Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments and in built up of scar tissue in one or more of the ankle ligaments resulting from mini or partial tears after ankle injury.

 

The most common mechanism of injury to the ankle ligaments is inversion of the foot.

With this mechanism of injury, the anterior talofibular ligament is the first or only ligament to sustain injury. A total rupture involves the calcaneofibular ligament and the posterior talofibular ligaments as well.

An eversion injury will cause damage to the deltoid ligaments, lat. lig. collaterale mediale, while a hyperdorsiflexion trauma might cause an injury to the syndesmotic ligaments. [1]

The ligaments around the ankle can be divided, depending on their anatomic position, into three groups:

  • Lateral ligaments
  • Medial ligaments
  • Ligaments of the tibiofibular syndesmosis that join the distal epiphyses of the bones of the leg (tibia and fibula).

Lateral ligaments


The lateral collateral ligament complex (LCL) consists of:

  • Anterior talofibular ligament
  • Calcaneofibular ligament
  • Posterior talofibular ligament

REMEMBER: The anterior talofibular ligament is the most common ligament to sustain injury!

 

 

 

 

Medial ligaments

The medial collateral ligament (3) (MCL), also known as the deltoid ligament, is a multifascicular group of ligaments and can roughly be divided into a superficial and deep group of fibres. [1]

 

(Platzer)

Lig. collaterale mediale (3):

Pars tibionavicularis (4)

Pars tibiocalcanea (5)

Pars tibiotalaris anterior (6)

Capsule (2)

Calcaneus (14)

Lig. calcaneocuboideum plantare (18)

Lig. plantare longum (19)

 

 

 

Twisting the ankle causes strain or tear in ankle ligaments. This trauma weakens the ligament, adhesive scar tissue builds up and the functional movement of the foot gets changed.

In many cases it can be observed that people suffering with plantar fasciitis had a twisted ankle some time before. That suggests that treatment of plantar fasciitis should include treatment of the ankle ligaments.

The treatment is carried out with frictioning massage of the lateral and medial ankle ligaments, transverse to the fibre, to break down scar tissue and get the normal function back.

                        
Reference:

[1] Golano, P., Vega, J., Leeuw de, P.A.J., Malagelada, F., Manzanares, C.M., Goetzens, V., Diek van, N.C. (2010). Anatomy of the ankle ligaments: a pictorial essay. US National Library of Medicine, National Institute of Health. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855022/

[2] Platzer W. (1999). Taschenatlas der Anatomie in 3 Bänden, 1 Bewegungsapparat. Stuttgart, Georg Thieme Verlag. (7. vollständig überarbeitete Auflage)