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The leg and ankle demystified | Izaak Lavarenne, Masso-Kiné 

 

Izaak Lavarenne

The mercury rises in this month of June and the runners
come out of their lair and abandon the treadmill.
At the same time, less active people are abandoning their boots
and return to their everyday sneakers.

 

In any case, spring is good for us and we tend to increase our active travel. All of this means that our ankles, which were limited in their movements during the winter months, are suddenly put to great use. Some may feel some discomfort or at least fatigue of the muscles around this joint because of this change. So today, I'm proposing that we take a look at the ankle and the main muscles that mobilize it in order to better protect ourselves against injuries that can be common - pun intended - at this time of the year.

Let's first establish a few points to make the reading of this article more natural. The ankle is the joint between your shin and your tarsus, a group of bones between the shin, heel and long side of the foot. The tarsus has its own movements that are subtle and will, for simplicity, be considered part of the ankle's for today. Also, the leg, not to be confused with the lower extremity, is the segment between your knee and your ankle. The ankle moves in two axes of motion: the axis of plantar flexion (pointing the foot down) and its opposite dorsal flexion, and that of inversion (if you turn your soles toward each other as if walking on the outside of the foot) and eversion (sending your soles to the sides). I'll end with a special mention for the arches of the foot. Used to quantify the hollow under your feet, arches are anatomical measurements that are relevant here because they influence the mechanics of your ankles.

Muscle by muscle
Now that the basics are clear, let's look at each of the most important muscles of the ankle and leg and their specifics, starting with the most visible: the gastrocnemius (or gastrocs). The gastrocnemius is the large, double-bellied muscle at the back of your calf. It is a powerful plantar flexor and will therefore provide you with great power in this movement. It is also somewhat involved in knee flexion, although that is off topic for today.

Next comes the soleus, an often forgotten muscle. Hidden under your gastrocnemius, and spanning the entire leg, the soleus is your largest leg muscle; together, these two muscles form the sural triceps. It is also the plantar flexor of the ankle, but it is more involved in your standing posture, and therefore your balance. Interestingly, if you want to stretch your gastrocnemius, you have to do a dorsal flexion and knee extension, but if you want to stretch your soleus, you only have to do the dorsal flexion with the knee flexed. This will shorten the gastrocnemius, which will stretch the soleus.

Third, let's move forward in the leg to talk about the tibialis anterior. Located on the lateral edge of your front leg, this muscle is your strongest dorsal ankle flexor and is also an ankle inverter. It is a muscle that is often discovered when you start a sport that includes running. Among other things, it is the one that brings the foot back after the push-up during the run. Since this movement is almost impossible when wearing boots, it is also possible that you will feel it when transitioning from boots to sneakers.

Fourth, the other muscle group most atrophied by wearing boots is the fibulars. These muscles that run along the lateral edge of your leg and fibula are the primary ankle everters although they also do plantar flexion. Knowing that the majority of ankle sprains occur in a dry inversion movement, the fibulars are the main muscles that can protect you from this problem. If you tend to have weak or sprained ankles, the fibulars are important stabilizing muscles to strengthen for prevention.

 

Fifth, let's take a look at the flexor hallucis longus and the flexor hallucis longus (big toe). Being even deeper than the soleus, these muscles are attached to the posterior aspect of your tibia and fibula respectively. They obviously perform flexion of the toes to which they are attached, but also participate in plantar flexion. I mention them because since the sole of our summer shoes is less rigid, these muscles are more solicited and can cause pain, especially the long flexor of the toes. For relief, you can self-massage and apply pressure to the muscle by running your thumb along the back of your shin.

Our last topic of inspection today, the tibialis posterior, is another very deep muscle, which is crucial in your ankle stabilization. Its actions are plantar flexion and inversion, and it is also very important in maintaining a good plantar arch. It is an often under-trained muscle and therefore benefits greatly from strengthening. A pain in the posterior tibial is often described as if it were a pain in the inside of the calf.

Practical advice 
As you may have noticed, each muscle is very different from the others in the segment that is the leg. That's why I recommend that if you have identified yourself as someone who would benefit from strengthening a particular one, you consult a kinesiologist. Also, if you are bothered by one of these muscles, don't hesitate to consult your manual therapist, because an unhealthy leg can greatly influence the rest of your body as it is involved in your walking.

One piece of advice I can give you however, is to warm up your ankles before any physical activity. To do this, walk forward by stomping on your toes, on your heels, on the outside of your feet (inversion) and on the inside (eversion), eight times per style and for two sets or more. This exercise is especially good for sports with a lot of running and jumping such as jogging, soccer, volleyball, ultimate frisbee or similar sports. Now go enjoy the nice weather outside and move with the peace of mind that your ankles are better protected than before.

Happy running!
Izaak Lavarenne, NDG Physiotherapist

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