Foot & Ankle

The Ankle & Foot

This is regarded as one entity and is usually named foot-and-ankle. We can divide it into three regions.

The hindfoot houses the ankle joint and the under ankle (subtalar) joint and this includes the heel bone (calcaneus), the ankle bone (talus), the four tendon groups and the two large ligament complexes. These are the peroneals (the outer, small toe side tendons), the large posterior heel cord ( Achilles tendon), the inside/large toe side three tendons called the tibialis posterior( which supports your arch ), the flexor digitorum ( which bends your toes) and the flexor hallucis longus tendon which bends your big toe. Finally, the anterior group consisting of three tendons which lift your ankle up (tibialis anterior) and lift your toes up (the extensor digitorum) and lift your large toe up, called the extensor hallucis longus.

The two large ligaments are the lateral complex ligaments which stop your ankle from giving way to the outside and the deltoid complex, which prevents your ankle from giving way to the inside.

The midfoot is comprised of the bones and ligaments that support your arch and the end of the tibialis posterior, anterior and peroneal brevis tendons.

The forefoot includes the large toe bones making up the front of the arch and the joints that connect them to the digits (phalanges), the large toe ( the hallux ), their tendons and the large cushion pad on the sole of the foot.

Problems can arise from any or a combination the Sites

  • Heel cord problems usually cause pain and swelling of the heel cord and weakness and pain pushing off the ground.
  • Instability or giving way of the ankle is usually due to injury or stretching of the ligaments and if left can cause ankle arthritis later.
  • High arches can cause ankle ligament, 5th toe and forefoot pressure problems. An arch that sags is usually caused by a tight heel cord and a weak tibialis posterior tendon.
  • Clawing of toes usually cause corns on the top of affected toes and pain or corns on the pad under the toes.
  • Ligament laxity, muscle imbalance and poor shoes can cause the large toe to move out of joint and form a bunion.
  • Pain from the back can be felt in different parts of the foot and is called referred pain.
  • People with Diabetes, nerve disorders and poor blood flow to the feet must be on high alert. They must check their feet daily as severe problems can be masked by the mentioned illness, and this makes early detection of problems difficult.

Inside of Ankle

  • Tibialis tendon tear or insufficiency
  • Deltoid ligament tear or laxity
  • Flexor hallucis longus ( FHL) tendon inflammation
  • Talar neck fractures

Arch Problems

  • Flat foot
  • Cavus( high arch) problems
  • Midfoot arthritis
  • Navicular fractures
  • Chopart and Lisfranc fractures
  • Metatarsal bone fractures
  • Avascualar necrosis of midfoot bones

Ankle Problems

  • Back of ankle
  • Achilles’ tendon inflammation or tear
  • Haglunds syndrome
  • Post ankle impingement

Outside of Ankle:

  • Lateral ligament complex tears
  • Fibula fractures
  • Sub-fibula impingement
  • Peroneal tendon synovitis, tear or instability
  • Subtalar arthritis

Forefoot (toe) Problems

  • Metatarsalagia
  • Claw toes
  • Hammer toes
  • Curly toes
  • Bunions ( large toe )
  • Bunionettes ( small toes)
  • Corns between toes (soft corn)
  • Corns under foot
  • Plantar warts
  • Fractures of toes