Foot & Ankle Anatomy
The foot and ankle in the human body work together to provide balance, stability, movement, and propulsion.
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Achilles Tendon Rupture
Achilles tendon is a strong fibrous cord present behind the ankle that connects the calf muscles to the heel bone. It is used when you walk, run and jump. The Achilles tendon ruptures most often in athletes participating in sports that involve running, pivoting and jumping. Recreational sports that may cause Achilles rupture include tennis, football, basketball and gymnastics.
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A sprain is the stretching or tearing of ligaments, which connect adjacent bones and provide stability to a joint. An ankle sprain is a common injury that occurs when you suddenly fall or twist the joint or when you land your foot in an awkward position after a jump.
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Common Toe Deformities
Anatomically the foot is divided into the forefoot, mid foot and hind foot. The Forefoot has 4 small toes called phalanges and 1 large toe called the hallux or big toe. Phalanges have 3 bones and 3 joints, while the big toe has 2 bones and 2 joints.
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Plantar fasciitis refers to inflammation of the plantar fascia, a thick band of tissue that lies at the bottom of the foot. It runs from the heel bone to the toe and forms the arch of your foot. Plantar fasciitis is one of the most common causes of heel pain. It is most often seen in middle-aged men and women, but may also occur in those who are constantly on their feet such as soldiers.
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A bunion, also known as hallux valgus, is bony prominence at the base of the big toe, which often results in pain, redness and rubbing against footwear. The 1st metatarsal bone abnormally angles outward towards the other foot from its midfoot joint. A bunion can change the shape of your foot, make it difficult for you to find shoes that fit correctly and worsen the symptoms if left untreated.
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Arthroscopy is a minimally invasive surgical procedure during which the internal structure of a joint is examined for diagnosis and treatment. Ankle Arthroscopy includes the diagnosis and treatment of ankle conditions. In an arthroscopic examination, a small incision is made in the patient’s skin through which a pencil-sized instrument with a small lens and lighting system (arthroscope) is passed.
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Ankle Joint Replacement
The ankle joint connects the leg with the foot and provides free movement to the foot. It is formed by connecting the bones of the lower leg, tibia and fibula, with the talus, or ankle bone.
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Fungal infections are common in nails, and occur most often in toe nails. Termed as onychomycosis, nail fungus affects the keratin, the hard material that makes up the nail and can include the entire nail or a portion of the nail, along with the nail root, plate or bed. It gradually leads to thickening, distortion and discoloration of the nails.
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Nails are made of hard keratin tissue that helps protect the underlying tissue of your fingers and toes. They can reveal a lot about your overall health. Healthy nails are uniform in color and consistency, and smooth, without grooves or pits. Changes in color and growth rate can indicate various diseases. Nails are prone to problems such as infections and even warts and tumors, so developing good habits can help keep them healthy.
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Nail Bed Injuries
The nail is composed of a nail plate, nail matrix and nail bed. The nail bed is the soft tissue that lies below the nail and is essential for the growth of the nail. Nail bed injuries such as crush and avulsion injuries are commonly associated with injuries to the hands or fingertips.
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Osteochondral Injuries of the Ankle
The ankle joint is an articulation of the end of the tibia and fibula (shin bones) with the talus (heel bone). Osteochondral injuries, also called osteochondritis dissecans, are injuries to the talus bone, characterized by damage to the bone as well as the cartilage covering it. Sometimes the lower end of the tibia or shin bone may also be affected.
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The heel is made up of the calcaneus bone and supported by a network of muscles, tendons, ligaments and soft tissues, which together support the weight of the body and stress during movement. Heel pain is a common symptom of excessive strain placed on these structures.
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Stress Fracture of the Foot
A stress fracture is a small crack in the bone which occurs from overuse injury. It commonly develops in the weight-bearing bones of the lower leg and foot. When the muscles of the foot are overworked or stressed, they are unable to absorb the stress and transfer it onto the bone, which cracks under the pressure.
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Foot infections may occur after trauma to the foot or loss of tissue because of contamination from foreign material and/or bacteria or fungus. Infections can occur in healthy individuals as well as in those whose health is compromised. Common foot infections include
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Feet support your body weight, help maintain proper posture and help in movement. As the feet bear the entire weight of the body and are involved in most activities, they are more prone to problems such as calluses, corns, cracks, infections and traumatic injuries. To maintain good health of your feet, you should always wear comfortable, good quality and proper fitting footwear. Specially-designed shoe inserts, called orthotics, help in alignment and stabilization of the feet and can also reduce foot pain.
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Shin splints or medial tibial stress syndrome (MTSS) is pain around the tibia or shin bone due to inflammation of the tendons, muscles and bone tissue. It occurs as a result of vigorous physical activity such as with exercise or sports.
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Chronic Wound Care
An injury or small wound over the skin will normally heal within a week or two. However, sometimes due to an underlying medical condition, a small wound on the leg may take months to heal and may even worsen. Wounds that take more than six weeks to heal are considered chronic leg wounds or ulcers.
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Congenital Limb Deformities
Limb deformities can be congenital (present at birth) or develop at a later stage as a result of fracture, infection, arthritis or tumor. Congenital deformities of the lower limbs are developmental disorders that cause alterations in the shape and appearance of the legs. Several factors including genetics influence the fetal growth in the womb, and exposure to teratogenic drugs and chemicals can increase the risk of congenital deformities.
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Diabetic Foot and Chronic Wounds
Diabetes is a chronic condition that is characterized by high blood glucose (sugar) levels. Diabetic patients are at a high risk for developing chronic wounds, especially in the feet. If left untreated, these wounds can cause serious problems that can lead to infections and eventually gangrene, which may require amputation.
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The calcaneus or heel bone is a large bone found at the rear of the foot. A fracture is a break in a bone from trauma or various disease conditions. The types of fracture to the calcaneus depend on the severity and include stable fractures, displaced fractures, open fractures, closed fractures and comminuted fractures.
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Lisfranc (Midfoot) Fracture
The lisfranc joint or tarsometatarsal joint refers to the region in the middle of the foot. It is a junction between the tarsal bones (seven bones in the foot arch) and metatarsal bones (five long bones in the foot). Lisfranc fractures can occur due to a fall from a height or traumatic motor accidents.
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The talus is a small bone at the ankle joint that connects the heel bone and the shin bones, enabling the up and down movement of the foot. Fractures in the talus bone may occur due to a fall from great heights, motor vehicle accidents or sports injuries. Symptoms include severe ankle pain, inability to walk, swelling and tenderness.
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Toe and Forefoot Fractures
The forefoot is the front of the foot that includes the toes. Fractures occurring in this part of the foot are painful, but very often not disabling. There are 2 types of fractures namely, traumatic fracture and stress fracture.
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Clubfoot and Congenital Deformities
Congenital deformities of the lower limbs are developmental disorders that are present at birth, causing alterations in the shape and appearance of the legs. Several factors such as genetics, teratogenic drugs and chemicals can cause congenital deformities.
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An ingrown toenail is a common and painful condition of the toe. It occurs when the sides or corner of the nail grow inwards and penetrates into the skin of the toe. Pain is often accompanied by swelling and redness. The big toe is affected most often.
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Foot reconstruction is a surgery performed to correct the structures of the foot and restore the natural functionality of the foot that has been lost due to injury or illness.
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Custom Foot Orthotic Fitting
Custom foot orthotics are specially designed corrective devices to restore the natural position of the feet. Orthotics acts as an interface between the feet, the shoe and the ground. The purpose of the device is to support the bones and joints of the feet to maintain optimal neutral position and to eliminate or compensate any misalignments or structural problems of the feet.
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Treatment of Foot & Ankle Sports Injuries
Injuries during sports are common. They can result from accidents, inadequate training, improper use of protective devices, or insufficient stretching or warm-up exercises. Injuries to the foot and ankle are common while playing sports such as football, hockey, skating and in weekend athletes. Common sports injuries include sprains and strains, ankle fractures, and Achilles tendinitis.
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Athlete’s foot is a fungal infection on the skin of the foot. It is characterized by itchy, red, scaly rashes between the toes. It is contagious and spreads through contact to the sides of the foot, to the other foot, to your hands and other people when they are in moist areas such as swimming pools and bathrooms, from sharing shoes of an infected person or having contact with pets carrying the fungi.
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An ankle fracture is a common injury that involves a break in one or more bones that make up the ankle joint. Sometimes ligaments may also be damaged. Ankle fractures are most often caused by motor vehicle accidents, rolling or twisting of the ankle, tripping or falling or during sports activities.
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Ankle instability is a chronic condition characterized by the recurrent slipping of the outer side of the ankle. It usually results from repeated ankle sprains, and is generally noticed during movement, but can also occur during standing as well.
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Arthritis of the Foot and Ankle
Arthritis is inflammation resulting from the degeneration of cartilage surrounding joints of bones causing pain, swelling and stiffness, and restricted movement. Arthritis of the foot and ankle joint can occur due to fracture, dislocation, wear and tear associated with aging, or autoimmune disease.
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A bunion is a bony protuberance that appears on the external surface of especially the big toe, making the toe angle toward the adjacent toe. It is an extra bone and a fluid-filled sac that grows at the base of the big toe.
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Congenital Vertical Talus
The talus bone makes up the ankle joint, and navicular bone is a small bone found in front of it. Congenital vertical talus is a foot deformity in which the talus and navicular bones of the child’s feet are abnormally positioned.
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Forefoot pain, also referred to as metatarsalgia, is pain at the ball of the foot (around the ends of the metatarsal bones). You may experience pain of varied intensity and discomfort, from numbness or tingling sensation in your toes to a sharp, aching or burning pain in the ball of your foot.
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Intoeing, also called “pigeon-toed”, is an abnormal condition characterized by the inward facing of the toe or feet instead of its straight alignment. You may observe this condition at an early age when your child starts walking.
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Morton’s neuroma is a painful condition caused by the thickening of a nerve usually between the third and fourth toes (interdigital nerve).This thickening results from any form of compression and irritation of the nerve, which can eventually lead to permanent nerve damage.
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The foot is composed of different structures including bones, ligaments, tendons and muscles. Foot pain occurs from distress induced by certain factors on the various components of the foot.
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The arch of the foot usually develops between the age of 3 and 5 years. Flatfoot, also known as fallen arches or pesplanus, is a deformity in which the arch that runs along the sole of the foot is not formed (in children) or collapses to the ground (in adults due to various foot problems). Flatfoot can be rigid or flexible. Flexible flatfoot usually resolves without any treatment unless pain is involved, while rigid flatfoot usually requires intervention.
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Biomechanics is the study of the movement of parts of our body. Biomechanical analysis or examination is an important tool that helps determine the cause of injuries and ways to prevent them. It plays an important role in sports medicine, where physiotherapists analyze various sports to determine safe and effective techniques.
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Sesamoiditis is an inflammation of the sesamoid bone and the associated tendons. It is commonly seen in ballet dancers, sprinters and basketball players. It is an overuse injury caused by an increased pressure over the sesamoid bones resulting in a chronic inflammation.
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Click on the topics below to find out more from the orthopedic connection website of American Academy of Orthopedic Surgeons.
- Achilles tendon
- Adult (Acquired) Flatfoot
- Athletic Shoes
- Rotura de tobillo (Broken Ankle)
- Broken Ankle
- Diabetic foot
- Flexible flatfoot in children
- Hammer toe
- Orthotic Devices
- Paediatric Thigh Bone Fracture
- Plantar fasciitis
- Posterior Tibial Tendon Dysfunction
- Rheumatoid Arthritis of the Foot and Ankle
- Sprained Ankle
- Stiff Big Toe (Hallux rigidus)
- Heel Pain
- Fracture of the Talus
- Toe and Forefoot Fractures
- Ingrown Toenail
- Fractures of the Heel
- Stress Fractures of the Foot and Ankle
- Ankle Fractures
- Arthritis of the Foot and Ankle
- Foot Pain