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Anatomy
Foot
Hind foot bones : calcaneus and talus joints : talocalcaneal Midfoot bones : naviculare, cuboid, cuneiforms joints : transverse tarsal, calcaneocuboid, distal intertarsal, cuneonavicular, cuboideonavicular, intercuneiform and cuneocuboid complex
Forefoot bones : metatarsal and phalanges joints : tarsometatarsal, intermetatarsal, metatarsophalangeal, interphalangeal
Ankle stability
Mechanics of the joint Ligaments Muscles
Talus
The talus is the mechanical keystone at the apex of the foot Talus is an extremely important bone for
Ankle and foot For the entirely lower extremity
LIGAMENTS
Interosseous ligament and membrane Lateral collateral ligament
Anterior talofibular Calcaneofibular Posterior talofibular
Because of the relative inability of the medial malleolus to adequately block the medial side of the mortise the majority of ankle sprains involve excessive inversion and subsequent injury to the lateral collateral ligaments
DELTOID LIGAMENT :
THE PRIMARY FUNCTION OF DELTOID LIGAMENT :
To limit eversion across the TALOCRURAL, SUBTALAR and TALONAVICULAR
Muscles
The musculotendinous surrounding the ankle joint on the medial and lateral sides plays a small role in stabilizing the joint
Muscles
Anterior Lateral Posterior Medial : TA, EHL. EDC : PL. PB : GN. SOL : TP, FHL, FDL
Kinematics
Uniplanar One degree freedom of motion Axis rotation :
100 to ML axis on frontal plane 60 to ML axis on horizontal
ROM :
Dorsifleksi Plantar fleksi : 20 degree : 50 degree
Axis rotation
Axis rotation
The axis rotation is inclined slightly superior and anterior, from lateral to medial
Dorsi flexion is associated with slight abduction and eversion Plantar flexion is associated with adduction and inversion
Walking
Walking
Heel strike foot flat : 0 100 plantar flexion Foot flat heel off : dorsiflexion 100 heel off toe off : 200 plantar flexion
Kinetics ( static )
Muscle force transmitted through the Achilles The line of gravity pass through the ball of the foot The reaction force on the ankle can be calculated
KINETICS (dynamics)
The main compressive force across the ankle during gait was produced by contraction gastrocnemius and soleus at push off, about five times body weight The contraction pretibial group during early stance phase was less than 20 percent body weight
Running cycle
Running cycle
Support phase Flight / recovery phase
Support phase
Foot strike:
The foot initially contacts the ground and continues until the plantar surface of the foot is fully plantigrade to the support surface
Mid-support
The foot is in full contact with the ground and continues until the heel starts to leave the ground
Takeoff
The heel starts to leave the ground and continues until the toes are completely free of the supporting surface
Flight phase
Follow-through
The end of take-off until the foot stops any posterior or backward motion
Forward swing
The initiation of forward movement of the foot until the foot reaches the most forward position
Foot descent
The foot reaches the most forward position until foot strike
Running phase
Foot strike to midsupport
Joint
Hip Knee Ankle
Motion
450 200 flexion 200 400 flexion 50 plantar flexion to 100 dorsiflexion 200 flexion to 50 extension 400 150 flexion 100 -200 dorsi flexion
Knee Ankle
Running phase
Follow through
Joint
Hip Knee Ankle Hip Knee Ankle
Motion
5 20 hyperextension 15 5 flexion 20 30 plantar flexion 20 65 flexion 5 130 flexion 30 plantar flexion 0
Forward swing
Foot descent
FUNGSIONAL LIMB VARUS IN THE RUNNERS CAN INCREASE VALGUS STRESS AT THE KNEE AND FOOT PRONATION
APROXIMATE 10 DEGREE INCREASE IN FUNCTIONAL LIMB VARUS IN RUNNING COMPARED WITH WALKING
Running Kinetics
The vertical component of the ground reaction force throughout the stance phase is 125 percent of body weight The vertical component of the ground reaction force during running is150 200 percent greater than during walking