Everything a Personal Trainer needs to know about the Foot and Ankle

2 / 3 - Bones in the foot and ankle

Tibia - The larger of the two bones in the lower leg, located on the medial (inner) side.

Fibula - The smaller of the two bones in the lower leg, located on the lateral (outer) side.

Talus - The bone that sits above the heel bone (calcaneus) and forms the lower part of the ankle joint.

Calcaneus - The heel bone, the largest bone in the foot.

Navicular - A boat-shaped bone located in the midfoot.

Cuboid - A cube-shaped bone located on the lateral side of the foot.

Cuneiforms - Three wedge-shaped bones located in the midfoot:

• Medial cuneiform
• Intermediate cuneiform
• Lateral cuneiform

Metatarsals - The five long bones in the midfoot, numbered I to V starting from the medial (inner) side.

Phalanges - The bones of the toes. Each toe has three phalanges (proximal, middle, and distal) except for the big toe (hallux), which has two (proximal and distal).

4 – All the names of the joints at the foot and ankle

Ankle Joint (Talocrural Joint) - Formed by the tibia, fibula, and talus. It allows for dorsiflexion and plantarflexion.

Subtalar Joint (Talocalcaneal Joint) - Between the talus and calcaneus, allowing for inversion and eversion of the foot.

Transverse Tarsal Joint (Chopart Joint) - Includes two joints:

• Talonavicular Joint - Between the talus and navicular.
• Calcaneocuboid Joint - Between the calcaneus and cuboid.

Tarsometatarsal Joints (Lisfranc Joint) - Between the tarsal bones and the bases of the metatarsals.

Intermetatarsal Joints - Between the bases of the metatarsal bones.

Metatarsophalangeal Joints - Between the metatarsal bones and the proximal phalanges of the toes.

Interphalangeal Joints - Between the phalanges of the toes. Each toe has two interphalangeal joints (proximal and distal), except for the big toe, which has only one.

Slides 5 and 6

Ankle Joint (Talocrural Joint)

• Dorsiflexion: Lifting the foot upwards towards the shin.
• Plantarflexion: Pointing the foot downwards away from the shin.

Subtalar Joint

• Inversion: Turning the sole of the foot inward.
• Eversion: Turning the sole of the foot outward.
• Abduction: Moving the foot away from the midline of the body.
• Adduction: Moving the foot towards the midline of the body.

Coordinated Movements

1. Dorsiflexion, Eversion, and Abduction:
• These movements occur together because of the anatomical orientation of the ankle and subtalar joints. When the foot dorsiflexes at the talocrural joint, the foot also everts and abducts at the subtalar joint.
• This combination helps in accommodating uneven surfaces and provides stability during the initial contact and mid-stance phases of walking.
2. Plantarflexion, Inversion, and Adduction:
• These movements occur together because the anatomical structure of the joints facilitates this combination. When the foot plantarflexes at the talocrural joint, it simultaneously inverts and adducts at the subtalar joint.
• This combination is crucial during the push-off phase of walking or running, where a rigid and stable foot is necessary for propulsion.

Constraints on Movement

The evolution of the ankle and subtalar joints limits certain combinations of movements to ensure stability and prevent injury:

• Dorsiflexion and Inversion: These movements cannot occur simultaneously because dorsiflexion aligns the talus in a position that locks the ankle, preventing inversion.
• Plantarflexion and Eversion: These movements cannot occur together because plantarflexion aligns the foot in a position that locks the ankle, preventing eversion.

Biomechanical Basis

• Joint Orientation: The orientation of the talocrural and subtalar joints dictates that dorsiflexion naturally couples with eversion and abduction, while plantarflexion naturally couples with inversion and adduction. This ensures that the foot remains stable during different phases of gait.
• Ligament and Tendon Tension: The ligaments and tendons around the ankle and foot are arranged to support these specific combinations of movements, providing stability and preventing excessive or injurious movements.