Why the ankle joint is so important?

The ankle joint is one of the more important joints in the body for movement. Imagine trying to move the body forward over the foot if the ankle joint did not move. It is not impossible, but it is going to be very hard to move forward and it will be very exhausting. The ankle joint anatomically links the foot to the leg. The joint consists of the talus bone that sits on top of the calcaneus or heel bone. The talus is between the ends of the tibia and fibula. The structure of the ankle joint means that it functions like the hinge joint. That hinge allows the leg to move forward over the foot when the foot is on the ground so that we can move forward efficiently. This efficient movement is based on there being a large enough range of motion at the ankle joint and there is nothing that limits that such as tight calf muscles or osteoarthritis in the joint.

As the range of motion of the ankle joint is so important clinicians involved in the movement and physical therapy professions like to check the range of motion at the ankle joint. There are several ways that they can do this, and it can be done with the foot up in the air and the foot is pushed back to see how far the ankle joint moves. A weightbearing measurement of the ankle joint is a specific test known as the lunge test is commonly used. A weight bearing lunge test is considered a more appropriate measure of ankle joint motion when walking as it is done weightbearing. Several studies have linked a reduction in motion of the ankle joint when weightbearing to an increased risk for injury in athletes.

These two reasons are the most common for problems with the gait. Osteoarthritis in the joint is painful, so those with this are not able to comfortable move over their ankle joint with ease. This is often due to a wear and tear on the joint or from trauma such as an old ankle fracture. A tight calf muscle is also a common reason for a limitation in the motion of the ankle joint. This is especially a common problem in athletes who really do need an adequate range of motion at the ankle joint to meet the demands of their sport. Clinically if the range of motion is reduced, then the easiest short term measure is to use a heel raise so that the joint does not have to move as far. If the calf muscles are tight, then the heel raise in the shoes will help, but a regular stretching problem should be put in place to help as well. For the resistant cases, a surgical lengthening could be considered. For those with arthritis, there are several approaches to help reduce the pain to make the walking more comfortable. The extreme cases now are getting a total ankle replacement which is improving a lot of outcomes in those with osteoarthritis.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.