Introduction to foot and ankle health

The foot and ankle is a complex joint capable of handling tremendous stress and possessing the ability to compensate to a wide variety of unpredictable forces. However for many of us our feet and ankles have become underdeveloped as a result of our lifestyle and now present with a diminished capacity to function. This dysfunction is the result of an imbalanced relationship between several of the major muscle groups. Bringing this group back into harmony creates a high functioning foot and ankle capable of carrying you through the racing season injury and pain free.

To ensure this article stays a reasonable length we will not be exploring the different self-care options. Feel free to explore the internet or contact Hybrid Health for further information. Most ankle issues can, and should be, self-managed. This takes a little education and self-discipline (easier said than done). Please recognize that if you stretch already weak overstretched muscles or strengthen overly tight and restricted muscles you will make the dysfunctions worse and further increase the likelihood for injury. It’s very important to have a qualified practitioner analyze your structure and educate you on your unique presentation.


 

Muscle Group 1: The Triceps Surae

Issues created: Achilles tendonitis/osis, plantar fascia pain, dropped arches, knee rotations, anterior/posterior shin splints

The Triceps Surae is a combination of the two heads of the Gastrocnemius muscle and the deep Soleus. Together they generate incredible power; capable of leveraging the weight of the human body up against gravity hundreds and thousands of times over without failing. Because of the ability to generate such power they often times overpower the muscles working alongside it. Therefore it is essential to ensure that these muscles maintain their range of motion and elasticity to both minimize their dominance over the supporting muscle groups and discourage an environment that causes them to irritate or tear at the Achilles tendon.

The Gastrocnemius crosses the knee joint which means a straight knee is required to place the muscle onto an appropriate stretch. This can be accomplished by either leaning forward with a straight leg back, placing your toes with a straight leg against a wall and leaning forward, or dropping your heels down off a curb or step while keeping the knee straight. It also has two muscle bellies that cross the knee on opposite sides creating the ability for subtle knee rotations. For this reason it is important to check and see if one muscle belly is tighter than the other. For most people this will be the lateral muscle belly however the medial can become overly restricted as well.

The SoleuSoleuss does not cross the knee. This means if we bend the knee and take the stretch out of the gastrocnemius we should see a slight increase in ankle range of motion with the stretch dropping lower and deeper into the Soleus. Most Achilles and plantar fascia issues see dramatic improvement as health returns to the Soleus.

Most clients see with lower leg issues only actively engage one of these two stretches which means they are leaving half the Triceps Surae to become restricted and irritate the foot and ankle complex. In addition to creating pain around the Achilles tendon and plantar fascia it can also overpower the Tibialis Anterior muscle causing it to weaken and overstretch. This results in anterior shin splint pain and dysfunctional medial arches of the foot.

 


 

Muscle Group 2: The Tibialis Anterior (figure 3).

Issues created: Anterior shin splints, dropped arches, flat archestibialis anterior

The Tibialis Anterior is responsible for lateral stability, raising your foot up, and keeping your arch elevated with its partners the Peroneals (figure 4). This muscle is rarely the initial source of dysfunction but can likely be the cause of your pain which we look at as the symptom. We must recognize if the calf is overly short and tight then it’s impossible for this muscle to function properly as it possesses far less strength. Most times instead of trying to stretch or release this muscle we must activate and strengthen it to ensure our ankle and foot is strong. Utilizing single stability and lateral stability exercises is a great way to activate the Tibialis Anterior. Weakness here causes tension stress which will be felt as anterior shin splints and can create a dropped arch. Sometimes we do see this muscle overly shortened and tight which may also create the shin splint pain as well as overly raise the medial arch of the foot. Foam or stick rolling will help in these situations.

 


Muscle Group 3: The Peronealsperoneals

Issues created: Dropped arches, raised arches, lateral ankle pain, lateral knee pain

The Peroneal muscle group (also referred to as the Fibularis muscle group) is responsible for lateral stability and pulling the arch down. Because of handling opposing actions of the Tibialis Anterior it is obvious they must be in close balance and harmony for the foot and ankle to function correctly. This muscle group lends itself to becoming overly tight and restricted as it assists the Triceps Surae in pointing the foot down. Often times this muscle resides in a state of chronic spasm as result of past ankle sprains that damaged the supporting ligaments. Self-myofascial release and stretching to this muscle along with lateral stability and single leg stability exercises will ensure that it stays mobile, healthy and supports the foot and ankle.

 


Muscle 4: The Tibialis Posteriortibialis posterior

Issues created: Posterior shin splints, plantar foot pain,

The final muscle being examined is the Tibialis Posterior. This muscle is also responsible for pointing the foot down and pulling the foot inward. Dysfunction to this muscle generally results in the deep posterior shin splint pain that can be very difficult to manage. When the muscle is short and tight we must mobilize and elongate it to remove the tension stress it will apply. In some situations it can be weak in which case we work to excite and strengthen it with stability related exercises.

2 Comments on “Introduction to foot and ankle health

  1. Pingback: Think Snow | Hybrid Health

  2. Pingback: Groin Pulls: An Introduction | Hybrid Health

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