ANKLE

GENERAL INFORMATION

The ankle is a hinge joint between the foot and the leg, allowing for movements such as plantar flexion and dorsiflexion. It bears significant weight and provides stability during walking, running and jumping.

ORIGIN

The ankle joint itself does not have a specific origin, as it comprises the tibia, fibula and talus bones that form the structure.

INSERTION POINT

The ankle does not have an insertion point, as it is a joint. However, numerous muscles, tendons and ligaments attach to the ankle to facilitate movement and stability.

MAJOR ARTERIES

The major arteries supplying blood to the ankle include:

• Posterior tibial artery: Provides oxygenated blood to the structures in and around the ankle and foot.
• Peroneal artery: Supplies blood to the lateral aspect of the ankle and lower leg.

NEURAL INNERVATION

The ankle is innervated by several nerves, including:

• Tibial nerve: Responsible for motor function to the muscles that move the foot and sensory function to the skin of the sole.
• Sural nerve: Provides sensory innervation to the skin on the lateral and posterior aspects of the foot and lower leg.

TRIGGER POINT

The ankle does not have specific trigger points. It is a joint where bones, ligaments and tendons work together to support movement and stability.

CONCENTRIC FUNCTION

The concentric function at the ankle includes muscle contractions. The gastrocnemius and soleus are shortened to perform plantar flexion while walking or running.

ECCENTRIC FUNCTION

Eccentric control in the ankle occurs when muscles like the tibialis anterior lengthen to slow down the lowering of the foot. Especially during the heel strike in walking.

ISOMETRIC FUNCTION

The ankle’s isometric function is crucial during static activities like standing on one leg, where stabilising muscles work to maintain balance without movement.

RELATED MUSCLES SCIENTIFIC NAMES

• Gastrocnemius: A primary calf muscle responsible for plantar flexion during running, jumping and other explosive movements.
• Soleus: A deeper calf muscle involved in stabilising the ankle during standing and walking.
• Tibialis Anterior: Helps with dorsiflexion, allowing the foot to lift off the ground during walking.
• Peroneus Longus: Assists stabilising the ankle by supporting foot eversion, especially during lateral movements.
• Flexor Hallucis Longus: Controls the movement of the big toe and assists with plantarflexion, playing a pivotal role in balance and stability.

ANTAGONIST

• Tibialis Posterior: Opposes the action of the peroneal muscles by helping with foot inversion and arch support.
• Extensor Digitorum Longus: Acts against the calf muscles, enabling dorsiflexion and toe extension.
• Peroneus Brevis: Counteracts the tibialis anterior by assisting with foot eversion.
• Extensor Hallucis Longus: Opposes the flexor hallucis longus, allowing for significant toe extension.
• Tibialis Anterior: Acts as an antagonist to the gastrocnemius and soleus by pulling the foot upwards during dorsiflexion.

COMMON INJURIES

• Ankle Sprain: This common injury occurs when the ankle ligaments are stretched or torn, often from sudden twisting motions, resulting in pain, swelling and instability.
• Achilles Tendonitis: Inflammation of the Achilles tendon, usually due to overuse, causes pain and stiffness in the back of the ankle.
• Plantar Fasciitis: A condition where the plantar fascia becomes inflamed, resulting in heel pain and stiffness, often due to excessive stress or improper footwear.
• Fractures: Bone fractures in the ankle usually occur from high-impact trauma or falls, leading to severe pain, swelling and immobility.
• Shin Splints: Characterised by pain along the shin bone, shin splints are often caused by overuse, improper footwear, or running on hard surfaces.

EXERCISES

• Ankle Circles: Helps increase ankle mobility by rotating the foot in slow, controlled circles to loosen up the joint and improve the range of motion.
• Calf Raises: Strengthens the gastrocnemius and soleus by lifting the heels off the ground, improving ankle stability and muscle endurance.
• Resistance Band Eversion: Targets the peroneal muscles by pushing the foot outward against resistance, enhancing lateral ankle stability.
• Toe Taps: Activates the tibialis anterior by tapping the toes on the ground while keeping the heels stationary, strengthening dorsiflexion.
• Single-Leg Balance: Improves proprioception by engaging stabilising muscles in the ankle as you balance on one leg, helping with overall joint stability.

STRETCHES

• Standing Calf Stretch: Targets the gastrocnemius and soleus by extending the leg and pressing the heel into the ground, helping to lengthen the calf muscles.
• Seated Ankle Stretch: Stretches the tibialis anterior by pointing the toes downward while seated, improving ankle flexibility and range of motion.
• Toe-to-Wall Stretch: A simple stretch that increases Achilles tendon and calf flexibility by pressing the toes against a wall and leaning forward.
• Band-Assisted Dorsiflexion Stretch: Helps improve dorsiflexion by pulling the foot back with a resistance band gently stretching the tibialis anterior and ankle.
• Heel Drop Stretch: Performed on a step, this stretch lengthens the Achilles tendon and improves flexibility by lowering the heel below the edge.