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033 Introduction to foot and ankle: anatomy

033 Introduction to foot and ankle: anatomy

By Jurmaine Health

Learn the anatomy of the foot and the ankle – the muscles that support your structural integrity. Find out the common sports which you’ll find where your foot/ ankle structures can be compromised. How many bones do you have in your foot? Can you visualise the anatomy of your foot from this podcast?!

Jackie [01:31]
So your calcaneus is also known as your heel. Ankle bears the full weight of our body, and in sports that involve running and jumping. It is a joint that bears even further loading, making it extremely prone to various injuries, which we’ll discuss in future episodes in this series. It’s three main joints are the taillow crural, also known as the true ankle, which is made up of the tibia, fibula, and talus. Its main actions, or its main movements that occur here are flexion and extension of the ankle.

Jackie [02:10]
Then you’ve got your next joint is your subtalar joint. So this one’s made up of your talus and your calcaneus. Again, your heel and side rotation of the ankle is the main action that occurs here. And then you have the inferior tibia fibula joint.

Jackie [07:13]
So here we have an area well, of course, with over 30 joints in each, but with only two main joints that control inversion. So again, turning the foot in, and eversion turning the foot out. So you have your subtalar joint and your transverse tarsal joints. Most of the remaining joints allow for small fine movements between themselves. Your feet play a major role in your weight bearing and walking patterns, and any changes in them or in one for that matter, can have ricocheting effects all the way up your body. They play a huge role as the first shock absorbers of your body, especially for the lower limb, making their health and correct movement vital for anyone, especially those that use their feet a lot.

Dr Jacqueline Swiatlowski is a qualified chiropractor with over 6 years of experience. She has worked in a range of different environments including roles within the allied health industry, professional sporting clubs as well as in her own private practice. With a Master of Clinical Chiropractic from RMIT University as well as a number of additional qualifications, including Active Release Technique (ART), Animal Flow and a Certificate III & IV in Fitness from the Australian Institute of Personal Trainers, Jacqueline is an expert in movement restoration and chiropractic care. In the past she has worked alongside local athletes, including players from the Western Eagles Soccer Club, Melbourne City Soccer Club and the Coburg Lions Football Club. In her role at Jurmaine Health, Jacqueline’s main focus is treating patients and looking after their health. “Jacqueline is also a TRE provider now and can offer TRE treatments to patients.”

Episode 033:Introduction to foot and ankle anatomy

Podcast brought to you by Jurmaine Health

JACKIE [00:00]

This is Jurmaine Health, the center to help you achieve wellness in both your brain and body. We endeavor to encourage cross communication between health professionals for your health and well being. We bring you topics on neuro psychology, neuro behavior, neuro musculoskeletal, neuro gastro, movement is well being, the Embodied Project, metabolism and microbiome, which are also some of the services that we provide.

Today's podcast will be the first in our ankle and foot series, and will cover the anatomy of the ankle and foot, and how it can affect the way we move.

Unfortunately I have no colleagues to introduce today, as one is away furthering her knowledge base, and the other is still recovering post surgery, so you'll be hearing my voice for the entire podcast. Sorry guys!

JACKIE [00:46]

So let's get down to the nitty gritty, and delve into the anatomy of the ankle and foot.

Let's start with the ankle, which is a synovial joint. We have 4 bones that make up the ankle; 2 are the end points of our lower leg bones, the tibia (on the inner side) and the fibula (on the outer side), and the other two, which are bones of the foot, are the talus and calcaneus (also known as your heel).

[01:31]

The ankle bears the full weight of our body, and in sports that involve running and jumping, it is a joint that's further loaded, making it prone to various injuries, which we'll discuss in future podcasts in this series.

Its 3 main joints are the talo-crural (also known as the true ankle), which is made up of the tibia, fibula and talus; the main movements that occur here are flexion and extension of the ankle; the next is the sub-talar joint, which is made up of the talus and calcaneus, with side rotation of the ankle being its main action, and the inferior tibio-fibular joint, which is a syndesmosis between the tibia and fibula; very fine movement of the two bones here.

The ankle is supported by a number of ligaments, fibrous bands of elastic connective tissue joining bone to bone, with their connections aptly giving rise to their names. A primary example of this naming, as well as a key ligament in the ankle, is your anterior talofibular ligament. As it's name states, it connects the front side of the talus and the fibula. This ligament may be known to many of you out there, especially many athletes who have previously sprained an ankle, as it is BY FAR the most commonly sprained ligament in the ankle, accounting for approximately 70-85% of sprains. It's mechanism of injury is usually through an inversion sprain, where you've rolled the outside of your foot (ankle over the outside).

I'm pretty sure that anyone out there who's ever played netball played soccer played footy anything else. So you guys would have experienced this in some way, shape or form. Any skaters out there.

[03:53]

The muscles that control the ankle/foot, are known as extrinsic muscles, as they originate from the lower leg, and attach to the areas. Starting with your gastrocnemius and soleus, which attach to your calcaneus as the Achilles tendon, these are responsible for plantarflexion; your ability to walk on your toes. Then we have your peroneals, longus and brevis, that are also responsible for plantarflexion, but also eversion of your foot (turning your foot out), and help prevent lateral ankle sprains; they have another sibling, peroneus tertius which is responsible for mild dorsiflexion and eversion of the foot. Next your posterior tibialis, responsible for plantarflexion and inversion (turns foot in) and supports the arch of your foot. You also have your posterior tibial artery pulse that runs near its attachment, and can be felt between your medial malleolus (that bump on the inner side of your ankle) and your achilles. We also have the muscle that most people are well aware of, the tibialis anterior, that attaches to the front of the foot and is responsible for dorsiflexion (pointing the toes toward the head), and inversion. And of course, let's not forget the muscles that flex and extend your toes, flexor digitorum longus and hallucis longus, and extensor digitorum longus and extensor hallucis longus respectively.

[04:44]

On a side note, as we'll cover compartment syndromes in later episodes, when the muscles of the lower leg are tight and under pressure, often resulting in a compartment syndrome, the nerves that run in the area can become caught, leading to issues such as foot drop. This is often seen in kicking sports, and the person may experience a dragging of their feet sensation when walking, or even feel like they're tripping more! Speaking from a soccer background, can definitely say this has more than once occurred to me during my playing years I'd experience the foot drop sensation after lots of shots of goal or free kick practice, and unfortunately, the random tripping would occur during games, when there was nothing in sight to even trip over. I provided the laughs.

[07:12]

Guys, let's move on to the foot now.

[07:13]

Here we have an area, well TWO of them technically, with over 30 joints in each, but with only TWO main joints that control inversion and eversion of the foot, your subtalar and transverse tarsal joints. Most of the remaining joints allow for small fine movements between themselves. Your feet play a major role in your weight-bearing and walking patterns, and any changes in them, or in one, can have ricocheting effects all the way up your body. They play a huge role as the first shock absorbers for your body, especially for the lower limb, making their health and correct movement vital for anyone, especially those that use their feet a lot, whether it's at work by being on your feet a lot, or in sport.

So the foot itself, is made up of 26 bones. You have your phalanges, so just like in your hands, these are the digits of your feet, also known as your toes. There are 14 of these, with your big toe only having 2. You have 5 metatarsals, those long bones that make up pretty much the middle part of your foot (the length), and 7 tarsals, your calcaneus (your heel), your talus, both of which we've already spoken about in their role in the ankle, then from the lateral side (outer side) working towards your medial side (inner side), we have your cuboid, your lateral, middle and medial cuneiform (aptly named by their positions in the foot), and your navicular, where your tibialis posterior attaches to. Some people also have sesamoid bones under their hallux/big toe. As you can see, the foot is pretty bony, which make it fairly prone to bone bruising, as it doesn't have much covering on it, especially not on the dorsal (top) aspect of it. Once again, soccer reference here, sorry guys, past player again, but when you get stepped on during training or game, with boots on. Studs and foot are DEFINITELY NOT a good combination! But I digress!

Now to cover the intrinsic muscles of the foot those that originate and insert into the foot, on either the dorsal (top) or plantar (bottom) sides. I won't name you all the muscles, as we'd be sitting here for a while, but the largest muscles of the foot are on the plantar side (bottom), and are arranged in 4 layers, depending on their depth. Most of these are involved in flexing your toes, so curling them up, as well as supporting the arch of your foot, as well as the finer muscles that abduct and adduct our toes, so splay the toes out and bring them back. We also have the extensor muscles, the muscles that straighten our toes, on the dorsal (top) side of our foot. And let's not forget, that thing that everyone always talks about as the source of all pain under the foot, your plantar fascia. That fibrous band of tissue that runs from your calcaneus (heel) to your toes. I promise we'll be mentioning this more in the next podcast, so keep your ears pealed! The foot also has an array of ligaments, and I'm going to refer you to Google now, if you'd like to see them all, as well as your retinacula, which are thin fibrous bands that help support and keep your tendon groups together.

[09:06]

On the dorsal side of your foot (top), you may also have your dorsalis pedis pulse. It is not found in everyone, so don't be surprised if you don't have one, but I wonder how many of you are now going to try see if they have this pulse.

I won't go into the full nerve supply of the ankle and foot in this episode, as that'd leave me very little to talk about in future episodes, but the nerve supply originates from the sciatic nerve, so as you'll learn in the upcoming episodes, a disruption to the sciatic nerve and/or its nerve roots, can cause PLENTY of issues all the way down into your foot! Yes, I have a story of such a case for you!

So for today, I think you've heard enough from me. I hope you haven't been too bored with my extensive anatomy lesson. And I hope it gives you a better idea as to why we always make sure to check your feet and ankles. We'll continue on with some common presentations, or I should say I should I'll continue on with some common presentations in the next episode.

Guys, if you like what we're presenting, please give us a thumbs up a like or share it with one other person who you think we may be a help. For those of you who are coaches, dancers or athletes, and may find difficulty with expressing or executing movement patterns. Please do connect with us on our website, www.jurmainehealth.com.au and Jurmaine Health is spelled j u r m a i n e h e a l t h. Or please socialize with us on Facebook, which is Jurmaine Health or Instagram which is Jurmaine Health body. And last but not least, since this podcast is made for you, our clients, patients and fans, please do let us know what else you might like to hear about. Thanks for today guys. See you.

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