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INTRODUCTION

Objectives

  • To identify on a human skeleton the most important bone features, ligaments, and arches of the ankle and foot

  • To draw and label on a skeletal chart the muscles of the ankle and foot

  • To determine, list, and palpate the muscles of the ankle and foot joints and their antagonists

  • To demonstrate and palpate the movements of the ankle and foot and list their respective planes of motion and axes of rotation

  • To palpate the superficial joint structures including the ligaments on a human subject and appreciate their role in providing joint stability

  • To list and organize the muscles that produce movement of the ankle and foot and list their antagonists

  • To learn and understand the innervation of the ankle and foot joint muscles

  • To determine, through analysis, the ankle and foot movements and muscles involved in selected skills and exercises.

The complexity of the foot is evidenced by the 26 bones, 19 large muscles, many small (intrinsic) muscles, and more than 100 ligaments that make up its structure.

Support and propulsion are the two functions of the foot. Proper functioning and adequate development of the muscles of the foot and practice of proper foot mechanics are essential for everyone. In our modern society, foot trouble is one of the most common ailments. Quite often, people develop poor foot mechanics or gait abnormalities secondary to improper footwear or other relatively minor problems. Poor foot mechanics early in life inevitably leads to foot discomfort and pathological conditions in later years.

Walking may be divided into stance and swing phases (Fig. 10.1). The stance phase is further divided into three components—heel-strike, midstance, and toe-off. Midstance may be further separaated into loading response, midstance, and terminal stance. Normally, heel-strike is characterized by landing on the heel with the foot in supination and the leg in external rotation, followed immediately by pronation and internal rotation of the foot and leg, respectively, during midstance. The foot returns to supination and the leg returns to external rotation immediately prior to and during toe-off. The swing phase occurs when the foot leaves the ground and the leg moves forward to another point of contact. The swing phase may be divided into initial swing, midswing and terminal swing. Problems often arise when the foot is too rigid and does not pronate adequately or when the foot remains in pronation past midstance. If the foot remains too rigid and does not pronate adequately, then impact forces will not be absorbed through the gait, resulting in shock being transmitted up the kinetic chain. If the foot overpronates or remains in pronation too much past midstance, then propulsive forces are diminished and additional stresses are placed on the kinetic chain. Walking differs from running in that one foot is always in contact with the ground and there is a point at which both feet contact the ground whereas ...

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