The foot and ankle complex is an engineering marvel. During walking or running, the foot must dynamically balance and adapt as the foot connects with the ground, and then rapidly stabilize for the push-off phase of gait. During running, the body lands with five times its weight and the demands on this system increase even more.
The ankle joint is also known as the talocrural joint. It is formed by:
- Tibia - large and stronger of the two lower leg bones, which forms the inside part of the ankle
- Fibula - smaller bone of the lower leg, which forms the outside of the ankle
- Talus - a small bone between the tibia, fibula and calcaneus (heel bone)
- Lower (Subtalor) Ankle Joint - formed by the talus, calcaneus and navicular bone
The ends of each of the bones are covered by articular cartilage. The space in the joint is lined with a thin membrane called the synovium. The synovium cushions the joint and secretes a lubricating fluid (synovia), which reduces bone friction and help with fluid movement.
These bones are held together by a set of three strong bands of connective tissue, called ligaments. A number of tendons attach the lower leg muscles to the foot and ankle bones.
The foot has 28 bones and is divided into three regions:
- The Hindfoot - begins at the ankle joint and stops at the transverse tarsal joint (talonavicular and calcaneal-cuboid joints combined). The hindfoot has two bones: the talus and calcaneus.
- The Midfoot - begins at the transverse tarsal joint and ends where the metatarsals begin - at the tarsometatarsal (TMT) joint. The midfoot has five bones: navicular, cuboid and the three cuneiforms (medial, middle, and lateral).
- The Forefoot - made up of the metatarsals, phalanges, and sesamoids. The forefoot has 21 bones: five metatarsals, fourteen phalanges and two sesamoids (bones embedded within a tendon or a muscle that act like pulleys, providing a smooth surface over which tendons can slide to increase its ability to transmit muscular forces).
...and two columns:
- The Medial Column - a mobile column consisting of the talus, navicular, medial cuneiform, 1st metatarsal, and great toe bones.
- The Lateral Column - a staffer that includes the calcaneus, cuboid, and the 4th and 5th metatarsals.
When assessing your condition, a physical therapist will consider all the variables related to the foot and ankle, including the knee, hip and pelvis. Shoes and orthotics also play a role in how stress is dispersed, adding yet another component to the assessment process. At Premier Physical Therapy of the Upstate, we will closely evaluate and treat your foot and ankle issue as well as address other factors that may be contributing to the problem.
Common conditions we help include:
- Ankle sprains and strains
- Foot pain
- Ankle Pain
- Collapsed Arches
- Tendonitis
- Plantar Fasciitis
- Arthritis
- Post fracture Rehabilitation
- Postsurgical Rehabilitation
