- ANATOMY - Foot and Ankle
ANATOMY - Foot and Ankle
At some time in your life you should experience foot, heel, or ankle pain. This is just natural since we ambulate over one million steps per year. Luckily, over 95% of all foot, heel and ankle pain will heal itself over time. However, you would like to know what are the fastest and most effective methods to reduce this pain. This section will empower you to understand the basic anatomy of your foot and ankle so you can get onto healing your body.
The center of this ring is the bone called the talus. The talus bone has a shiny joint surface covering which allows your ankle to glide effortlessly across the shiny undersurface of your large leg bone called the tibia. When these two bones meet they form your ankle joint. On the outside of your ankle you will find a smaller, thin bone called the fibula. This bone helps prevent your major ankle bone from shifting outward. On the other side of your ankle you will find a bump on the inside which is connected to the larger leg bone called the tibia. This part of the tibia is called the malleolus, which just means, "hammer" in Latin.
The stability of your ankle joint is dependent upon the ability of these bones to keep the central bone in place while the ankle moves back and forth. The joint is more stable when your foot is flat on the floor. The ankle is more rigidly held in place by the bony stabilizers of the fibula and malleolus because they are closer to the talus. However, when you point your toes, your ankle becomes unstable because the distance between the bony stabilizers of your ankle becomes larger. Thus, your ankle than relies more and more on the soft tissues including your ligaments to continue to provide stability. Since soft tissues are "softer" than your bones, you become more vulnerable to a sprain when you are pointing your toes.
When an ankle twists, it is usually when you are pointing your toes. However, you can twist your ankle in any position. There are six major soft tissue structures that hold your ankle in place. Four of these are located on the outside part of your ankle and all attach to your smaller ankle bone called your fibula. Thus, all three of these ligaments have the word fibula in them. The most commonly injured ligament of your ankle is called the Anterior (meaning front) Talo-Fibular Ligament, or ATFL for short. This is the ligament that is most commonly torn in ankle sprains. The second most commonly torn ligament is the ligament connecting your heel bone to your fibula called the Calcaneal-Fibular Ligament. The third ligament again attaches the fibula to the back of talus called the Posterior (meaning back) Talo-Fibular Ligament. The fourth ligament connected to the fibula is the Syndesmotic Ligament, which connects the fibula to the large leg bone (tibia). The soft tissue just in front of your ankle is the capsule of your ankle joint and helps keep the ankle from sliding forward along with your other ligaments. The final stabilizing ligament is on the inside part of your ankle. The ligament forms a triangle shape like the Greek letter delta thus it is called the deltoid ligament. The deltoid ligament attaches the malleolus to the talus. This is sometimes referred to as the strongest ligament in your body, however it is commonly torn.
Sometimes the bones around your ankle can break. Most commonly it is the smaller outer bone called the fibula. However, with larger forces applied to your ankle, both bones can break and occasionally, a part of the back of your tibia can also break. When the bones around your ankle break, they can cause gross instability and this may even result in a dislocation of your ankle joint. In some cases, your ankle moves slightly out of joint called a subluxation. If your physician informs you that you have a break or fracture, they may recommend surgery usually based upon the actual dislocation or potential dislocation of your ankle.
The foot is a very complex joint with millions of combinations of movements and motions very similar to your hand. The most common form of foot pain is usually involves the heel. Thus, this section will concentrate around the heel.
The heel bone is called the calcaneus (meaning heel in Latin). This is the largest bone of your foot and it is connected to your heel cord (Achilles tendon) above and a large broad tendon on the sole of your foot called the plantar fascia. The plantar fascia helps keep the arch of your foot supported and provides support to your foot with every step. Sometimes this ligament becomes inflamed. When this happens, the medical community adds the ending "itis" to the name of the structure inflamed. Thus, your plantar fascia becomes plantar fasciitis. This condition can cause disabling pain if it is not treated correctly.
Sometimes heel spurs will form at the tip of the calcaneus. However, we, as orthopedic surgeons, generally do not believe the heel spur itself causes pain. Usually, the pain is from the plantar fascia.
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