LEG, FOOT, ANKLE





The leg includes the tibia and fibula. The tibia articulates proximally with the femur and distally with the calcaneous. The fibula articulates on the lateral proximal and distal tibia.







The foot is a complex mechanical structure composed of 33 joints, 26 bones, and many muscles, tendons, and ligaments that all work together to bear weight, allow for locomotion, and transmit force.


The anatomy of the foot is divisible into the hindfoot, midfoot, and forefoot. The joints of the foot have two essential roles, including weight-bearing and propulsion during walking, running, and jumping.

The foot requires a high degree of flexibility and stability to be able to perform these functions. The vast number of joints in the foot is what provides this flexibility, while stability results through the articulation of the joints and the ability of the foot to act both as a rigid lever and a flexible lever during the normal gait cycle.





The architecture of the foot is dependent upon the articulation of the tarsals, the non-axial motion between them, and the fascia, tendons, and ligaments that play crucial supportive roles. The functions of the arches can be classified in various ways.





1. Weight bearing and distribution

The arches effectively distribute the body's weight across the foot, preventing excessive pressure on specific areas. The medial longitudinal arch, in particular, plays a significant role in absorbing and distributing the impact of each step.

2. Shock absorption

The arches act as natural springs, absorbing the impact of each step and protecting the bones, joints, and soft tissues from excessive stress. The elastic properties of the arches and associated structures like the plantar fascia, help in spreading ground contact forces, reducing the risk of musculoskeletal wear and damage.


3. Propulsion during locomotion

The arches, especially the medial longitudinal arch, act as a springboard, providing propulsive force for activities like walking, running, and jumping. During the stance phase of the gait cycle, the foot pronates, causing the medial longitudinal arch to flatten and store mechanical energy. During the swing phase, the foot supinates, causing the arch to elevate and become a rigid lever for propulsion.


4. Adaptability to uneven surfaces

The arches allow the foot to adapt to various surfaces, maintaining balance and stability on uneven terrain. The dynamic nature of the arches enables them to adjust to changes in terrain and movement, ensuring contact with the ground and providing stability.


5. Protection of structures

The concavity created by the arches provides protection for the nerves and blood vessels located on the sole of the foot.


In essence, the arches “work” synergistically to provide a strong and flexible foundation for the entire body, enabling efficient movement and absorbing the stresses of daily activities.


Disruptions to these arches, such as flat feet or high arches, can lead to pain, gait abnormalities, and other musculoskeletal up the kinetic chain.







Medial Longitudinal Arch


This is the most prominent arch, running along the inner side of the foot. It's formed by the calcaneus, talus, navicular, cuneiforms, and the first three metatarsals, and is supported by the plantar fascia and muscles. This arch acts as a spring, absorbing impact and distributing weight.


Lateral Longitudinal Arch


Located on the lateral aspect of the foot, this arch is less pronounced. It's made up of the calcaneus, cuboid, and the fourth and fifth metatarsals. It contributes to weight distribution and balance. Parts of this of the lateral arch may contact the supporting surface with weight bearing.

Transverse Arch


This arch runs across the midfoot, formed by the cuboid and cuneiform bones, as well as the bases of the metatarsals. It provides structural integrity and helps with weight transfer.









The Ankle Joint/COMPLEX





The ankle joint, also known as the talocrural joint, is a hinge joint formed by the tibia, fibula, and talus bones. It allows for dorsiflexion and plantarflexion. The ankle joint complex also includes the subtalar joint (between the talus and calcaneus), which allows for inversion and eversion.