FOOT AND ANKLE ANATOMY

What is the Normal Anatomy of the Foot and Ankle?

The foot and ankle are a complex joint involved in movement and providing stability and balance to the body. The foot and ankle consist of 26 bones, 33 joints, and many muscles, tendons and ligaments.

Bones of the ankle

The ankle joint connects the leg with the foot and is composed of three bones: tibia, fibula and talus. The tibia or shinbone and fibula or calf bone are bones of the lower leg which articulate with the talus or ankle bone, enabling up and down movement of the foot.

Three bony bumps present on the ends of the tibia and fibula form parts of the ankle joint:

  • The medial malleolus, formed by the tibia, is found on the inside of the ankle.
  • Posterior malleolus, also formed by the tibia, is found at the back of the ankle.
  • Lateral malleolus, formed by the fibula, is found on the outer aspect of the ankle.

Bones of the feet

The foot acts as a single functional unit, but can be divided into three parts: the hindfoot, midfoot and forefoot.

The hindfoot forms the ankle and heel and is made up of the talus bone and calcaneus or heel bone. The heel bone is the largest bone in the foot.

The midfoot connects the hindfoot to the forefoot, and consists of one navicular bone, one cuboid bone, and three cuneiform bones. The navicular bone is found in front of the heel bone, and the cuneiform and cuboid bones are arranged in front of the navicular bone.

These bones are connected to five metatarsal bones of the forefoot, which form the arch of the foot for shock absorption while walking or running. The forefoot is also made up of the toes or digits, formed by phalanges, three in each toe, except the big toe, which has only two phalanges. The big toe has two additional tiny round sesamoid bones in the ball of the foot, which help in upward and downward movement of the toe.

Ankle and foot joints

There are 33 joints in the ankle and foot. They include:

  • Hinge joints in the ankle, which allow flexion (bending) and extension
  • Gliding joints found in the hindfoot, which allow gliding movements
  • Condyloid joints found in the forefoot and toes, which allow the flexion (bending) and extension, adduction and abduction (sideward movement).

The joints of the foot and ankle provide stability and support the weight of the body, helping you to walk or run, and to adapt to uneven ground.

The joint surface of all bones of the ankle and foot are lined by a thin, tough, flexible, and slippery surface called articular cartilage, which acts as a shock absorber and cushion to reduce friction between the bones. The cartilage is lubricated by synovial fluid, which further enables smooth movement of the bones.

Soft Tissues of the Ankle and Foot

Our feet and ankle bones are held in place and supported by various soft tissues such as cartilage, ligaments, muscles, tendons and bursae.

artilage is the flexible, shiny, smooth tissue on the ends of bones that meet to form a joint. Cartilage provides cushioning between the bones allowing smooth movement.

Ligaments are tough rope-like tissue that connect bones to other bones, and holds them in place providing stability to the joints. The plantar fascia is the largest ligament in the foot, originating from the heel bone to the forefoot, it extends along the bottom surface of the foot and is involved in maintaining the arch of the foot. The plantar fascia ligament stretches and contracts to provide balance and strength to the foot. Lateral ligaments on the outside of the foot and medial ligaments on the inside of the foot provide stability and allow up and down movement of the foot.

The foot is made up of 20 muscles, which help in movement. The main muscles include:

  • Anterior tibial muscle: allows up and down movement of the foot
  • Posterior tibial muscle: supports the arch
  • Peroneal tibial muscle: controls movement on the outside of the ankle
  • Extensors: enable the ankle to raise the toes just before stepping forward
  • Flexors: stabilize the toes against the floor
  • Smaller muscles are also present to help the toes lift and curl.

Tendons are soft tissues that connect muscles to bones. The largest and strongest tendon in the foot is the Achilles tendon, present at the back of the lower leg around the heel bone. Other tendons include peroneal and anterior and posterior tibialis.

Bursae

Bursae are small fluid-filled sacs that decrease friction between tendons and bone or skin. Bursae contain special cells called synovial cells that secrete a lubricating fluid.

Plantar Fasciitis

What is Plantar Fasciitis? Plantar fasciitis refers to inflammation of the plantar fascia, a thick...

Ankle Sprain

A sprain is the stretching or tearing of ligaments, which connect adjacent bones and provide...

Ankle Fractures

What is Normal Ankle Joint Anatomy? The ankle joint is composed of three bones: the tibia, fibula...

Ankle Ligament Injury

What is an Ankle Ligament Injury? An ankle ligament injury, also known as an ankle sprain, can be...

Foot and Ankle Arthritis

What is Foot and Ankle Arthritis? Arthritis is inflammation resulting from the degeneration of...

Bunion

What is a Bunion? A bunion is a bony protuberance that appears on the outer surface of the big toe...

Athlete’s Foot

What is Athlete’s Foot? Athlete's foot, also known as tinea pedis, is a fungal infection on the...

Ankle Sprain

A sprain is the stretching or tearing of ligaments, which connect adjacent bones and provide...

Ankle Fractures

What is Normal Ankle Joint Anatomy? The ankle joint is composed of three bones: the tibia, fibula...

Ankle Ligament Injury

What is an Ankle Ligament Injury? An ankle ligament injury, also known as an ankle sprain, can be...

Foot and Ankle Arthritis

What is Foot and Ankle Arthritis? Arthritis is inflammation resulting from the degeneration of...

Bunion

What is a Bunion? A bunion is a bony protuberance that appears on the outer surface of the big toe...

Athlete’s Foot

What is Athlete’s Foot? Athlete's foot, also known as tinea pedis, is a fungal infection on the...

Ankle Fractures

What is Normal Ankle Joint Anatomy? The ankle joint is composed of three bones: the tibia, fibula...

Ankle Ligament Injury

What is an Ankle Ligament Injury? An ankle ligament injury, also known as an ankle sprain, can be...

Foot and Ankle Arthritis

What is Foot and Ankle Arthritis? Arthritis is inflammation resulting from the degeneration of...

Bunion

What is a Bunion? A bunion is a bony protuberance that appears on the outer surface of the big toe...

Athlete’s Foot

What is Athlete’s Foot? Athlete's foot, also known as tinea pedis, is a fungal infection on the...

Athlete’s Foot

What is Athlete’s Foot? Athlete's foot, also known as tinea pedis, is a fungal infection on the...

Bunion

What is a Bunion? A bunion is a bony protuberance that appears on the outer surface of the big toe...

Foot and Ankle Arthritis

What is Foot and Ankle Arthritis? Arthritis is inflammation resulting from the degeneration of...

Ankle Ligament Injury

What is an Ankle Ligament Injury? An ankle ligament injury, also known as an ankle sprain, can be...

Ankle Fractures

What is Normal Ankle Joint Anatomy? The ankle joint is composed of three bones: the tibia, fibula...

Ankle Sprain

A sprain is the stretching or tearing of ligaments, which connect adjacent bones and provide...

Plantar Fasciitis

What is Plantar Fasciitis? Plantar fasciitis refers to inflammation of the plantar fascia, a thick...

Ankle Ligament Injury

What is an Ankle Ligament Injury? An ankle ligament injury, also known as an ankle sprain, can be...

Ankle Fractures

What is Normal Ankle Joint Anatomy? The ankle joint is composed of three bones: the tibia, fibula...

Ankle Sprain

A sprain is the stretching or tearing of ligaments, which connect adjacent bones and provide...

Plantar Fasciitis

What is Plantar Fasciitis? Plantar fasciitis refers to inflammation of the plantar fascia, a thick...

Bunion

What is a Bunion? A bunion is a bony protuberance that appears on the outer surface of the big toe...

Foot and Ankle Arthritis

What is Foot and Ankle Arthritis? Arthritis is inflammation resulting from the degeneration of...

Ankle Ligament Injury

What is an Ankle Ligament Injury? An ankle ligament injury, also known as an ankle sprain, can be...

Ankle Fractures

What is Normal Ankle Joint Anatomy? The ankle joint is composed of three bones: the tibia, fibula...

Ankle Sprain

A sprain is the stretching or tearing of ligaments, which connect adjacent bones and provide...

Plantar Fasciitis

What is Plantar Fasciitis? Plantar fasciitis refers to inflammation of the plantar fascia, a thick...

Foot and Ankle Arthritis

What is Foot and Ankle Arthritis? Arthritis is inflammation resulting from the degeneration of...

Bunion

What is a Bunion? A bunion is a bony protuberance that appears on the outer surface of the big toe...

Athlete’s Foot

What is Athlete’s Foot? Athlete's foot, also known as tinea pedis, is a fungal infection on the...

Foot Discharge Instructions

You should receive a printed copy of these instructions. Your surgeon will check the orders you should follow to facilitate your healing process. Use these instructions until your first follow-up appointment. You will be given further instructions at your follow-up...

Foot and Ankle Surgery

Your doctor has recommended that you consider having surgery performed. The goal of the procedure is to attempts to reduce symptoms. Since almost all foot and ankle surgery is elective (not a matter of life and death), there are several things you need to know so you...

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