Foot & Ankle Anatomy

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The foot and ankle in the human body work together to provide balance, stability, movement, and propulsion.

This complex anatomy consists of:

  • 26 bones
  • 33 joints
  • Muscles
  • Tendons
  • Ligaments
  • Blood vessels, nerves, and soft tissue

In order to understand conditions that affect the foot and ankle, it is important to understand the normal anatomy of the foot and ankle.

Ankle

The ankle consists of three bones attached by muscles, tendons, and ligaments that connect the foot to the leg.

In the lower leg are two bones called the tibia (shin bone) and the fibula. These bones articulate (connect) to the Talus or ankle bone at the tibiotalar joint (ankle joint) allowing the foot to move up and down.

  • Tibia (shin bone)
  • Fibula
  • Talus
  • Lateral Malleolus
  • Medial Malleolus

The bony protrusions that we can see and feel on the ankle are:

  • Lateral Malleolus: this is the outer ankle bone formed by the distal end of the fibula.
  • Medial Malleolus: this is the inner ankle bone formed by the distal end of the tibia.

Hind foot

The foot can be divided into three anatomical sections called the hind foot, mid foot, and forefoot. The hind foot consists of the Talus bone or ankle bone and the calcaneous bone or heel bone. The calcaneous bone is the largest bone in your foot while the talus bone is the highest bone in your foot. The calcaneous joins the Talus bone at the subtalar joint enabling the foot to rotate at the ankle.

The hind foot connects the mid foot to the ankle at the transverse tarsal joint.

  • Talus
  • Calcaneus

Mid foot

The mid foot contains five tarsal bones: the navicular bone, the cuboid bone, and 3 cuneiform bones. It connects the forefoot to the hind foot with muscles and ligaments. The main ligament is the plantar fascia ligament. The mid foot is responsible for forming the arches of your feet and acts as a shock absorber when walking or running.

The mid foot connects to the forefoot at the five tars metatarsal joints.

  • Navicular
  • Cuboid
  • Cuneiform Bones

Forefoot

The forefoot consists of your toe bones, called phalanges, and metatarsal bones, the long bones in your feet. Phalanges connect to metatarsals at the ball of the foot by joints called phalange metatarsal joints. Each toe has 3 phalange bones and 2 joints, while the big toe contains two phalange bones, two joints, and two tiny, round sesamoid bones that enable the toe to move up and down. Sesamoid bones are bones that develop inside of a tendon over a bony prominence.

The first metatarsal bone connected to the big toe is the shortest and thickest of the metatarsals and is the location for the attachment of several tendons. This bone is important for its role in propulsion and weight bearing.

  • Phalanges
  • Metatarsal

Soft Tissue Anatomy

Our feet and ankle bones are held in place and supported by various soft tissues.

  • Cartilage: Shiny and smooth, cartilage allows smooth movement where two bones come in contact with each other.
  • Tendons: Tendons are soft tissue that connects muscles to bones to provide support. The Achilles tendon, also called the heel cord, is the largest and strongest tendon in the body. Located on the back of the lower leg it wraps around the calcaneous, or heel bone. When inflamed, it causes a very painful condition called Achilles tendonitis and can make walking almost impossible due to the pain.
  • Ligaments: Ligaments are strong rope like tissue that connects bones to other bones and help hold tendons in place providing stability to the joints. The plantar fascia is the longest ligament in the foot, originating at the calcaneous, heel bone, and continuing along the bottom surface of the foot to the forefoot. It is responsible for the arches of the foot and provides shock absorption. A common cause of heel pain in adults, plantar fasciitis can occur when repetitive micro tears occur in the plantar fascia from overuse. Ankle sprains, the most commonly reported injury to the foot and ankle area, involve ligament strain, and usually occur to the talo-fibular ligament and the calcaneo-fibular ligament.
  • Muscles: Muscles are fibrous tissue capable of contracting to cause body movement. There are 20 muscles in the foot and these are classified as intrinsic or extrinsic. The intrinsic muscles are those located in the foot and are responsible for toe movement. The extrinsic muscles are located outside the foot in the lower leg. The gastrocnemius or calf muscle is the largest of these and assists with movement of the foot. Muscle strains occur usually from overuse of the muscle in which the muscle is stretched without being properly warmed up.
  • Bursae: Bursae are small fluid filled sacs that decrease friction between tendons and bone or skin. Bursae contain special cells called synovial cells that secrete a lubricating fluid. When this fluid becomes infected, a common painful condition known as Bursitis can develop.

Biomechanics of Foot & Ankle

Biomechanics is a term to describe movement of the body. The ankle joint by itself permits two movements:

  • Plantar flexion: Pointing the foot downward. This movement is normally accompanied by inversion of the foot.
  • Dorsiflexion: Raising the foot upward. This movement is normally accompanied by eversion of the foot.

The foot (excluding the toes) also permits two movements:

  • Inversion: Turning the sole of the foot inward.
  • Eversion: Turning the sole of the foot outward

The toes allow four different movements:

  • Plantar flexion: Bending the toes towards the sole of the foot
  • Dorsiflexion: Bending the toes towards the top of the foot
  • Abduction: Spreading the toes apart. This movement normally accompanies plantar dorsiflexion.
  • Adduction: Bringing the toes together. This movement normally accompanies plantar flexion.

8 Facts About the Ankle

BY JORDAN ROSENFELD

The humble ankle has had a remarkable history as an object of fetishization: Think Victorian sexual repression and high heels. Of course, its significance is also practical. Without ankles, there would be no sports or dance. Not only would nobody be able to score a touchdown, we wouldn’t even be able to walk. Here are eight things you may not have known about this basic but crucial joint:

1. THE ANKLE IS COMPOSED OF JUST THREE MAIN BONES.

The true ankle joint is composed of three bones: the tibia, or the inside part of the ankle; the fibula, the outside part of the ankle, and the talus, underneath. These allow the flexion and extension of the foot, letting you make the up and down motions that you require to walk. Below the ankle joint is actually a second joint called the subtalar joint, which allows side-to-side motion of the foot. Altogether, the human foot and ankle contain 26 bones, 33 joints, and more than 100 muscles, tendons, and ligaments.

2. THE ANKLE JOINT IS NOTORIOUSLY WOBBLY.

Despite how often humans are on their feet, the ankle joint is small and unstable in the best of times because of its precarious anatomical structure. Most people will experience a tweaked, twisted or sprained ankle at least once in their lives.

3. ANKLE SPRAINS ARE THE MOST COMMON INJURY IN AMERICA.

When you couple the weak ankle joint with the vigorous activity it’s required to perform, it’s no surprise that ankle sprains account for nearly 2 million injuries every year, or 20 percent of all sports injuries in the United States.

4. NOT ALL OF THESE SPRAINS ARE SPORTS-RELATED.

Researchers from the University of Alabama at Birmingham reported an estimated 125,355 high heel-related injuries in U.S. Emergency Departments between 2002 and 2012. In 2011 alone, there were a reported 19,000 injuries from high heels. The injury rate was greatest for women in their 20s. Another survey from the College of Podiatry found that most women reported foot pain after one hour and six minutes of wearing high heels, and 20 percent of participants said that they felt pain after just 10 minutes of wear.

5. NEVER JUST “WALK OFF” AN ANKLE SPRAIN.

You can actually do significant damage if you’re walking on an untreated ankle sprain, according to the National Athletic Trainers’ Association. Treatments may range from rest, ice, and ibuprofen to casts, braces, and even surgery. Always seek a doctor’s care if you think you’ve sprained an ankle.

6. THE ANKLE WAS TOO EROTIC FOR PUBLIC VIEWING IN VICTORIAN ENGLAND.

A woman lifting her skirt to show her ankle was considered provocative in Victorian England. This is ironic, given that the Victorians were at the same time producers of copious pornography.

7. “PRETTIEST ANKLE” CONTESTS WERE POPULAR THROUGH THE 1930s.

While the Victorian era repressed women’s displays of their bodies, the 1930s were all about exposing the ankles. In fact, according to Mashable, in the UK “pretty ankle” competitions were popular events until about World War II.

8. YOU MIGHT WANT TO RETHINK AN ANKLE TATTOO.

Because the foot and ankle generally don’t have much fat or flesh, getting a tattoo on this skinny extremity can be extremely painful. Because of how much use your foot and ankle get, they also can take twice as much time to heal as other locations—but it could give you a leg up in an ankle competition.

What Makes a Podiatrist

podiatrist is a doctor of podiatric medicine, which is why you will often see the initials (D.P.M.) after their name. Podiatrists work to treat conditions and injuries that are related to the foot, ankle, and lower leg regions of the body. Some podiatrists work in private practices, while others work in hospitals and clinics. Some podiatrists will also do house-calls or visit nursing homes for geriatric patients. To become a podiatrist, one must complete a 4-year program at a college for podiatric medicine, as well as complete a residency post-graduation. Some may also continue their education by taking advanced training in areas such as surgery. If you are interested in learning more about the field of podiatry, we recommend you consult with a podiatrist for professional career advice.

If you are experiencing pain in the feet or ankles, don’t join the stubborn majority refusing treatment. Feel free to contact one of our podiatrists from Advanced Care Podiatry. Our doctors can provide the care you need to keep you pain-free and on your feet.

What Is a Podiatrist?

Someone would seek the care of a podiatrist if they have suffered a foot injury or have common foot ailments such as heal spurs, bunions, arch problems, deformities, ingrown toenails, corns, foot and ankle problems, etc.

Podiatric Treatment

A podiatrist will treat the problematic areas of the feet, ankle or lower leg by prescribing the following:

  • Physical therapy
  • Drugs
  • Orthotic inserts or soles
  • Surgery on lower extremity fractures

A common podiatric procedure a podiatrist will use is a scanner or force plate which will allow the podiatrist to know the designs of orthotics. Patients are then told to follow a series of tasks to complete the treatment. The computer will scan the foot a see which areas show weight distribution and pressure points. The podiatrist will read the analysis and then determine which treatment plans are available.

If you have any questions please feel free to contact one of our offices located in Bensalem, Pennsylvania, Port Richmond, Philadelphia, and Hamilton, New Jersey. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.Read more about What is a Podiatrist?

Types of Arthritis That Can Affect The Feet

The medical term that is known as osteoarthritis may cause bone spurs at the bottom of the big toe, which may lead to the development of a bunion. If you have this type of arthritis, relief may be found when larger size shoes are worn. This may prevent additional pressure from being exerted on the bunion. A common type of arthritis that is referred to as rheumatoid arthritis typically causes inflammation on the ball of the foot. Calluses may develop as a result of the bones pushing against the skin on that part of the foot. An additional form of arthritis, which is known as gout, can affect the big toe, and may come from eating foods that are high in purine levels. Gout attacks may be prevented when healthy eating habits are implemented into the daily routine. If you have arthritis in your feet, it is strongly suggested that you consult with a podiatrist who can help you to manage this condition.

Arthritis can be a difficult condition to live with. If you are seeking treatment, contact one of our podiatrists from Advanced Care Podiatry. Our doctors can provide the care you need to keep you pain-free and on your feet.

Arthritic Foot Care  

Arthritis is a term that is commonly used to describe joint pain.  The condition itself can occur to anyone of any age, race, or gender, and there are over 100 types of it.  Nevertheless, arthritis is more commonly found in women compared to men, and it is also more prevalent in those who are overweight. The causes of arthritis vary depending on which type of arthritis you have. Osteoarthritis for example, is often caused by injury, while rheumatoid arthritis is caused by a misdirected immune system.

Symptoms

  • Swelling
  • Pain
  • Stiffness
  • Decreased Range of Motion

Arthritic symptoms range in severity, and they may come and go. Some symptoms stay the same for several years but could potentially get worse with time. Severe cases of arthritis can prevent its sufferers from performing daily activities and make walking difficult.

Risk Factors

  • Occupation – Occupations requiring repetitive knee movements have been linked to osteoarthritis
  • Obesity – Excess weight can contribute to osteoarthritis development
  • Infection – Microbial agents can infect the joints and trigger arthritis
  • Joint Injuries – Damage to joints may lead to osteoarthritis
  • Age – Risk increases with age
  • Gender –Most types are more common in women
  • Genetics – Arthritis can be hereditary

If you suspect your arthritis is affecting your feet, it is crucial that you see a podiatrist immediately. Your doctor will be able to address your specific case and help you decide which treatment method is best for you.

If you have any questions, please feel free to contact one of our offices located in Bensalem, Pennsylvania, Port Richmond, Philadelphia, and Hamilton, New Jersey. We offer the newest diagnostic and treatment technologies for all your foot care needs.

Why Stretching Is Important Before and After Running

People who experience running injuries may find that they lose the motivation to continue running or jogging. Additionally, this type of injury can affect everyday activities, and may cause severe pain and discomfort. The average runner typically runs 1400 steps per mile. With that in mind, it is important to properly stretch the muscles, tendons and ligaments to prepare for your activity. This can be accomplished by warming up and cooling down before and after running. Flexibility can be maintained by performing lunges, and mimicking movements such as marching. The bones can become stronger as strength training is practiced, in addition to increased running efficiency. If you would like more information about how running injuries can affect the feet, please consult with a podiatrist.

Exercising your feet regularly with the proper foot wear is a great way to prevent injuries. If you have any concerns about your feet, contact one of our podiatrists of Advanced Care Podiatry. Our doctors will treat your foot and ankle needs.

How to Prevent Running Injuries

Many common running injuries are caused by overuse and overtraining. When the back of the kneecap starts wearing out and starts causing pain in your knee, this is commonly referred to as runner’s knee. Runner’s knee is a decrease in strength in your quadriceps and can occur if you’re not wearing properly fitted or supporting shoes. To prevent runner’s knee, focusing on hip strengthening is a good idea, as well as strengthening your quads to keep the kneecaps aligned.

What Are Some Causes of Running Injuries?
– One cause of a common running injury is called iliotibial band syndrome.
– Plantar fasciitis is also another common injury.
– Stress fractures can occur from overtraining, lack of calcium, or even your running style.

Best Ways to Prevent Running Injuries
– Wear footwear that fits properly and suits your running needs.
– Running shoes are the only protective gear that runners have to safeguard them from injury.
– Make a training schedule. Adding strengthening exercises as well as regular stretching can help keep you strong and limber and can lessen the possibility of injuries.
– Stretching keeps muscles limber; this will help you gain better flexibility.

If you have any questions please feel free to contact one of our offices located in Bensalem, Pennsylvania, Port Richmond, Philadelphia, and Hamilton, New Jersey. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.