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The ankle joint is where the shin bone (tibia), calf bone (fibula), and talus bone meet, joining the foot to the lower leg. The ankle contains cartilage, muscles, ligaments, nerves, and blood vessels. There are many different muscles and ligaments in the ankle, which give the ankle its strength, flexibility, and range of motion. The ankle muscles include the tibialis anterior, extensor digitorum longus, extensor hallucis longus, peroneus tertius, gastrocnemius, soleus, tibialis posterior, peroneus longus, peroneus brevis, flexor hallucis longus, flexor digitorum longus, and lateral malleolus.
| Characteristics | Values |
|---|---|
| Number of bones in each foot | 26 |
| Number of joints in each foot | 33 |
| Number of muscles, tendons, and ligaments in each foot | Over 100 |
| Ankle joint | Where the tibia, fibula, and talus bones meet |
| Ankle movement | Plantar flexion, dorsiflexion, inversion, and eversion |
| Muscles that control plantarflexion | Gastrocnemius, Tibialis posterior, Flexor digitorum longus, Flexor hallucis longus, Peroneus brevis, Peroneus longus |
| Muscles that control dorsiflexion | Tibialis anterior, Extensor digitorum longus, Extensor hallucis longus, Peroneus tertius |
| Muscles that control eversion | Peroneus longus, Peroneus brevis, Peroneus tertius |
| Muscles that control inversion | Tibialis posterior, Flexor digitorum longus, Flexor hallucis longus |
| Muscle that extends the big toe | Extensor hallucis longus |
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What You'll Learn
Gastrocnemius and soleus muscles
The ankle is a commonly injured joint due to its frequent use. It contains cartilage, muscles, ligaments, nerves, and blood vessels. The ankle joint is where the tibia (shin bone), fibula (calf bone), and talus bone meet.
The calf muscle, located in the back of the lower leg, consists of two main muscles: the gastrocnemius and the soleus. These muscles come together above the heel and attach to the Achilles tendon. The gastrocnemius is situated just under the skin at the back of the lower leg, with its two heads starting on the inside and outside of the thighbone (femur). It forms the bulk of the calf muscle. The soleus, on the other hand, is wider and flatter and sits slightly deeper than the gastrocnemius.
To stretch the gastrocnemius, one can perform exercises with the back leg's knee extended. In contrast, to target the soleus, the same exercises can be done with the back leg's knee flexed. Caution is advised when using weight-bearing exercises to stretch the plantarflexor muscles, as stress on the arches of the feet should be minimised.
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Tibialis posterior and anterior
The ankle is a joint that connects the shin bone (tibia), calf bone (fibula), and talus bone to the foot. It is part of the skeletal system and contains cartilage, muscles, ligaments, nerves, and blood vessels. The ankle's ligaments form part of the joint capsule, a fluid-filled sac that surrounds and lubricates articulating joints.
The tibialis posterior is a deep posterior leg muscle that helps with plantar flexion and inversion of the foot. It is located deep in the posterior compartment of the lower leg, between the tibia and fibula, and is hidden by the large, superficial muscles of the leg, including the gastrocnemius and soleus. The tibialis posterior is also related to important neurovascular structures, such as the posterior tibial artery and its branches, which provide blood supply to the muscle.
The tibialis anterior is found in the anterior compartment of the leg and is the primary muscle that facilitates dorsiflexion of the ankle joint. It is one of the muscles that can be inhibited and underactive, leading to abnormalities in the anticipatory postural adjustment (APA) phase during gait initiation. The tibialis anterior overlaps the anterior tibial vessels and the deep peroneal nerve in the upper part of the leg.
Both the tibialis posterior and anterior play important roles in ankle movement and stability. The tibialis posterior helps with plantar flexion, which is the bending of the ankle downward, and inversion of the foot. It is also a key stabilising muscle that supports the medial arch of the foot. The tibialis anterior, on the other hand, facilitates dorsiflexion, which is the movement of the ankle upward, and is the primary dorsiflexor of the ankle.
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Peroneal muscles
The peroneal muscles, also known as the fibular muscles, are a group of muscles in the lower leg. They are composed of three muscles: the fibularis longus, fibularis brevis, and fibularis tertius. The first two are located in the lateral compartment of the leg and are supplied by the fibular artery and the superficial fibular nerve. The fibularis tertius is located in the anterior compartment of the leg and is supplied by the anterior tibial artery and the deep fibular nerve.
The fibularis longus and fibularis brevis muscles make up the lateral compartment of the lower leg. The fibularis longus is the largest of the fibularis muscles and lies superficial to the fibularis brevis. It extends down the lateral compartment of the lower limb, tapering into a long tendon that descends into the foot. This muscle provides support to the arches of the foot and helps with eversion and plantar flexion of the foot.
The fibularis brevis originates from the distal two-thirds of the lateral surface of the fibula and the adjacent intermuscular septum. It is located deep and anterior to the fibularis longus muscle. The fibularis brevis also functions in the eversion of the foot.
The fibularis tertius, located in the anterior compartment of the leg, pulls the foot upward toward the body (dorsiflexion). All three muscles work together to move the sole of the foot outward, away from the midline of the body (eversion). The longus and brevis muscles extend the foot downward away from the body (plantar flexion).
The peroneal muscles are susceptible to various pathologies, including contracture/shortening, tears, and fractures. A physical exam can assess the range of motion and motor strength of the ankle to detect any issues with the peroneal muscles.
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Flexor hallucis longus
The flexor hallucis longus (FHL) is a powerful muscle located on the posterior aspect of the fibula below the deep fascia of the calf. It is part of a group of muscles called the deep flexors of the calf, which also include the popliteus, flexor digitorum longus, and tibialis posterior muscles. The FHL is a unipennate muscle, meaning its muscle fibres attach obliquely to its tendon on one side.
The FHL is involved in plantar flexion, or the movement of the foot down and away from the body. It also functions to flex the great toe and helps supinate the ankle. The FHL tendon passes downwards, deep to the flexor retinaculum, crossing the posterior ankle joint, and wraps around the lower end of the tibia, the back of the talus, and the inferior surface of the sustentaculum tali on the calcaneus. As the tendon enters the sole of the foot, it lies superficial to the spring ligament and passes forward deep to the tendon of the flexor digitorum longus. It then enters the fibrous sheath of the great toe, passing between the two sesamoid bones to insert at the base of the distal phalanx of the great toe.
The FHL is susceptible to various injuries and conditions due to its function and location. Common issues associated with the FHL tendon include tenosynovitis, tendinopathies, and muscle strains. "Dancer's tendinitis" is a common condition that occurs in ballet dancers, gymnasts, and runners due to excessive use of toe flexion, resulting in inflammation and irritation at the sustentaculum tali. Hallux saltans is another condition that can develop from overusing the FHL muscle, leading to a nodule formation along the tendon and potential stiffness in the big toe.
Rehabilitation exercises for the FHL can include walking or running on different surfaces, such as grass or sand, to challenge the muscle's function. Stretches can also be performed by pulling the great toe into an extended position while dorsiflexing the ankle. In cases where conservative management does not provide significant improvement, individuals may require arthroscopic surgery to address FHL-related issues.
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Extensor digitorum longus
The extensor digitorum longus (EDL) is a pennate muscle located at the lateral part of the front of the leg. It is one of four muscles in the anterior compartment of the lower leg, alongside the tibialis anterior, extensor hallucis longus, and peroneus (fibularis) tertius. The EDL is the most lateral muscle in the anterior compartment.
The EDL originates from the inferior part of the lateral tibial condyle, the proximal half of the medial surface of the fibula, and the anterior surface of the interosseus membrane (its most superior part). The muscle fibres attach to one side of the tendon, classifying it as an unipennate muscle. The tendon passes under the superior and inferior extensor retinaculum of the foot, dividing into four slips that run forward on the dorsum of the foot and insert into the second and third phalanges of the four lesser toes.
The EDL is involved in dorsiflexion, eversion, and extension of the foot and toes. Dorsiflexion is the movement of the foot upward towards the body, while plantarflexion is the movement of the foot downward and away from the body. The EDL is innervated by the deep fibular nerve (L5, S1), a branch of the common fibular nerve. The leg portion of the muscle is supplied by the anterior tibial artery and the fibular artery.
The EDL tends to become overactive and tight when the tibialis anterior is inhibited. Stretching and myofascial release of the EDL, along with activation of the tibialis anterior, can help regain muscle balance and improve functional ankle dorsiflexion.
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Frequently asked questions
The muscles involved in ankle extension (plantar flexion) include the gastrocnemius, soleus, tibialis posterior, flexor digitorum longus, flexor hallucis longus, peroneus longus, and peroneus brevis.
The gastrocnemius is the primary muscle involved in ankle extension.
The gastrocnemius is one of the calf muscles. It enables the ankle to bend downward and upward by tightening and relaxing.
Yes, the tibialis posterior, flexor digitorum longus, flexor hallucis longus, peroneus longus, and peroneus brevis also contribute to ankle extension.
