Ankle joint

Synonyms in a broader sense

Medical: Articulatio talocruralis

  • OSG
  • Outer ankle
  • Inner ankle
  • Outer belts
  • Interior hinges
  • Hock leg (talus)
  • Shinbone (Tibia)
  • Calf bone (fibula)
  • Delta tape
  • USG

Anatomy

The upper ankle joint, often referred to as the ankle joint (OSG), is formed by three bones. The outer ankle (fibula) forms the outer ankle fork; the shin bone (tibia) forms the inner ankle fork. The talus is the transmission of force to the foot and forms the joint opponent.

The ankle fork (malleolus fork) consisting of the tibia and fibula surrounds the ankle bone in a U-shape. The calf and tibia are connected by a very strong ligament connection (syndesmosis). The upper ankle joint is stabilized by a tight capsule-ligament apparatus. There are three important stabilizing ligaments on the outer ankle: On the inner ankle, the most important stabilizing ligament is the Ligamentum deltoideum.

  • The Ligamentum fibulotalare anterius
  • The Ligamentum fibulocalcaneare
  • The Ligamentum fibulotalare posterius

Tapes

The ankle joint receives its stability from various ligaments. However, these ligaments also represent the weak point of the joint, as they can quickly overstretch or even tear. A distinction is made between an outer and an inner ligament complex.

The outer ligament complex is made up of three ligaments that extend from different tarsal bones to the outside of the fibula. The name of the ligaments is based on the names of the tarsal bones and the lower leg that connect them. The inner ligament complex consists of a flat, fan-shaped ligament complex called Ligamentum deltoidium or deltoid ligament.

The deltoid ligament is in turn composed of individual ligament sections or “ligaments”, namely the tibio-scaphoid part (pars tibionavicularis), the anterior and posterior tibio-arpal part (pars tibiotalaris anterior and posterior), and the tibio-hepatic part (pars tibiocalcanea). The outer ligament complex in turn consists of three ligaments, two of which connect the anterior and posterior ankle and fibula (Ligamenti talofibulare anterius and posterius), and one ligament connecting the heel bone and fibula (Ligamentum calcaneofibulare). The fibula and shinbone, which together form the ankle joint fork, are also reinforced on the front and back by a ligament each, which is called the anterior and posterior tibiofibular fibula ligament (Ligamenti tibiofibulare anterius and posterius).

As already mentioned, the ligaments secure the ankle joint, but can be injured quite quickly. The classic accident/injury mechanism here is twisting the ankle. The outer ligament complex is particularly frequently affected by injuries, for example when the ankle is bent over with shoes that have high heels.

The bony stability of the foot is less in this position, and the ligaments are also taut and therefore tend to be overstretched, pulled or, in the worst case, torn. Furthermore, the ankle ligaments are mainly injured during sports and, at 20%, represent a large proportion of sports injuries.

  • Ligamentum fibulotalare posterius
  • Ligamentum fibulocalcaneare
  • Ligamentum fibulotalare anterius
  • Fibula (fibula)
  • Shinbone (Tibia)
  • Hock leg (talus)
  • Scaphoid (Os naviculare)
  • Sphenoid bone (Os cuniforme)
  • Metatarsal bone (Os metatarsale)
  • Cuboid bone (Os cuboideum)

The upper ankle joint (OSG) absorbs the force from the tibia and transmits it to the lower ankle joint (USG).

From there, the force is distributed to the ground, or forefoot and hindfoot. The upper ankle joint (OSG) is a hinged joint with minimal rotation. A healthy ankle joint can be extended by approx.

20-25° (extension = toes towards the tip of the nose) and flexed by approx. 30 – 40° (flexion = toes towards the floor). The outer edge of the foot can be raised approx.

10° (eversion); the inner edge of the foot can be raised approx. 20° (supination). This mobility is made possible by the lower ankle joint.

With its mobility, the ankle joint enables a fluid gait pattern.

  • Fibula (fibula)
  • Shinbone (Tibia)
  • Hock leg (talus)
  • Syndesmosis (not visible)

The ankle tape initially consists of two parts, namely a basic tape, which in turn consists of a U-bridle and an eighth bridle, as well as so-called cross-pulls.The basic tape is used as a preventive measure to stabilize the ankle joint in sports that put strain on it, such as long runs. The transverse pulls are particularly important for an already unstable ligament apparatus, as they can give it the desired stability under load.

In the following example, we assume that the inner ankle has a problem. If the problem is on your outer ankle, you can “mirror” the instructions on this ankle, i.e. everything that was started/finished here on the inner ankle, started/finished on the outer ankle. It is advisable to read through the instructions completely before starting.

The first step is to attach the U reins. However, first the correct length of the tape must be determined. To do this, hold your foot as if you were standing upright on the floor with the tips of your feet pointing forward.

Now apply the tape 3-4 cross fingers above your inner ankle without sticking it on, pull it vertically along under your heel and end 3-4 cross fingers above the outer ankle. Once you have cut the tape, put your foot in the position it was in when you cut it. Now place the tape over your inner ankle and stick it under tension over the painful or unstable area towards the sole of your foot.

As soon as you reach the sole of the foot, loosen the tension from the tape and apply it without pulling under the heel on the other side to the outer ankle. Make sure that all tapes are applied without wrinkles. The second step is to attach the figure-of-eight reins.

Cut the reins 3-4 cross fingers longer at each end than the U-bridle. Bring your foot into the already described, so-called “neutral position”. The tape is now placed in the middle of the back end of the sole of your foot and should almost completely cover the already attached U-bridle at this point.

Now the tape is crossed over the instep, i.e. the inner part of the tape is stuck towards the outside, the outer part towards the inside. Again, make sure that the tape is applied to the sick side of the foot with a light pull. In our example, this means that the tape is attached from the inside to the outside.

The third and last step is to apply the cross-pulls. Cut these to about one hand length. Again, make sure that your foot is in the neutral position before applying the tape.

The cross-pull is applied at the level of the unstable and/or painful area on the back of the lower leg and is applied with full pull over the unstable/painful area in the direction of the little toe. If there is a problem with the outer ankle, they are stuck under full pull in the direction of the big toe. Since, depending on the extent of the problem, a varying number of cross-pulls are required, which in the case of the latter are glued together in a fan shape, it is recommended that the ankle joint be briefly loaded after each cross-pull is applied in order to test whether the desired stability has already been achieved.

The ankle joint achieves its stability and cohesion through strong ligaments. Unfortunately, these ligaments also represent the joint’s major weak point, as they can often be pulled or overstretched, especially in connection with sports and/or unfavorable twisting, and in the worst case they can tear. Above all, overstraining, such as strains and overstretching, can be prevented by strengthening the muscles from which the corresponding tendons originate.

Five exercises are now presented, which should ideally be performed barefoot and with dry feet. It is recommended that you read the entire description before doing each exercise. First exerciseTo warm up, stand up straight on both legs.

The legs should be at hip height. Stand with both feet on the heel and roll your feet forward until you stand on your toes. From here, roll the foot backwards again until you are back in the heel position.

Repeat this about 20 times. Second ExerciseFind a free-standing wall and stand in front of it at a distance of 30 cm so that your back is facing the wall. Now lean back slowly until your back touches the wall and you are just standing on your heels.

You are now in the so-called “heel position”. In this position, try to pull your toes towards the tip of your nose as much as you can, as this will result in additional flexion of the ankle joints. Then straighten up again so that the toes of your feet move towards the ground.

Make sure that the toes never touch the floor completely. It helps if you imagine that the floor is fragile.Repeat the exercise described above 15 – 20 times. Before the next exercise is performed, allow yourself a short break.

Third ExercisePosition yourself in the heel position as in Exercise 1. It is advisable to lean your back against the wall as this will help you achieve a secure stand. Again, pull the toes towards the tip of the nose as much as possible and then lower the foot towards the floor.

Now you must make sure that you stop 2-3 cm before the floor. Then, starting from this position, pull your toes back as far as possible towards the tip of your nose. Lifting and lowering should follow each other quickly and, if possible, there should be no long pauses between the repetitions.

Perform the procedures Lift toes – Lower foot as in the first exercise 15-20 times. The already presented exercises are for beginners and are well suited for beginners. For the following exercises, the ankle joints should already be somewhat strengthened.

This is achieved by consistently doing the first and second exercise for two to three weeks. Fourth ExerciseStand on your heels and try to walk on them in about 15 to 20 meters. Fifth ExerciseFor this exercise take the starting position of the second exercise.

Before you start, lift one leg so that your weight is only on one leg. With the leg on the floor you now carry out the procedures described in exercise 2. Repeat this 15 to 20 times.