Welcome to Momentum Health's patient resource about ankle problems.
The ankle joint acts like a hinge. But it's much more than a simple hinge joint. The ankle is actually made up of several important structures. The unique design of the ankle makes it a very stable joint. This joint has to be stable in order to withstand 1.5 times your body weight when you walk and up to eight times your body weight when you run.
Normal ankle function is needed to walk with a smooth and nearly effortless gait. The muscles, tendons, and ligaments that support the ankle joint work together to propel the body. Conditions that disturb the normal way the ankle works can make it difficult to do your activities without pain or problems.
This guide will help you understand:
what parts make up the ankle
how the ankle works
Important Structures
The important structures of the ankle can be divided into several categories. These include
bones and joints
ligaments and tendons
muscles
nerves
blood vessels
The top of the foot is referred to as the dorsal surface. The sole of the foot is the plantar surface.
Hear from some of our Foot Therapy patients
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Sprained my ankle while playing soccer. Got the best treatment from the best physios Mark Taylor and Sofia. They were patient enough to answer all my dumb questions. Also want to mention about the... ”
“ Sprained my ankle while playing soccer. Got the best treatment from the best physios Mark Taylor and Sofia. They were patient enough to answer all my dumb questions. Also want to mention about the lady at the front desk who was really kind. Overall, received the treatment that I was looking for and people are amazing! Highly recommend, would give 6/5 stars. ”
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My wife and I are very selective customers of about everything. If we spend money in today's world, we should get a top and customer-oriented service. The same goes for accessing physiotherapy and... ”
“ My wife and I are very selective customers of about everything. If we spend money in today's world, we should get a top and customer-oriented service. The same goes for accessing physiotherapy and other rehabilitation services after a trauma or a motor vehicle accident. I had never experienced good at other physiotherapists' clinics before. Most clinics are more interested in your insurance money than their patients' complete recovery. I can be biased, but it is my personal opinion. I was very apprehensive in my search for a professional physiotherapy center. I Google-searched for nearly two days and read lots of reviews. I narrowed my search and selected Momentum Health at Deerfoot and 64th Avenue, NE. I can say my hrs. long search was not in vain. The treatment is top-notch and very professional in medical and customer services. I highly recommend this clinic for any massage, physiotherapy, or related service. My physiotherapist, Mark Taylor, Kinesiologist, Safia, and massagist, Meagan, are professional and sincere healthcare professionals. They go beyond and above to help you with your problem. They listen to you and then advise accordingly. I highly recommend this clinic and those individuals I dealt with. It is worth your money, time, and energy to give them a chance and try their positive, effective, and professional service. I will go back to them for sure again if another occasion arises. ”
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I recently saw Joel for an ankle injury. He was professional, empathetic and really helped me understand my limits. I really felt comfortable with his IMS techniques and I felt a lot of relief... ”
“ I recently saw Joel for an ankle injury. He was professional, empathetic and really helped me understand my limits. I really felt comfortable with his IMS techniques and I felt a lot of relief following! One could say he has ‘magic hands’. 5/5 service! ”
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Just had an amazing deep tissue massage from Christina. Walked in with major foot pain. Told her exactly where it hurt. She messaged the area and listened to me if it hurt too much. She then worked on... ”
“ Just had an amazing deep tissue massage from Christina. Walked in with major foot pain. Told her exactly where it hurt. She messaged the area and listened to me if it hurt too much. She then worked on areas she thought would help my foot and it worked. I got up from the table and could walk without pain. The deep tissue massage was perfect. She kept asking if the pressure was good or too much and acted accordingly to my answer. There’s a reason she books so far out. She’s that good. Extremely happy to have found Christina. I would highly recommend her to anyone ”
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Rebecca and Karissa have helped me immensely in recovery from a ruptured achilles tendon. Their guidance and program has helped me heal and strengthen the injury. Top notch quality and care from the... ”
“ Rebecca and Karissa have helped me immensely in recovery from a ruptured achilles tendon. Their guidance and program has helped me heal and strengthen the injury. Top notch quality and care from the best people. Thanks for everything! ”
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I have been a client of Brad Fugimoto for several years and when I developed a sore heel (plantar fasciitis ), I asked him about it. He found that my calf muscle was very tight and said if I could... ”
“ I have been a client of Brad Fugimoto for several years and when I developed a sore heel (plantar fasciitis ), I asked him about it. He found that my calf muscle was very tight and said if I could tolerate deep massage of it, the heel pain would likely resolve. However I didn't think I could tolerate it so decided to try other practitioners, including seeing a podiatrist for new orthotics, another chiropractor for Cold Laser, a Physiotherapist for Ultrasound and Acupuncture , plus doing many prescribed exercises. The pain persisted. So I saw my Homeopath/RN for her opinion. She diagnosed it as a muscle/fascia problem of the lower leg which caused the inflammation in the plantar fascia (heel). Bingo! She recommended a technique called Myofascial Release. This is the same as what Brad had described 3 months ago. So back to Brad I went and after one treatment (which was painful), the heel pain is relieved about 50% and hopefully a few more treatments will bring it back to normal. I very much recommend Brad Fugimoto for his expertise, professionalism and his intuitive ability. ”
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Mark, our physiotherapist was absolutely amazing!! My son sprained his ankle playing sports and months later it was still bothering him to the point he couldn’t play for his competitive soccer team... ”
“ Mark, our physiotherapist was absolutely amazing!! My son sprained his ankle playing sports and months later it was still bothering him to the point he couldn’t play for his competitive soccer team anymore. Mark spent time with him on a weekly basis for a few weeks and drew up a plan for him to also work on his ankle at home and now he is 100% pain free!! Mark made my shy son feel comfortable during his visits and helped him so much! Even on our last visit, my son had strained his neck sleeping awkwardly one night and one visit with Mark fixed him right up! I highly recommend Momentum Health Deerfoot! Thanks so much to Mark and the very friendly reception staff who always made our visits enjoyable! ”
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Good morning i have been having nerve problems and numbness in my left leg hip and ankle, since i have been coming there i have been treated with respect and kindness for my problem, i feel very... ”
“ Good morning i have been having nerve problems and numbness in my left leg hip and ankle, since i have been coming there i have been treated with respect and kindness for my problem, i feel very confident that the team there will help me to get better if possible. Russ is awesum he has done things that no other physio place has tried i believe he accutually cares about my injury and healing process. Hats off to all of you i would recommend treatment here for anyone who has issues with your body. ”
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I have been working with Mark Taylor to help remidy my ankle tendonitis for a couple months now, already seeing massive improvements and very little pain anymore. Would recommend. ”
“ I have been working with Mark Taylor to help remidy my ankle tendonitis for a couple months now, already seeing massive improvements and very little pain anymore. Would recommend. ”
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I've been coming here for a few months. My foot got crushed in forklift incident at the company I was working for and I've been having to learn how to walk on the for again. So far my experience has... ”
“ I've been coming here for a few months. My foot got crushed in forklift incident at the company I was working for and I've been having to learn how to walk on the for again. So far my experience has been positive with Mark being easy to talk to and not overbearing or aggressive. The current negative is that finding the location is hard due to the set up of the mall, but that is the fault of the overseers Shape Properties not knowing how to do competent address designation. ”
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I had an inflamed Achilles’ tendon after rolling my ankle during a winter run. I could barely walk. Amy diagnosed the problem and gave me treatment and exercises that set me right. She focused on... ”
“ I had an inflamed Achilles’ tendon after rolling my ankle during a winter run. I could barely walk. Amy diagnosed the problem and gave me treatment and exercises that set me right. She focused on strengthening my ankle so the problem would not re-occur and stretching to address muscle tightness. The team at Momentum West Springs is my first choice whenever I have an injury. I trust them to get me back fast. Thanks Amy and Nicole! ”
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My first trip to Momentum Health Ogden today had me meeting with Meghan Murphy for physio for my Achilles Tendonitis. She was thorough, knowledgeable and thoughtful of my pain tolerance. I’m... ”
“ My first trip to Momentum Health Ogden today had me meeting with Meghan Murphy for physio for my Achilles Tendonitis. She was thorough, knowledgeable and thoughtful of my pain tolerance. I’m confident in the regimen she’s laid out for my recovery and highly recommend her to help you work through any injuries you may have! ”
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Kaylie and Rachel were absolutely phenomenal in getting me back to life and mobile. I came in with a serious ankle sprain and developed a secondary sprain on my other ankle, too. They worked... ”
“ Kaylie and Rachel were absolutely phenomenal in getting me back to life and mobile. I came in with a serious ankle sprain and developed a secondary sprain on my other ankle, too. They worked diligently with me to make sure I was progressing in my healing process and are both extremely friendly. I would highly recommend Momentum Health and Rachel and Kaylie if you are in need of physiotherapy treatment! ”
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Kaylie and Rachel were an amazing team helping to heal my foot. They were super knowledgeable about the body and friendly to chat with during each session. Thanks so much for the help!!! ”
“ Kaylie and Rachel were an amazing team helping to heal my foot. They were super knowledgeable about the body and friendly to chat with during each session. Thanks so much for the help!!! ”
The ankle joint is formed by the connection of three bones. The ankle bone is called the talus. The top of the talus fits inside a socket that is formed by the lower end of the tibia (shinbone) and the fibula (the small bone of the lower leg). The bottom of the talus sits on the heelbone, called the calcaneus.
The talus works like a hinge inside the socket to allow your foot to move up (dorsiflexion) and down (plantarflexion).
Talus Works Like a Hinge
Woodworkers and craftsmen are familiar with the design of the ankle joint. They use a similar construction, called a mortise and tenon, to create stable structures. They routinely use it to make strong and sturdy items, such as furniture and buildings.
Mortise and Tenon
Inside the joint, the bones are covered with a slick material called articular cartilage. Articular cartilage is the material that allows the bones to move smoothly against one another in the joints of the body.
The cartilage lining is about one-quarter of an inch thick in most joints that carry body weight, such as the ankle, hip, or knee. It is soft enough to allow for shock absorption but tough enough to last a lifetime, as long as it is not injured.
Cartilage
Ligaments and Tendons
Ligaments are the soft tissues that attach bones to bones. Ligaments are very similar to tendons. The difference is that tendons attach muscles to bones. Both of these structures are made up of small fibers of a material called collagen. The collagen fibers are bundled together to form a rope-like structure. Ligaments and tendons come in many different sizes and like rope, are made up of many smaller fibers. Thickness of the ligament or tendon determines its strength.
Collagen
Ligaments on both sides of the ankle joint help hold the bones together. Three ligaments make up the lateral ligament complex on the side of the ankle farthest from the other ankle. (Lateral means further away from the center of the body.) These include the anterior talofibular ligament (ATFL), the calcaneofibular ligament(CFL), and the posterior talofibular ligament (PTFL). A thick ligament, called the deltoid ligament, supports the medial ankle (the side closest to your other ankle).
Three Main Ligaments
Ligaments also support the lower end of the leg where it forms a hinge for the ankle. This series of ligaments supports the ankle syndesmosis, the part of the ankle where the bottom end of the fibula meets the tibia. Three main ligaments support this area. The ligament crossing just above the front of the ankle and connecting the tibia to the fibula is called the anterior inferior tibiofibular ligament (AITFL). The posterior fibular ligaments attach across the back of the tibia and fibula. These ligaments include the posterior inferior tibiofibular ligament (PITFL) and the transverse ligament. The interosseous ligament lies between the tibia and fibula. (Interosseous means between bones.) The interosseus ligament is a long sheet of connective tissue that connects the entire length of the tibia and fibula, from the knee to the ankle.
The ligaments that surround the ankle joint help form part of the joint capsule. A joint capsule is a watertight sac that forms around all joints. It is made up of the ligaments around the joint and the soft tissues between the ligaments that fill in the gaps and form the sac.
Joint Capsule
The ankle joint is also supported by nearby tendons. The large Achilles tendon is the most important tendon for walking, running, and jumping. It attaches the calf muscles to the calcaneus (heelbone) and allows us to raise up on our toes. The posterior tibial tendon attatches one of the smaller muscles of the calf to the underside of the foot. This tendon helps support the arch and allows us to turn the foot inward.
Achilles Tendon
Posterior Tibial Tendon
The anterior tibial tendon allows us to raise the foot. Two tendons run behind the outer bump of the ankle (the lateral malleolus). These two tendons, called the peroneals, help turn the foot down and out.
Muscles
Most of the motion of the ankle is caused by the stronger muscles in the lower leg whose tendons pass by the ankle and connect in the foot. Contraction of the muscles in the leg is the main way that we move our ankle when we walk, run, and jump.
The key ankle muscles have been discussed earlier in the section on ligaments and tendons. These muscles and their actions are also listed here.
The peroneals (peroneus longus and peroneus brevis) on the outside edge of the ankle and foot bend the ankle down and out.
The calf muscles (gastrocnemius and soleus) connect to the calcaneus by the Achilles tendon. When the calf muscles tighten, they bend the ankle down.
The posterior tibialis muscle supports the arch and helps turn the foot inward.
The anterior tibialis pulls the ankle upward.
Nerves
The nerve supply of the ankle is from nerves that pass by the ankle on their way into the foot. The tibial nerve runs behind the medial malleolus. Another nerve crosses in front of the ankle on its way to top of the foot. There is also a nerve that passes along the outer edge of the ankle. The nerves on the front and outer edge of the ankle control the muscles in this area, and they give sensation to the top and outside edge of the foot.
Tibial Nerve
Nerves on Front and Outer Edge
Blood Vessels
The ankle gets blood from nearby arteries that pass by the ankle on their way to the foot. The dorsalis pedis runs in front of the ankle to the top of the foot. (You can feel your pulse where this artery runs in the middle of the top of the foot.) Another large artery, called the posterior tibial artery, runs behind the medial malleolus. It sends smaller blood vessels to the inside edge of the ankle joint. Other less important arteries entering the foot from other directions also supply blood to the ankle.
Posterior Tibial Artery
Arteries Entering the Foot
Summary
As you can see, the anatomy of the ankle is very complex. When everything works together, the ankle functions correctly. When one part becomes damaged, it can affect every other part of the ankle and foot, leading to problems.
