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The Ankle latin “ angulus ” - bent. Key Players. Bones: Tibia, fibula, talus and calcaneus Ligaments: Anterior Tibio fibular Ligament (ATFL) Posterior Tibio fibular Ligament (PTFL) Anterior Talo fibular Ligament (ATL) Posterior Talo fibular Ligament (PTL). Talocrural Joint. - PowerPoint PPT Presentation
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The Anklelatin “angulus” - bent
Key PlayersBones:Tibia, fibula, talus and calcaneusLigaments:Anterior Tibiofibular Ligament
(ATFL)Posterior Tibiofibular Ligament
(PTFL)Anterior Talofibular Ligament
(ATL)Posterior Talofibular Ligament
(PTL)
Talocrural JointBetween the tibia, fibula and
talusThis is a hinge joint and allows
most of the motion with plantar flexion and dorsiflexion.
________________
________________Talocrural Jt.
Subtalar JointThe articulation between the
talus and the calcaneus is referred to as the subtalar joint. Motion allowed by this joint is inversion (roll inward)/eversion (roll outward) as well as rear foot pronation (inward tilt of the calcaneus) and supination (outward tilt of the calcaneus) .
calcaneus
Talus
---Subtalar Joint
Medial aspect of foot
Ankle LigamentsThere are three lateral ligaments
predominantly responsible for the support and maintenance of bone apposition (best possible fit). These ligaments prevent inversion of the foot.
These ligaments are:◦Anterior talofibular ligament◦Calcaneofibular ligament◦Posterior talofibular ligament
Talus
FibulaTibia
Ant. Talofibular Ligament
Ant.Ti
biofibu
lar
Lig.
Post. Tibiofibular Lig.
<- Fibula
<- Ant. Talofibular Lig
<- Talus
Peroneal Tendons
Calca
neofi
bula
r Lig
amen
tCalcaneus
Subtalar Joint Space
Cuboid
calcaneus
<-Fibular head
Posterior tibiofibular Ligament
Achilles Tendon
Talus
Posterio
r
talofibular lig.
Peroneal tendons
The deltoid ligamentThis is located on the medial
aspect of the foot. It is the largest ligament but is actually comprised of several sections all fused together. This ligament prevents (eversion) of the ankle. The deltoid ligament is triangular in shape and has superficial and deep layers. It is the most difficult ligament in the foot to sprain.
Tibia
X
X
XNavicular ---
-- Talus
Tibial
is Pos
terior
Tendon
Tibi
alis
Ant.
Tend
on
Deltoid LigamentX
Ankle SprainsThe ankle is weakest when it is
plantar flexed.
Ankle SprainsInversion Sprain “rolling
over on your ankle”Mechanism: landing
from a jump while PFAffects the lateral
ligaments of the ankleFirst time sprain, 90% of
the time on uneven ground. Multiple sprains, could be on flat ground
Ankle SprainsEversion SprainsLess common due
to:◦ Strength of the
deltoid ligament (medially)
If forceful ankle eversion occurs, usually a tip of medial maleolus (tibia) chips off
What ligaments could be damaged from:
A. Inversion Sprain?• Lateral
ligaments: most commonly the Anterior Talofibular Ligament,
B. Eversion Sprain?• Deltoid ligament
(despite its strength)
Prevention of Injury to the Ankle
Stretching of the Achilles tendonStrengthening of the surrounding
musclesProprioceptive training: balance
exercises and agilityWearing proper footwear and or
tape when appropriate
Achilles Tendon Tear and Repair
Preventative Taping and Orthosis
Taping is often post injury treatment. Some will argue that taping will weaken the ankle. This has not been proven without a doubt but exercise and strengthening of the ankle is always advised.
Othotics will help rectify conditions that are permanent and will not be fixed by any other means.
Tape vs. BraceWhy choose one over anotherTaping may be more time consuming over
braceBraces may or may not allow more support
over tapeTape allows more functional movement and
often feels more stableTape will loosen with timeBraces will often loosen with timeIt really is based on the quality of the brace
vs. the ability of the person to tape. Both have advantages and disadvantages.
Lab ActivityFind out if you are prone to leg, ankle and foot
injuries by completing the exercises on the handout.
Any interesting findings?1. Length of legs: unbalanced,
overcompensation of one side of the body2. Morton’s Toe: stress on metatarsals could
increase risk of Metatarsal Stress Syndrome3. Pronation: risk of PFS, Tibial Stress
Syndrome and plantar fascitis, among other things
Shoe ShoppingFeet come in many shapes and sizes. How
can one shoe size capture all these?Oftentimes we need different footwear for
different activities!
Things to consider:Midsole materials
◦ Firmer◦ Softer
Heel counter◦ Rigid (prevents foot pronation)◦ Less rigid
Tips for Shoe ShoppingShop where there are
knowledgeable clerksKnow the spectrum of foot typesKnow the spectrum of shoe types
Questions?See your family doctor or
podiatrist