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The Ankle latin “ angulus ” - bent

The Ankle latin “ angulus ” - bent. Key Players. Bones: Tibia, fibula, talus and calcaneus Ligaments: Anterior Tibio fibular Ligament (ATFL) Posterior Tibio fibular Ligament (PTFL) Anterior Talo fibular Ligament (ATL) Posterior Talo fibular Ligament (PTL). Talocrural Joint.

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The Ankle latin “ angulus ” - bent

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  1. The Anklelatin“angulus” - bent

  2. Key Players Bones: • Tibia, fibula, talus and calcaneus Ligaments: • Anterior Tibiofibular Ligament (ATFL) • Posterior Tibiofibular Ligament (PTFL) • Anterior Talofibular Ligament (ATL) • Posterior Talofibular Ligament (PTL)

  3. Talocrural Joint • Between the tibia, fibula and talus • This is a hinge joint and allows most of the motion with plantar flexion and dorsiflexion.

  4. ________________ ________________ Talocrural Jt.

  5. Subtalar Joint • The articulation between the talus and the calcaneus is referred to as the subtalar joint. Motion allowed by this joint is inversion (roll inward)/eversion (roll outward) as well as rear foot pronation (inward tilt of the calcaneus) and supination (outward tilt of the calcaneus) .

  6. Medial aspect of foot Talus ---Subtalar Joint calcaneus

  7. Ankle Ligaments • There are three lateral ligaments predominantly responsible for the support and maintenance of bone apposition (best possible fit). These ligaments prevent inversion of the foot. • These ligaments are: • Anterior talofibular ligament • Calcaneofibular ligament • Posterior talofibular ligament

  8. Tibia Fibula Ant.Tibiofibular Lig. Talus Ant. Talofibular Ligament

  9. <- Talus <- Fibula Post. Tibiofibular Lig. <- Ant. Talofibular Lig  Subtalar Joint Space Calcaneofibular Ligament Cuboid Calcaneus Peroneal Tendons

  10. Posterior tibiofibular Ligament Peroneal tendons Talus <-Fibular head Posterior talofibular lig. Achilles Tendon calcaneus

  11. The deltoid ligament • This is located on the medial aspect of the foot. It is the largest ligament but is actually comprised of several sections all fused together. This ligament prevents (eversion) of the ankle. The deltoid ligament is triangular in shape and has superficial and deep layers. It is the most difficult ligament in the foot to sprain.

  12. X Tibia Deltoid Ligament X Tibialis Posterior Tendon Tibialis Ant. Tendon -- Talus X X Navicular ---

  13. Ankle Sprains The ankle is weakest when it is plantar flexed.

  14. Ankle Sprains Inversion Sprain “rolling over on your ankle” • Mechanism: landing from a jump while PF • Affects the lateral ligaments of the ankle • First time sprain, 90% of the time on uneven ground. Multiple sprains, could be on flat ground

  15. Ankle Sprains Eversion Sprains • Less common due to: • Strength of the deltoid ligament (medially) • If forceful ankle eversion occurs, usually a tip of medial maleolus (tibia) chips off

  16. What ligaments could be damaged from: • Inversion Sprain? • Lateral ligaments: most commonly the Anterior Talofibular Ligament, • Eversion Sprain? • Deltoid ligament (despite its strength)

  17. Prevention of Injury to the Ankle • Stretching of the Achilles tendon • Strengthening of the surrounding muscles • Proprioceptive training: balance exercises and agility • Wearing proper footwear and or tape when appropriate

  18. Achilles Tendon Tear and Repair

  19. Preventative Taping and Orthosis • Taping is often post injury treatment. Some will argue that taping will weaken the ankle. This has not been proven without a doubt but exercise and strengthening of the ankle is always advised. • Othotics will help rectify conditions that are permanent and will not be fixed by any other means.

  20. Tape vs. Brace • Why choose one over another • Taping may be more time consuming over brace • Braces may or may not allow more support over tape • Tape allows more functional movement and often feels more stable • Tape will loosen with time • Braces will often loosen with time • It really is based on the quality of the brace vs. the ability of the person to tape. Both have advantages and disadvantages.

  21. Lab Activity Find out if you are prone to leg, ankle and foot injuries by completing the exercises on the handout. Any interesting findings? • Length of legs: unbalanced, overcompensation of one side of the body • Morton’s Toe:  stress on metatarsals could increase risk of Metatarsal Stress Syndrome • Pronation:  risk of PFS, Tibial Stress Syndrome and plantar fascitis, among other things

  22. Shoe Shopping • Feet come in many shapes and sizes. How can one shoe size capture all these? • Oftentimes we need different footwear for different activities! Things to consider: • Midsole materials • Firmer • Softer • Heel counter • Rigid (prevents foot pronation) • Less rigid

  23. Tips for Shoe Shopping • Shop where there are knowledgeable clerks • Know the spectrum of foot types • Know the spectrum of shoe types Questions? See your family doctor or podiatrist

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