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104 m a s s a g e & b o d y w o r k s e p t e m b e r / o c t o b e r 2 0 1 4 The Ankles and Feet By Mary Ann Foster The ankles and feet provide a foundation for musculoskeletal health throughout the body. When they ache, the whole body suffers. When they are healthy, functional, and moving according to design, we feel energized and springy. Each part of the foot supports a corresponding kinetic chain. For example, lifting the heel in gait initiates a sequence of concentric muscular contractions along the extensor chain of the lower limb (Image 1). The primary functions of the ankles and feet are weight bearing and locomotion, which demand a sturdy and aligned, yet flexible and mobile, structure. Each foot is made sturdy by more than 100 ligaments that bind its 27 bones together into a stable base of support. Each foot is made mobile by the 25 joints in it and the 24 muscles acting on it. To simplify a study of movement in this small but complex body part, we'll look at the general organization of joints and movement in the three functional sections of the feet (Image 2): • The rearfoot contains the talus and calcaneus. • The midfoot contains the navicular and cuboid bones, and three cuneiforms. • The forefoot contains the five metatarsals and the 14 phalanges. Each section has different types of joints. The rearfoot and forefoot have hinge and ellipsoid joints suited for mobility and lateral motion. In contrast, the midfoot has many gliding joints built for support and spring in the arches. JOINTS OF THE REARFOOT The ankle and foot form a multisegmented articular chain with eight links you can see and feel when you point your toes (Image 2). The most mobile joints are on the ends of the chain, in the ankle and toes. The ankle, or talocrural joint, is a synovial hinge made up of the tibia, fibula, and talus that connects the rearfoot to the leg. This sturdy articulation includes the malleolus—the bony projections at the lower end of the tibia that grip each side of the talus like a wrench gripping and turning around a bolt. 104 m a s s a g e & b o d y w o r k s e p t e m b e r / o c t o b e r 2 0 1 4 technique THE SCIENCE OF MOVEMENT 2 Three functional sections of the foot. 1 Muscular actions along flexor and extensor chains. Rearfoot Midfoot Forefoot Concentric Eccentric