Maximus Gage
The ankle joint is one of the most valuable structures in the human body due to its intricate articulating surfaces and function in ambulation. Dorsiflexion is an essential movement of the ankle joint, where the mid- and forefoot are raised while the tibia and fibula remain static, causing an upward bend at the ankle joint. The muscles that facilitate dorsiflexion are located in the anterior compartment of the leg and include the tibialis anterior, extensor digitorum longus, extensor hallucis longus, and fibularis tertius. These muscles work together to dorsiflex the ankle and prevent the foot from dragging on the ground during gait.
| Characteristics | Values |
|---|---|
| Muscles involved | Tibialis anterior, extensor digitorum longus, extensor hallucis longus, fibularis tertius, peroneus tertius |
| Joint involved | Ankle joint |
| Range of motion | 10-20 degrees, with some sources stating up to 40 degrees in very flexible individuals |
| Function | Allows the foot and toes to be lifted, preventing them from dragging on the ground during walking |
| Antagonists | Calf muscle (gastrocnemius), soleus |
| Related conditions | ACL tears, plantar fasciitis, drop foot |
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What You'll Learn
Tibialis anterior
The tibialis anterior is a fusiform muscle found in the anterior part of the leg. It is the most superficial and anterior-facing muscle of the dorsiflexors. The muscle is easily palpable on the lateral side of the tibia and is thick and fleshy above, becoming tendinous below. The tibialis anterior is innervated by the deep fibular nerve, and recurrent genicular nerve (L4). It is supplied by branches of the anterior tibial artery and, to a lesser extent, the posterior tibial artery.
The tibialis anterior muscle acts as the main foot dorsiflexor on the talocrural joint, but it also inverses the foot at the subtalar joint. Both actions are important in the gait cycle, helping to stabilise the ankle as the foot hits the ground during the contact phase of walking. It also functions to ''lock' the ankle, as in toe-kicking a ball, when held in an isometric contraction.
The tibialis anterior is the primary dorsiflexor of the ankle, with synergistic action from the extensor hallucis longus, extensor digitorum longus, and peroneous tertius. It is involved in the inversion and adduction of the foot and contributes to maintaining the medial arch of the foot.
Pain along the path of this muscle is often referred to as "shin splints" or medial tibial stress syndrome (MTSS). This is caused by repetitive microtrauma to the tibialis anterior, which can occur due to excessive physical activity, especially in runners and military personnel.
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Extensor digitorum longus
The extensor digitorum longus is a pennate muscle, situated at the lateral part of the front of the leg. It is one of the four muscles in the anterior compartment of the lower leg, alongside the tibialis anterior, extensor hallucis longus, and peroneus (fibularis) tertius. The extensor digitorum longus is the most lateral muscle in the anterior compartment.
The extensor digitorum longus 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 passes under the superior and inferior extensor retinaculum of the foot, along with the fibularis tertius, and divides into four slips that run forward on the dorsum of the foot. These slips are inserted into the second and third phalanges of the four lesser toes.
The anterior tibial artery and vein pass between the extensor digitorum longus and the tibialis anterior. The distal part of the muscle crosses the anterior side of the ankle joint, sitting medially to the tendon of fibularis tertius and laterally to the extensor hallucis longus tendon. The leg portion of the muscle is supplied by the anterior tibial artery and the fibular artery, while the tendons are vascularized by the anterior lateral malleolar, lateral tarsal, metatarsal, plantar, and digital arteries.
The extensor digitorum longus is involved in dorsiflexion of the foot, which is the upward bending of the mid- and forefoot while the tibia and fibula remain static. This movement is essential for gait, as it prevents the foot and toes from dragging on the ground. The extensor digitorum longus also contributes to eversion of the foot and extension of the toes.
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Extensor hallucis longus
The extensor hallucis longus (EHL) is a thin skeletal muscle located in the anterior compartment of the lower leg. It is responsible for extending the big toe at both the metatarsophalangeal and interphalangeal joints. The EHL is situated between the tibialis anterior and the extensor digitorum longus muscles. It originates from the anteromedial aspect of the fibula, with its origin extending to the anterior aspect of the interosseous membrane of the leg, located between the fibula and tibia. From here, the muscle runs inferomedially towards the foot, ending in a tendon.
The main function of the EHL is to extend the big toe, but it also has accessory actions in other joints. It assists in the inversion of the foot and dorsiflexion of the ankle. The EHL is innervated by the deep fibular nerve (root value L5 and S1), and its blood supply mainly comes from the anterior tibial artery and its branches. Weakness of the EHL can cause the toe to fold under the foot when pulling on socks or shoes, leading to tripping. It can also result in a claw toe deformity, where hyperextension of the great toe pulls the plantar plate distally, causing pain and calluses.
To target the EHL and improve its range of motion, an exercise called the "Big Toe Lift" can be performed. This involves raising the big toe while keeping the other toes flat on the floor and avoiding letting the foot roll out or scrunching the little toes. Another exercise is the "Big Toe Extension with Heel Raises", where heel raises are performed while keeping the big toe extended. A towel roll under the toes can assist with mobility. Additionally, the "Short Foot Exercise" helps activate the intrinsic foot muscles, where the base of the big toe is pulled towards the heel to create an arch while keeping the toes flat.
The EHL plays a crucial role in walking and running, and its strength and proper function are important for overall foot health and stability.
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Fibularis tertius
The fibularis tertius, also known as the peroneus tertius, is a muscle in the anterior compartment of the leg. It is involved in ankle dorsiflexion, which is the upward bending of the mid- and forefoot while the tibia and fibula remain static. This movement is particularly important during the gait cycle, as it helps to lift the foot and toes off the ground, preventing them from dragging.
The fibularis tertius arises from the lower third of the front surface of the fibula, the interosseous membrane, and the connective tissue between it and the fibularis brevis. It passes downward and ends in a tendon that inserts into the medial part of the posterior surface of the shaft of the fifth metatarsal bone. This tendon passes through the same canal as the extensor digitorum longus muscle, which may lead to it being mistaken for a fifth tendon of this muscle.
The fibularis tertius is considered a weak dorsiflexor and evertor of the foot due to its small size and poor mechanical leverage. It assists in pulling the foot upward toward the body and tilting the sole of the foot away from the midline of the body at the ankle (eversion). This muscle is supplied by the deep fibular nerve, a branch of the sciatic nerve, and it receives arterial blood from several sources, including the anterior tibial artery and the dorsalis pedis artery.
The fibularis tertius may be absent in humans, with its prevalence varying significantly across different populations. While it is likely to be helpful in bipedal walking, its absence does not seem to cause any movement impairment, as its functions can be performed by other, more powerful muscles. However, it may be involved in ankle injuries and can rupture due to hyperextension.
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Peroneus tertius
The peroneus tertius, also known as the fibularis tertius, is a muscle in the anterior compartment of the leg. It is located on the lower lateral aspect of the leg and is one of the four muscles in the anterior compartment, the others being the tibialis anterior, extensor hallucis longus, and extensor digitorum longus. The peroneus tertius muscle is responsible for dorsiflexion and eversion of the foot.
The peroneus tertius muscle arises from the lower third of the front surface of the fibula, the lower part of the interosseous membrane, and the septum or connective tissue between it and the fibularis brevis. The septum is sometimes referred to as the intermuscular septum of Otto. The muscle extends from the distal end of the fibula to the base of the fifth metatarsal bone, passing under the extensor retinaculum of the foot. It acts on two main joints of the foot: the talocrural (ankle) and subtalar joints.
The peroneus tertius is considered a weak dorsiflexor and evertor of the foot due to its small size and poor mechanical leverage. Its presence varies among individuals, and it may be absent in some people. The peroneus tertius is supplied by the deep fibular nerve, a branch of the sciatic nerve. It receives arterial blood from several sources, including the anterior tibial artery, the dorsalis pedis artery and its branches, and the posterior tibial artery.
The peroneus tertius plays a role in the gait cycle, working with other foot dorsiflexors to lift the foot and toes off the ground during the swing phase. It also has supporting functions for the ankle joint, helping to prevent excessive inversion of the foot during physical activities. While the peroneus tertius contributes to ankle dorsiflexion, its absence does not compromise the strength of eversion and dorsiflexion in individuals who lack this muscle.
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Frequently asked questions
Dorsiflexion is the upward bending of the ankle joint, causing the toes to point upward.
The muscles involved in dorsiflexion include the tibialis anterior, extensor digitorum longus, extensor hallucis longus, and fibularis tertius.
These muscles work together to lift the foot and toes, preventing them from dragging on the ground during walking or running.
Yes, the peroneus tertius, also known as peroneus brevis, contributes to dorsiflexion and eversion of the foot.
Weak dorsiflexion muscles can lead to a lack of ankle dorsiflexion, causing increased stress on other joints, such as the knee, and potentially contributing to injuries like ACL tears.
