Anatomi Kinesiologi Pergelangan Kaki Dan Kaki

Ankle and Foot Part 2
Ligaments of the Ankle and Foot

• The ligaments of the
ankle mortise are the
Interrosseous ligament
and membrane and the
anterior and posterior
tibiofibular ligaments
• Attaches to the inner

aspect of tibia, proceeds
laterally and downward
to the inner aspect of the
fibula
• Reinforced by the
posterior and anterior
tibiofibular ligaments
• Ankle dorsiflexion:
▫ Fibula rises slightly  the
Interrosseous fibers
becomes more horizontal
 ankle mortise
widening  wedging of
the wider portion of talus
possible
• Plantar flexion:
▫ Presents the narrower
portion of the talus  the
fibula rides down 
Interrosseous ligament
returns to its oblique
course Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.
Clinical Significance
• All three ligaments may be torn in severe sprain
or fractures
Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

• The ankle joint receive its
strongest support from the
collateral ligaments:
1. Anterior talofibular
ligament (from the neck
of the talus, to the tip of
the fibula)
2. Calcaneofibular
ligament (form the
Calcaneus, to the tip of
fibula)
3. Posterior talofibular
ligament (from the
body of talus, to the tip
of fibula)
Clinical significance
• The anterior talofibular
and the calcaneofibular
most frequently injured
when ankle is sprained
• Usually inversion injury

during plantar flexion

• The medial aspect of the
ankle is more more
strongly supported by the
deltoid ligaments which
connects the medial
malleolus to the navicular,
the sustentaculum tali and
the posterior aspect of the
talus
• Consist of 4 bands:
1.Tibionavicular
2.Talotibial anterior
3.Calcaneotibial
4.Talotibial posterior

• The deltoid ligaments is so
strong that severe eversion
sprain of the ankle is
followed by the avulsion of
the medial malleolus
rather than tear of the
ligaments

• The rest of the ligaments of the foot can be
subdivided into:
▫ The dorsal ligaments
▫ The plantar ligaments, and
▫ The interosseous ligaments
• In general the dorsal ligaments are thin, while
the plantar ligaments are thick

• Calcaneonavicular
ligament
▫ Passes from the
sustaculum tali of the
calcaneus to the lower
surface of navicular
▫ Forms a string
supporting the head of
talus
▫ Restricts downward
motion of the talus and
help support the
highest part of the arch
▫ Also known as the
Spring Ligament

• Long plantar
ligament
▫ Between the
calcaneous and
cuboid and the three
lateral metatarsal
▫ Acts as the main
support of the lateral
arch

• Ligamen interosseous
▫ Talocalcaneal ligaments
 Run through the entire

length of the tarsal
canal and forms a
discreet fibrous bands
 Connects the 2
tubercles called the
ligamentum cervicis

Extrinsic Muscles of the Ankle and Foot
• Posterior group • Lateral group
▫ M. gastrocnemius ▫ M. peroneus longus
▫ M. soleus ▫ M. peroneus brevis
• Anterior group • Medial group
▫ M. tibialis anterior ▫ M. tibialis posterior
▫ M. extensor digitorum ▫ M.flexor digitorum
longus longus
▫ M. extensor hallucis ▫ M. flexor hallucis
longus longus
▫ M. peroneus tertius
• Posterior group
▫ M. gastrocnemius
▫ M. soleus
• Also known as the triceps surae (2 heads of the
gastrocnemius and 1 head of the soleus) or the
gastrosoleus muscles
• Produces supination of the foot when fore foot is fixed to
the floor, due to the obliquity of the subtalar joint
• Responsible for the most of the total pull to lift heel of the
ground
Muscles of the Ankle and Foot
Posterior group
• Becomes flat tendon called

the Tendon of Achilles
halfway down the calf

Cantarella, V. Bones and Muscles
Posterior group
• Found under the gastrocnemius

• No origin above the knee joint
• Plantar flexion while the knee
bent is produced by the soleus
muscle alone
• Medial group
▫ M. tibialis posterior
▫ M.flexor digitorum
longus
▫ M. flexor hallucis
longus
• Only contributes 5 % of
the total pull to lift heel of
the ground
• Produce stability in the

ankle joint by coordinating
with the lateral muscle
group
Medial group

Medial group
• Flex the toes in a gripping manner

Medial group
• Tend to press the distal phalanx to

the floor since only passes through
two joints

• Lateral group
▫ M. peroneus longus
▫ M. peroneus brevis
• Produce stability in the

ankle joint by coordinating
with the medial group
using feedback from the
plantar nerve
• Acts most effectively as

evertors when the foot is
plantar flexed
Lateral group
• Anterior group
▫ M. tibialis anterior
▫ M. extensor digitorum
longus
▫ M. extensor hallucis
longus
▫ M. peroneus tertius

Anterior group

Anterior group
Anterior group

The intrinsic muscle of the foot
• Cannot be tested individually with clinical
importance
• Major function: cupping of the sole of the foot
• Innervation: medial and lateral plantar nerve

The nerve supply
• Sensory innervation • Motoric innervation
▫ Peroneal nerve ▫ Tibial nerve
 Deep ▫ Peroneal nerve
 Superficial Deep
▫ Posterior tibial nerve Superficial
▫ Sural nerve

▫ Peroneal nerve
 Most of the upper
surface of the
foot (superficial
branch)
 Small triangular
area between the
first and the
second toe (deep
branch)
▫ Posterior tibial
nerve
 Plantar aspect of
the foot
 Medial plantar
nerve innervates
medial 3 and a half
toes
 The lateral
supplies the lateral
1 and a half toes
• Tarsal tunnel (area behind the medial malleolus,
comprise of the posterior tibial nerve, posterior tibial
tendon, artery and tendon of the flexor digitorum longus,
bound by flexor retinaculum of the foot)

Common sites of amputation
• Metatarsophalangeal (disarticulation)
• Transmetatarsal
• Lisfranc
• Chopart
• Syme (tibial and fibular malleoli amputation)

Except for Syme’s and metatarsophalangeal disarticulation, other common
sites of amputation have been abandoned due to poor prosthetic fitting and
recurrent stump breakdown
Deformities of the foot
Deformities can be classified into 4 positions
Equinus • Heel is elevated, and the foot is plantar flexed
Calcaneus • Foot is dorsiflexed, heel is depressed
Varus • Foot is inverted and adducted
Valgus • Foot is everted and abducted
Combination of the above is possible

Deformities of the foot
• Flatfoot / Calcaneovalgus
• Pigeon-toed (excessive
internal tibial torsion)
• Clubfoot / Talipes
equinovalgus
• Metatarsus varus (
combination of
flatfootedness with internal
tibbial torsion with the
forefoot abducted
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Ankle and Foot Part 2

Ligaments of the Ankle and Foot

• Attaches to the inner

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

• Usually inversion injury

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

 Run through the entire

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

• Becomes flat tendon called

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

• Found under the gastrocnemius

• Produce stability in the

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

• Flex the toes in a gripping manner

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

• Tend to press the distal phalanx to

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

• Produce stability in the

• Acts most effectively as

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

Sumber : Reyes, TM., Reyes, OBL. Kinesiology. Vol. 4. UST : Philipines.1978.

Equinus • Heel is elevated, and the foot is plantar flexed

Calcaneus • Foot is dorsiflexed, heel is depressed

Varus • Foot is inverted and adducted

Valgus • Foot is everted and abducted

Combination of the above is possible

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