Comprehensive Guide to Foot and Ankle Anatomy and Conditions
Walking is one of the first major milestones in life. Our feet and ankles are critical to our daily activities, from simply walking around our home or workplace, to more strenuous physical exercise. Whether it’s an injury, underlying condition, or just wear and tear, problems with the foot and ankle are incredibly uncomfortable, debilitating, and painful. Simply put, if walking is hard, going about most of your day will be too. We’re here to help you get back on your feet, so you never miss a step.
To help you discuss foot and ankle conditions and treatment options with your surgeon, here’s a breakdown of the anatomy of the foot and ankle.
- Anatomy
- Conditions
- Procedures
Anatomy of the Foot & Ankle
The foot and ankle is a complex joint that provides movement, stability, and balance to the body. It consists of 26 bones, 33 joints, and many muscles, tendons and ligaments.
Bones of the Feet
The foot acts as a single functional unit, but can be divided into three parts:
The hindfoot forms the ankle and heel, and is made up of the talus bone and calcaneus, or heel bone. The heel bone is the largest bone in the foot.
The midfoot connects the hindfoot to the forefoot, and consists of one navicular bone, one cuboid bone, and three cuneiform bones.
The forefoot forms the arch of the foot for shock absorption while walking or running, and is made up of five metatarsal bones. Each toe is made of three phalanges, except the big toe, which has two phalanges, as well as two small sesamoid bones in the ball of the foot.
Bones of the Ankle
The ankle joint connects the leg with the foot and is composed of three bones:
The tibia, or shinbone, and the fibula, or calf bone, are bones of the lower leg which articulate with the talus, or ankle bone, enabling up and down movement of the foot.
Ankle and Foot Joints
There are 33 joints in the ankle and foot, and include:
- Hinge joints in the ankle, which allow flexion (bending) and extension.
- Gliding joints in the hindfoot, which allow gliding movements.
- Condyloid joints in the forefoot and toes, which allow the flexion (bending) and extension, adduction and abduction (sideward movement).
- Articular cartilage is a thin, tough, flexible, and slippery surface that lines the joint surface of all ankles and bones. It absorbs shock and reduces friction between the bones.
Ligaments of the Foot and Ankle
The ligaments of the foot and ankle connect bones together and provide stability to the joints. The Plantar fascia is the largest ligament in the foot, and stretches and contracts to provide balance and strength to the foot. Lateral ligaments on the outside of the foot and medial ligaments on the inside of the foot provide stability and allow up and down movement of the foot.
Muscles of the Foot
The foot is made up of 20 muscles, which include:
- Anterior tibial muscle allows up and down movement of the foot.
- Posterior tibial muscle supports the arch.
- Peroneal tibial muscle controls movement on the outside of the ankle.
- Extensors enable the ankle to raise the toes just before stepping forward.
- Flexors stabilize the toes against the floor.
- Smaller muscles help the toes lift and curl.
Tendons of the Foot and Ankle
Tendons of the foot and ankle connect muscles to bones. The largest and strongest tendon in the foot is the Achilles tendon, present at the back of the lower leg around the heel bone. Other tendons include peroneals and anterior and posterior tibialis.
Other Soft Tissues of the Foot and Ankle
Bursae are small fluid filled sacs that decrease friction between tendons and bone or skin.
Cartilage provides cushioning between the bones allowing for smooth movement.
If you’re missing a step due to foot and ankle problems, conditions, or injuries, we’re here to help. Get back on your feet and back to living your best life.
Foot Pain
Foot pain occurs from distress induced by certain factors in the foot. It is a common problem experienced by young athletes involved in various activities such as running and jumping.
Heel Pain
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.
Achilles Tendon Rupture
The 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.
Foot Fracture
The foot has 26 bones, and can be divided into 3 parts:
- The hind foot is comprised of two bones, the talus bone which connects to the bones of the lower leg, and the calcaneus bone which forms the heel.
Plantar Fasciitis
Plantar fasciitis refers to inflammation of the plantar fascia, a thick band of tissue that is present 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.
Flatfoot
Flatfoot, also known as “fallen arches” or Pes planus, is a deformity in children’s feet in which the arch that runs lengthwise along the sole of the foot has collapsed to the ground or not formed at all. Flatfoot is normal in the first few years of life as the arch of the foot usually develops between the age of 3 and 5 years.
Diabetic Foot
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.
Bunion
A bunion is a bony protuberance that appears on the outer surface of the big toe when it angles toward the adjacent toe. It is an extra bone and a fluid-filled sac that grows at the base of the big toe.
Hammertoe
A hammertoe is a deformity of a lesser toe (second through fifth toes), where the toe is bent upward at the toe’s middle joint, resembling a hammer. The bent portion may rub against a shoe causing pain, irritation and development of corns.
Ingrown Toenail
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 penetrate the skin of the toe. Pain is often accompanied by swelling and redness. The big toe is affected most often.
Foot & Ankle Arthritis
Arthritis is inflammation resulting from the degeneration of cartilage in the joint causing joint pain, swelling, and stiffness resulting in restricted movements. Arthritis of the foot and ankle joint can occur due to fractures, dislocation, inflammatory disease, or congenital deformity.
Ankle Sprain
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 ankle joint or when you land your foot in an awkward position after a jump. Most commonly it occurs when you participate in sports or when you jump or run on a surface that is irregular.
Ankle Instability
Ankle instability is a chronic condition characterized by a recurrent slipping of the outer side of the ankle. It usually results from repeated ankle sprains. It is generally noticed during movement of the ankle joint but can also occur during standing as well.
Ankle Arthritis
Arthritis is inflammation resulting from the degeneration of cartilage in the joint causing joint pain, swelling, and stiffness resulting in restricted movements. Arthritis of the foot and ankle joint can occur due to fractures, dislocation, inflammatory disease, or congenital deformity. The joint between the shinbone (tibia) and ankle bone (talus) is commonly affected by arthritis.
Sports Injuries
Sports injuries occur when playing indoor or outdoor sports or while exercising. They can result from accidents, inadequate training, improper use of protective devices, or insufficient stretching or warm-up exercises. The most common sports injuries are sprains and strains, fractures and dislocations.
Toenail Conditions
Nails are an extension of the top layer of the skin and are composed of a nail plate (top layer) and nail bed (skin below the nail plate). The nail matrix is the region where your toenail begins to grow. Nails are made of keratin (protein) and help to protect your fingers and toes from injury. Toenail conditions can range from minor infections to severe trauma.
Nerve Conditions
The foot is composed of bones, ligaments, nerves, muscles, and tendons. Nerve conditions of the foot can range from minor nerve injuries to serious conditions like nerve entrapment and damage. A podiatrist is a doctor specializing in the treatment of foot problems including nerve conditions.
Non-Surgical Treatments
Platelet Rich Plasma
Our blood consists of a liquid component known as plasma. It also consists of three main solid components which include red blood cells (RBCs), white blood cells (WBCs), and platelets. Platelets play an important role in forming blood clots. They also consist of special proteins, known as growth factors, which help with our body’s healing process.
Foot Care
The feet support our 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 healthy feet, you should always wear comfortable, good quality and properly fitting footwear.
Foot Activity & Exercise Guide
A foot injury or foot surgery may leave you immobile for a period of time. To return to your regular activities and more strenuous recreational activities, it is necessary for you to follow a well-planned activity and exercise program.
Surgical Treatments
Bunion Surgery or Bunionectomy
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 in footwear. The 1st metatarsal bone abnormally angles outward towards the other foot from its joint in the midfoot. 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.
Foot Reconstruction
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. Ideally, any foot surgery for reconstruction is done to improve the appearance and function of the foot so that patients can maintain their quality of life.
Total Ankle 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.
Subtalar Arthrodesis
Subtalar arthrodesis is the surgical fusion of bones that form the subtalar joint. The subtalar joint is a complex joint located below the ankle joint and is formed by the union of the heel (calcaneus) and the talus (ankle) bone. The subtalar joint allows side-side movement of the foot.
Ankle Arthroscopy
Ankle arthroscopy is a minimally invasive surgical procedure in which an arthroscope, a small, soft, flexible tube with a light and video camera at the end, is inserted into the ankle joint to evaluate and treat a variety of conditions.
Ankle Arthrodesis
Ankle arthrodesis is the surgical fusion of bones that form the ankle joint. The ankle joint is formed by the tibia, talus, and the fibula bones.
The goal of ankle arthrodesis is to relieve pain in the affected joint. This is achieved by surgically eliminating the joint.
Ankle Ligament Reconstruction
A sprain is the stretching or tearing of a ligament. Ligaments connect adjacent bones in a joint and provide stability to the joint.
An ankle sprain is a common injury and occurs when you fall or suddenly twist the ankle joint or when you land your foot in an awkward position after a jump.
Ankle Instability Surgery
Ankle instability is a chronic condition characterized by a recurrent slipping of the outer side of the ankle. Instability is generally noticed during movement of the ankle joint but can also occur during standing as well.
Minimally Invasive Foot Surgery
Minimally Invasive Foot Surgery (MIFS) uses the latest advanced technology to treat foot and ankle pain caused by a variety of conditions. Special surgical instruments, devices and advanced imaging techniques are used to visualize and perform the surgery through small incisions.