Ankle and Foot

Question 1

Pronation in open chain

Answer 1

Calcaneus DF
Calcaneus AB
Calcaneus EV

Question 2

Supination in open chain

Answer 2

Calcaneus PF
Calcaneus AD
Calcaneus IN

Question 3

Pronation in closed chain

Answer 3

Calcaneus EV
Talus AD
Talus PF
Tibial medial rotation

Question 4

Supination in closed chain

Answer 4

Calcaneus IN
Talus AB
Talus DF
Tibial lateral rotation

Question 5

Talocrural joint formed by the

Answer 5

Concavity of the distal end tibia and both malleoli, and the convex trochlea of the talus

Question 6

MCL in the ankle

Answer 6

Anterior tibiotalar
Posterior tibiotalar
Tibionavicular
Tibiocalcaneal 
Resists eversion sprains

Question 7

LCL in the ankle

Answer 7

Anterior talofibular (most common ligament sprain)
Posterior talofibular
Calcaneofibular
Resists inversion sprains (most common)

Question 8

Main component of pronation in talocrural joint is

Answer 8

DF

Question 9

Main component of supination in talocrural joint is

Answer 9

PF

Question 10

DF at the talocrural joint

Answer 10

Superior surface of the talus rolls anterior and slides posterior in open chain

Question 11

What ligament become taut in DF of the talocrural joint?

Answer 11

calcaneofibular ligament

Question 12

PF at the talocrural joint

Answer 12

superior surface of the talus rolls posterior and slides anterior in open chain

Question 13

What ligament becomes taut in PF of the talocrural joint?

Answer 13

Tibionavicular ligament

Question 14

What ligament is stretched during PF of the talocrural joint?

Answer 14

Anterior tibiofibular ligament

Question 15

Main components of pronation in the subtalar joint in open chain are

Answer 15

Eversion and abduction

Question 16

Main components of supination in the subtalar joint in open chain are

Answer 16

Inversion and adduction

Question 17

What happens if you cannot maintain all 5 rays in contact with the ground?

Answer 17

You lose feed forward mechanisms to your CNS which is going to decrease your ability for proprioceptive and neuromuscular control

Question 18

Transverse tarsal joint or mid-tarsal joint consists of

Answer 18

Calcaneocubioid joint (which provides more stability and less mobility) and the talonavicular joint (which provides more mobility but is still extremely stable)

Question 19

The mid-tarsal joint works together with the STJ to

Answer 19

control most of the pronation and supination

Question 20

Pronation and supination occurs as the navicular…

Answer 20

spins as the calcaneus is held firmly in place

Question 21

Navicular cannot move…

Answer 21

independent of the talus, strong ligamentous connections there, need complete dislocation and tear of every major stabilizer

Question 22

The function of the TTJ is complicated by

Answer 22

1. two separate axises of rotation
2. movement different during WB and NWB
3. stabilizing function of the TTJ at the mid foot is influenced by the position of the subtler joint (STJ coach, TTJ players)

Question 23

2 axes of the TTJ

Answer 23

longitudinal - Primary motion EV/IN

oblique - strong vertical and med-lat pitch

Question 24

Main components of pronation in the TTJ in open chain are

Answer 24

DF/AB/EV

Question 25

Main components of supination in the TTJ in open chain are

Answer 25

PF/AD/IN

Question 26

What is your primary supinator?

Answer 26

Tibialis posterior

Will eccentrically control pronation

Question 27

If someone is overly pronating they might develop…

Answer 27

Tibialis posterior tendinopathy - because they are putting a lot of tensile forces through their TP

Question 28

What initiates the spin of the navicular?

Answer 28

The tibias posterior. This will tighten the spring ligament around the convex head of talus

Question 29

What is your primary pronator?

Answer 29

Fibularis longus

Contributes to lowering of the medial side (1st ray) of the foot and raising of the lateral side

Question 30

What is the function of the plantar fascia?

Answer 30

Give passive stability and primary support of the medial longitudinal arch

Question 31

What stretches the central fascia?

Answer 31

Active toe extension (especially of the big toe), which should push the medial longitudinal arch higher. If you’re excessively pronated and that fascia is stretched out, it doesn’t have the ability to develop any tension to give it bowstringing so that you can get more of an arch

Question 32

Combined action STJ and TTJ during stance phase gait

Answer 32

Just after heel strike the STJ will pronate unlocking the MTJ so the foot is flexible and can adapt to the ground. Late stance the STJ will supinate locking the MTJ creating a rigid stable base for push off to propel the LE for swing

Question 33

Windlass mechanism

Answer 33

The windlass action causes the longitudinal arches of the foot to rise when the toes are extended as well as stiffening the fibrous tissues of the ball of the foot during push off.
The windlass action is most evident in the medial arch with extension of the hallux.
One risk factor is a pronated foot, another is limited dorsiflexion (don’t get that stretch through the plantar fascia so you’re walking through a very hypo mobile foot, lots of traction)

Question 34

Pronation occurs during

Supination occurs during

Answer 34

Initial contact = increased foot mobility

Terminal stance = increased foot stability

Question 35

Who is more likely to have overuse injuries? Stress fractures?

Answer 35

People with low arches are more likely to have overuse injuries (because foot is not very stable). People with high arches more likely to have stress fractures (because they can’t disperse force).

Question 36

During walking, the 1st ray…

Answer 36

Dorsiflexes and everts during the loading phase, and then plantar flexes and inverts during the propulsion phase (puts tension through the plantar fascia which acts as a bowstring and lifts arch to increase stability)

Question 37

Altered mobility of the 1st ray can result in

Answer 37

Excess rear foot pronation and supination and the development of bunions