints (lateral view)

MUSCLE MOVEMENTS n Plantar-flexion – is due to the muscles in the posterior compartment of the calf i.e. gastrocnemius, soleus, posterior tibialis, flexors of the toes n Dorsi-flexion – is caused by the muscles in the anterior compartment of the shin i.e. tibialis anterior and extensors of the toes n Eversion – is caused by the peroneii muscles (i.e. longus, brevis and tertius) n Inversion – is down to movements of the extensors of the toes, tibialis anterior and posterior combined. The gastrocnemius muscles are

Figure 4a: Inversion

the power muscles for running. Soleus is the main muscle for walking and standing. The other muscles in gross terms manoeuvre and stabilise the foot during movement. As with the knee, the ankle is a joint which is stable due to the array

Figure 3b: Plantarflexion

of ligaments connecting the talus and calcaneum to the tibia and fibula. The joint is surrounded by tendons of the shin muscles attaching to the calcaneum and other bones of the mid- and fore-foot (excepting the talus). Again as with the knee, the ligaments tighten when stretched, firing off stretch receptors which allow the spinal reflexes to contact the appropriate muscle to avoid/resist excess movement. During normal gait however the muscles control the movement of the foot and ankle to adapt to the underlying surface.

ambulation and their attachments - to fully understand their

+ Figure 4b: Eversion

ankle rolls toward centre

LEFT FOOT

RIGHT FOOT

Figure 4c: Pronation

Figure 5a: Pronation of the foot as seen from behind

Figure 4d: Supination

heel turns toward centre

little toe

big toe

heel rotates away from center

12 little toe

Figure 5b: Supination of the foot as seen from behind See

video 5 under the Interactive extras section for a video showing pronation and supination in standing.

little toe

big toe

little toe

sportEX medicine 2010;46(Oct):11-16

LEFT FOOT

RIGHT FOOT

ankle rolls away from centre

actions - both concentrically and eccentrically. A good history and examination will often help locate the source of the ankle ‘problem’.

KEY POINT:

Familiarise yourself with the muscles of