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Tuesday, June 26, 2012

Getting to Know Your Ankles

by Baxter

Like many joints and areas of your body, if your ankles are healthy and doing their job well, you don’t give the area way down there by your feet much thought. Yet, when an ankle is not healthy or functioning optimally, it can be hard to think of anything else! Once I began to practice yoga asana regularly, I noticed that my teachers would often have us do ankle rolls as a preparation for Thread the Needle pose (a nice hip opener), and I started to become more aware of the area of my ankles. I was not having any acute problems with my ankles at the time, but I began to notice patterns of tension, tightness and lack of coordination that were previously outside my conscious awareness. In retrospect, I now know that this is exactly one of the benefits of yoga:  to make what is not known knowable. 

Like many of my students, I have suffered the occasional ankle sprain in the past. Since this is the most common injury to ankles, I’ll be addressing this in a separate post (coming soon). In addition to these common sprains of the ankle area, the other fairly common problem is that of significant trauma to the area that results in fracture or severe tears of the ligaments and tendons. People with this problem have often undergone some sort of surgery to reconstruct and heal the damage. This surgery can be profoundly beneficial; however, people who have had surgery often complain about persistent aches, limited movement and even weakness. I’ll also talk about this group in a separate post, and propose some strategies for you to work with.

But to start, I’d like to step back for a moment and take a closer look at the ankle joint. This joint connects your foot to your lower leg, and is intimately involved in our ability to stand on two legs as well as our ability to walk and run effectively. The ankle is often thought of as a “hinge” joint, which allows for flexion (like the ankle position in your Downward-Facing Dog pose) and extension (like the front leg ankle in your Triangle pose). These actions are also known as dorsiflexion (the Downward-Facing Dog ankles) and plantar flexion (pointing of the foot).

The bones involved in creating the ankle joint include your lower leg bones (tibia and fibula) meeting the two big bones at the back of your foot (talus and calcaneus). The tibia and fibula extend down and around the sides of the talus and calcaneus, and their distant ends become our inner and outer ankle bones, technically called the medial malleolus (on the inside of the ankle) and the lateral malleolus (on the outside of the ankle bone).

If you look at how far down your two leg bones go, you may notice that the outer one extends farther down toward the foot than the medial one. This will come into play later when we talk about ankle sprains.

The ankle joint is held in close proximity by lots of small, short ligaments that run between the 4 bones. The talus bone, which sits just atop the calcaneus bone (the heel bone), is unique in that it is only attached to the bones around it by ligaments. There are no muscles directly connected to it.
Muscles from the lower and upper leg bones cross by the talus and connect onto the heel bone, such as with the famous Achilles’ tendon, or head further down to connect to other bones in the foot.  When these muscles contract, they create the movements of the ankle joint.
One other tidbit about the flexion and extension of the ankle joint: the joint is more stable the more dorsiflexion there is, as in squats and Downward-Facing Dog pose, and less stable the closer the joint gets to plantar flexion, such as coming up onto our toes in Mountain pose.

Although it would be neat and tidy if those were the only two movements at the ankle, it would limit our movement capabilities. And indeed there are other movements the joint enjoys, such as turning in and out a bit (adduction and abduction), as well a combination of plantar flexion and adduction known as supination, and a combination of dorsiflexion and abduction known as pronation.  Folks who stand on the outer edge of their feet have a bit more supination going on, and those with “flat feet” do a bit more of the pronation action. And often when people come up onto the ball of the foot, the combination of plantar flexion, adduction and supination cause an inversion of the joint. In the opposite scenario, when the ankle is dorsiflexing, abducting and pronating, an eversion is produced. This will become more important when figuring out ankle sprains, which I’ll address in my next post on ankles.

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