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Brunnstrom’s Clinical Kinesiology Sixth Edition
CHAPTER 11
Ankle and Foot
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Bones
 Tibia
 Bears 90% of weight
 Is easily palpated tuberosity down anterior ridge
 Features the prominent medial malleolus
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Bones
 Fibula
 Bears remaining 10%
 Prominent lateral malleolus
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Bones
 Parts of the foot
 Rearfoot (tarsals)
 Talus and calcaneus
 Midfoot (more tarsals)
 Forefoot (metatarsals and phalanges)
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Bones
 Three arches
 Medial longitudinal
 Lateral longitudinal
 Transverse
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Bones
 Calcaneus
 Is largest and strongest tarsal bone
 Is first through which ground reaction forces are
transmitted
 Transmits most of body weight from talus to
ground
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Bones
 Calcaneus
 Is protected by a thick fat pad
 Attaches to Achilles tendon on posterior aspect
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Bones
 Metatarsals
 Metatarsals and phalanges comprise forefoot
 Numbered 1–5; medial to lateral
 Two sesamoids are just posterior to first
metatarsal head on plantar surface.
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Bones
 Phalanges
 14 phalangeal bones
 1: two
 2–5: three each
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Joints
 Motion terminology
 Dorsiflexion and plantarflexion
 Occur close to sagittal plane
 Inversion and eversion
 Occur in frontal plane
 Abduction and adduction
 Occur in transverse plane
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Joints
 Motion terminology
 Pronation and supination
 Functional terms
 Motion occurs in three planes about an oblique axis
with one degree of freedom.
 Terms are typically used in reference to the subtalar
joint.
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Joints
 Motion terminology—pronation
 Open kinematic chain, superior tibiofibular joint, and
calcaneus on talus
 Dorsiflexion
 Abduction
 Eversion
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Joints
 Motion terminology—supination
 Open kinematic chain, superior tibiofibular joint, and
calcaneus on talus
 Plantarflexion
 Adduction
 Inversion
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Joints
 Talocrural
 Oblique hinge with one degree of freedom
 Medial collateral ligament = deltoid
 Lateral collateral ligament
 Anterior talofibular
 Calcaneofibular
 Posterior talofibular
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Muscles
 Posterior group
 Superficial
 Gastrocnemius—two-headed, two-joint phasic muscle
 Soleus—tonic or slow-twitch, postural muscle
 Plantaris—very small, short muscle with long tendon
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Muscles
 Posterior group
 Deep
 Posterior tibialis—primary decelerator of pronation
 Flexor digitorum longus
 Flexor hallucis longus
 Tarsal tunnel
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Muscles
 Lateral group
 Peroneus (fibularis) longus
 Has 2x larger in cross-sectional area compared with
brevis
 Passes behind lateral malleolus, through a groove on
cuboid, and onto base of first metatarsal
 Peroneus (fibularis) brevis
 Inserts into base of fifth metatarsal
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Muscles
 Lateral group
 Function as primary everters of ankle and foot
 Innervated by superficial peroneal nerve
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Muscles
 Anterior group
 Tibialis anterior
 Primary dorsiflexor of ankle
 Assists with controlling pronation
 Extensor hallucis longus—extend toes, evert ankle
 Extensor digitorum longus—extend toes
 Peroneus tertius
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Function of Muscles and Joints
 Arches of the foot
 Functions:
 Allow foot to adapt to ground
 Absorb forces
 Provide a weight-bearing surface
 Assist and support foot during supination/pronation
Copyright © 2012 F.A. Davis Company
Brunnstrom’s Clinical Kinesiology Sixth Edition
Function of Muscles and Joints
 Loading of the foot
 Weight is distributed 50%–50% between
calcaneus and metatarsal heads.
 During gait, heel and great toe experience greatest
amount of force.
Copyright © 2012 F.A. Davis Company