Foot/Ankle Kinesiology

Question 1

Name 3 regions making up the foot. Include the bones and joints in each region.

Answer 1

Rearfoot (Hindfoot)–talus, calcaneus, subtalar joints (STJ)
Midfoot–Navicular, Medial, Intermediate, and Lateral Cuneiform, and Cuboid. Transverse tarsal joint (midtarsal joint) and distal intertarsal joint.
Forefoot–Metatarsals and Phalanges. Tarsometatarsal jt., Intermetatarsal jt., Metatarsalphalangeal jt., Interphalangeal jt.

Question 2

What bones make up the ankle and what joints are considered relevant to the ankle?

Answer 2

Tibia, Fibia, Talus
Talocrural joint***
Proximal tibiofibular joint.
Distal tibiofibular joint.

Question 3

Define what is a ‘ray of the forefoot’?

Answer 3

A ray of the forefoot is functionally defined as one metatarsal and its associated set of phalanges. 1st ray and 5th ray are talked about often.

Question 4

List osteokinematic motions in the cardinal planes found at the foot/ankle and associate direction of axes for each motion.

Answer 4

Dorsiflexion/Plantar flexion…sagittal plane…medial/lateral.
Eversion/Inversion…Parallel to Frontal plane…Anterior/posterior. Sole of foot turns in and out.
Abduction/Adduction…Transverse plane…vertical. Forefoot or toes turn in and out.

Question 5

Define pronation and supination How are these different than cardinal plane motions?

Answer 5

Pronation–a combination of eversion, abduction, and dorsiflexion.
Supination–inversion, adduction and plantar flexion.
They occur along one oblique axis of rotation in one oblique plane. These motions are triplaner in that they “cut through” all three cardinal planes.
Pronation includes dorsiflexion/eversion/abduction moving in a diagonal plane = one plane of motion. We focus more on pron/sup than cardinal plane motion. The majority of a motion is in one plane – clinical significance.

Question 6

In which plane is the proximal tib-fib joint found?

Answer 6

Found in an oblique plane anterolateral to posteriomedial. When mobilizing, push/pull in a diagonal motion–not anterior/posterior.

Question 7

What makes up the talocrural joint?

Answer 7

Talus, Tibia, and Fibula. Trochlea (dome) of the talus articulates with the distal end of tibia and its medial malleolus and the fibular malleolus creating a mortise.

Question 8

What is the shape of the proximal and distal ankle joint surfaces of the talocrural jointin the sagittal plane?

Answer 8

Tibia–Concave

Talus–Convex (talar dome)

Question 9

Identify the location of axis of motion and how many degrees of freedom exist at this joint.

Answer 9

Axis runs from tip of lateral malleolus to tip of medial mallelus. Oblique axis. 1 degree of freedom.

(One degree of freedom. Semi medial-lateral (10 degrees off) through both malleoli and the talus.)

Question 10

Consider the orientation of the talocrural joint axis. What are the specific implication of this orientation on motion at the joint?

Answer 10

As the ankle plantarflexes, it will plantarflex/invert/addut which is supination. Dorsiflexion, the joint will dorsiflex/evert//abduct which is pronation.

Question 11

What are the main component motions at the talocrural joint?

Answer 11

**Motion is through all 3 cardinal planes, but it is one motion (sup/pron) in one oblique plane. Most motion is in sagittal plane–we measure dorsi/plantar flexion. 1. Dorsi/Plantarflexion, 2. Eversion/Inversion, 3. Add/Abduction.

Question 12

Describe the arthrokinematics of this joint during dorsiflexion and plantarflexion.

Answer 12

Dorsiflexion is open-chain–convex on concave–opposite motion…roll forward/ slide posterior.
Plantarflexion is open-chain–convex on concave–roll posterior/slide forward posterior.
Dorsi, closed-chain–concave on convex–same roll/slide together.
Plantar, closed-chain–concave on convex–same roll/slide together.

Question 13

How does the variable width of the anterior talus affect ankle joint stability during gait?

Answer 13

Wider anterior, slimmer posterior.
Up on toes–less bone on bone stability thank flat footed. As the foot dorsiflexes, the wider part of the bone gets wedged into the mortise joint. The wedging spreads the tibia and fibula slightly apart. This creates greater stability and allows the foot to absorb the shock.

Question 14

What is the purpose (based on reading the text) of the mobility at the STJ? (Subtalar joint)

Answer 14

Pg. 586 and pg 587. Allows foot to adapt to varying surfaces–either new surfaes you’re about to stand on or currently standing on and changing (skateboard, boat, walk across hill) surfaces.

Question 15

Identify the location of the axis of motion and degrees of freddom at the STJ.

Answer 15

1 degree of freedom. Supination/Pronation. Axis runs posterior/inferior/lateral calcaneus runs to anterior/superior/medial to head of talus.

Question 16

What is the orientation of the STJ axis and what are the specific implications of this on motion at this joint?

Answer 16

Orientation is oblique because of location. Passes through all 3 cardinal planes. 1 plane dominates.

Question 17

What are the main component motions of the STJ?

Answer 17

pg 587 Primary mvts are,
1. Inversion/Eversion.
2. Abduction/Adduction
3. Dorsiflexion/Plantarflexion
Due to individual variability, 1 & 2 are generally equal. Move calcaneal bone to determine mobility of subtalar joint.

Question 18

What might need to be considered when measuring “ankle joint” DF as a result of these component motions?

Answer 18

The subtalor joint gets involved and makes the ankle joint look like it has more ROM than it truly has.

DF (dorsi) = Talocrural jt. Move medial foot so subtalor joint is inverted. Eliminates DF cause by subtalor jt and isolates DF of talocrural joint.

Question 19

What is the relationship of leg rotation and STJ motion/function in weight bearing?

Answer 19

Coupled motion–marriage, where one goes, the other goes.

The supinatory motion of raising the arch rotates the tibia externally. Pronation or decreasing the arch results in the tibia rotating internally.

Question 20

How would variability in orientation of the STJ axis, high v low, affect this rotation of the leg?

Answer 20

If STJ angle is high, there would be more rotation. Creates a more vertical axis of rotation. This vertical axis will pull the tibia medially and change the orientation of the knee joint.

Question 21

What joints make up the transverse tarsal joint and what does the transverse tarsal joint help the STJ control at the foot?

Answer 21

Talonavicular joint. and Calcaneocuboid joint.
The TTJ is the most oblique joint. It cuts through nearly all 3 cardinal planes.
Adaptation to a variety of surface contours.

Question 22

What are important ligaments to the Transverse tarsal joint on the plantar aspect of the foot and why?

Answer 22

Spring Ligament– runs from susentaculum talus of calcaneus and medial-plantar surface of the navicular bone.supports the head of the talus and creates a floor and medial wall for the talonavicular joint. It resists the push of body weight depressing the head of the talus to the floor and medially.

Short and Long Plantar Ligaments–support the calcaneocuboid joint and provide structural stability to the lateral column of the foot.

Question 23

Identify the axes locations and degrees of freedom for the Midtarsal (Transverse tarsal) joint. Also their orientation.

Answer 23

2 axes. Longitudinal and Oblique.
Longitudinal axis is more Anterior/Posterior in orientation. It is lateral. Motion is mostly eversion/inversion. 1 degree of freedom.

Oblique axis has a strong vertical and medial-lateral pitch. Because of the vertical component of the axis, there is more transverse plane motion (abduction/adduction). Because of medial/lateral component of axis, it rotates on dorsi/plantarflexion.

Question 24

Transverse Tarsal joint, what are the specific implications of the 2 axis of rotation on motion at these joints? (That is, what are the main component motions?)

Answer 24

The motion at the transverse tarsal joint is pure supination/pronation. Eversion/Abduction/Plantarflexion are all components of the overall joint. This allows the midfoot (and forefoot) to adapt to different surface contours and shapes.

Question 25

What does the midtarsal (transverse tarsal) joint’s ability to stabilize the mid foot have to do with the STJ position? (Can this be demonstrated?)

Answer 25

It has to do with rigidity and stability. Subtalar joint position: Supination causes the midfoot to be stabilized. Pronation makes the midfoot unstable and unlocks the foot. Everything anterior to that joint is more mobile and adaptable.

Question 26

What is the medial longitudinal arch of the foot and what role does the plantar fascia have associated with this arch?

Answer 26

Calcaneus, Navicular (keystone or apex of arch), talus, Medial, and intermediate cuneiform, and first ray.
Plantar fascia. O: Calcaneus. Moves forward to insert at base of proximal phalanxes of all toes. Plantar fascia is the primary support to the medial longitudinal arch. Long and short ligaments and the spring ligaments help support this arch too.