The ankle is a complex joint that connects the foot to the lower leg. It is actually comprised of two joints: the true ankle joint (upper ankle joint) and the subtalar joint (lower ankle joint). With compressive forces in each ankle reaching 7 times our body weight while we do nothing more than walk, the ankle joint is required to withstand more stress than any other joint in the body. Our ankles enable bipedalisn (walking upright on two legs) and a normal gait. The upper ankle joint is comprised of 3 bones: the tibia, the fibula, and the talus. The upper ankle joint's range of motion is defined by the malleoli (the bony prominences on each side of the ankle) and the talus.
The U-shaped, combined structure of the malleoli establishes a kind of spring bearing that is harnessed by tight ligaments that give the ankle an essential degree of stability. The tightness of these ligaments can be used to assess the severity of ankle injuries. Like other joints in our body, the upper ankle joint is housed in a capsule and harnessed by ligaments. These ligaments act to stabilize the ankle joint as the foot operates within its range of motion. The upper ankle joint is responsible for the up and down motion of the foot. This movement is displayed when we roll on the balls of our feet through a full step and when we jump. The structure of the subtalar joint is far more complex than that of the upper ankle joint. We notice the operation of this multi-component joint when we stand on sloped surfaces or walk on uneven ground. The subtalar joint is harnessed by multiple ligaments. This makes it very prone to injury because its natural stability is significantly reduced as soon as the foot is lowered. The result is an increased incidence of ankle sprains, involving an overextension or tearing of the ligaments, ankle fractures and cartilage damage. Such injuries often lead to structural imbalance and an inferior management of compressive forces, which, in turn, set the stage for injuries to other joints.
The most common causes of ankle pain include accidents, stress and strain, congenital misalignment and earlier ligament injuries. The resulting cartilage damage is often not noticed until the cartilage has worn through to the bone.
Misalignment and other foot disorders can cause considerable pain while we are walking or resting. This pain can limit our mobility and reduce the quality of our lives.
We offer our patients advanced non-surgical and surgical forms of treatment for all known foot and ankle disorders.
What are some of the most common disorders of the foot and ankle?
- Stress fractures
- Bunions
- Axial displacement
The earliest possible detection of the disorder and the identification of any relevant causes are often crucial for treatment success. In this regard, our clinic offers specialist know-how and experience combined with state-of-the-art diagnostic equipment and procedures.
The goal of treatment is to implement suitable and timely measures so as to effectively eliminate or compensate for any disruptions in the complex biomechanics of the foot.
Computer-assisted examinations that measure the distribution of compressive forces in the foot as well as its exact movements when in action are carried out to support our customized treatment selection.
Diagnostic Examinations
- Manual diagnostics
- Digital weight-bearing x-rays
- Gait analysis
- Pedobarography
Our orthopedic specialists have access to a comprehensive range of proven treatment concepts that enables them to select the right treatment for our patients. We offer non-surgical forms of treatments (including foot gymnastics, shockwave techniques and other orthopedic techniques) and surgical procedures that alleviate pain and restore function in both early-stage and advanced disorders.
Ankle Facts
The ankle is a complex joint that connects the foot to the lower leg. It is actually comprised of two joints:
- True ankle joint (upper ankle joint)
- Subtalar joint (lower ankle joint)
With compressive forces in each ankle reaching 7 times our body weight while we do nothing more than walk, the ankle joint is required to withstand more stress than any other joint in the body.
Our ankles enable bipedalisn (walking upright on two legs) and a normal gait.
What is the bone structure of the upper ankle joint?
The upper ankle joint is comprised of 3 bones: the tibia, which forms the medial (inside) portion of the ankle; the fibula, which forms the lateral (outside) portion of the ankle and the talus, which forms the lower portion. The upper ankle joint's range of motion is defined by the malleoli (the bony prominences on each side of the ankle) and the talus. The structure of the malleoli is formed by the lateral fibula and the medial tibia. This structure establishes a kind of spring bearing for the talus. The U-shaped, combined structure of the malleoli is harnessed by tight ligaments. These ligaments, which are known as the syndesmoses, give the ankle and an essential degree of front and rear stability.
What is the role of the syndesmoses?
The U-shaped structure of the malleoli is harnessed by tight ligaments. These ligaments, which are known as the syndesmoses, give the ankle an essential degree of front and rear stability. A distinction is made between the anterior syndesmosis and the posterior syndesmosis.
Injury to the syndesmoses is important when it comes to determining the seriousness of an ankle injury because the stability and location of the malleoli are crucial for proper ankle joint function.
Ligaments of the Upper Ankle Joint
Like other joints in our body, the upper ankle joint is housed in a capsule and harnessed by ligaments. These ligaments act to stabilize the ankle joint as the foot operates within its range of motion.
A distinction is made between the following ligaments:
- Medial collateral ligaments
- Lateral collateral ligaments
The lateral three ligaments are named according to their anatomic disposition and the role they play for the ankle joint. 
The ligament that extends from the fibula to the talus in the front is the anterior talofibular ligament and the ligament that extends from the fibula to the talus in the rear is the posterior talofibular ligament. These two ligaments nearly form a right angle to one another.
Located between the anterior talofibular ligament and the posterior talofibular ligament, the calcaneofibular ligament extends from the fibula to the calcaneum (heel bone).
What is the structure of the subtalar joint and what is its function?
The structure of the subtalar joint is far more complex than that of the upper ankle joint. The subtalar joint is a point of convergence for the talus, calcaneum, cuboid bone and navicular bone.
It would be difficult to try to arrive at a spatial representation of the degrees of freedom for movement in the subtalar joint. We notice how the joint functions while standing on sloped surfaces and while walking on uneven ground. These situations also tend to elicit pain in case of subtalar joint disorders. The subtalar joint is harnessed by multiple ligaments. This makes the task of arriving at a diagnosis and implementing the right treatment for disorders considerably more difficult.
What is the function of the upper ankle joint?
The upper ankle joint is responsible for the up and down motion of the foot. This movement is displayed when we roll on the balls of our feet through a full step and when we jump. Of all the joints in the body, the upper ankle joint is exposed to the greatest compressive forces. The upper ankle joint is also very prone to injury because its natural stability is significantly reduced as soon as the foot is lowered. The result is an increased incidence of ankle sprains, involving an overextension or tearing of the ligaments, ankle fractures and cartilage damage. Such injuries often lead to structural imbalance and an inferior management of compressive forces, which, in turn, set the stage for later injuries to the upper ankle joint.
What is the upper ankle joint's range of motion?
The average range of motion in the upper ankle joint is 46°. The interaction of the remaining joints of the foot can extend this range to 60°.
