How it works - The Ankle

Anatomy

The ankle is made up of three different joints. The talocrural joint, the subtalar joint and the inferior tibiofibular joint. Each joint functions differently and they all work together to give motion through the ankle. The talocrural joint is where the tibia (main leg bone) and the talus articulate. The subtalar joint is made up of the talus and its articulation with the calcaneus (the heel bone). The third and final joint that is in the ankle is called the inferior tibiofibular joint and it is where the two lower leg bones meet.

With any joint in the body, there a ligaments surrounding the joint to provide stability. There are three ligaments that support the ankle on the lateral side which mainly prevent excessive inversion of the ankle. The TFLs  (talo fibular ligaments) connect the talus to the fibula (outside shin bone). There are two different TFL’s in the ankle, an anterior and a posterior. The final lateral ligament is the CFL (calcaneofibular ligament) which connects the heel bone to the fibula. On the inside, is the deltoid ligament which supports the medial side of the joint and helps to prevent excessive eversion of the ankle. The final ligament that we will discuss is the anterior inferior tibiofibular ligament which joins the two shin bones together. As well as the ligamentous support there are also muscles and tendons that cross the ankle joint, further strengthening the joint.

Function

The ankle complex as a whole is critical for gait. The movement that the talocrucual joint allows (dorsiflexion and plantarflexion) the heel to make first contact with the ground and then the whole foot to momentarily be grounded before then pushing off with the toes. It is in the stance phase of gait where there is some movement at the subtalar joint which allows the foot to roll into some pronation. Obviously the other function of the ankle joint is to allow the muscles to contract, creating explosive movements such as jumping.

Common Injuries

There are three main injuries that affect the ankle joint. A rolled ankle, or sprained ankle is by far the most common type of injury. Generally, this occurs after an inversion sprain of the ankle. Inversion ankle sprains can happen in any sport and predominantly occur after landing on a foot or stepping into an uneven surface. It is also fairly common for fractures around the ankle. In order to fracture, there does need to be a high speed impact or fairly traumatic event. If there is a traumatic event, you have difficulty weight bearing at injury and later that day as well as tenderness through the bony structures it is recommended that an Xray is sought to ensure that the appropriate management can be placed. Another of the more common injuries to the ankle is a talar dome leision. This is an injury to the cartilage that lines the talus. These injuries tend to happen from extremely high speed ankle inversion sprains.

Our Physiotherapists are experts in the assessment and management of Ankle injuries, if you have any questions about your ankles then please do not hesitate to contact us. We look forward to helping you out