BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND THERAPEUTIC BODYWORK Musculoskeletal Anatomy & Kinesiology KNEE & ANKLE MUSCLES MSAK201-I Session 3 1) REVIEW a) THIGH, LEG, ANKLE & FOOT i) Tibia Medial Malleolus Tibial Tuberosity Lateral Tibial Condyles Medial Tibial Condyles ii) Fibula Head Lateral Malleolus iii) Tarsals Talus Calcaneus Cuboid Navicular 1 st cuneiform 2 nd cuneiform 3 rd cuneiform iv) Metatarsals and Phalanges Base (proximal end) Shaft Head (distal end) Proximal, middle and distal phalanges (except big toe) 08/12 Blue Sky School of Professional Massage and Therapeutic Bodywork 1
2) ANTERIOR LEG MUSCLES a) Tibialis Anterior i) Origin (1) Lateral tibial condyle. (2) Proximal, lateral surface of tibia. (3) Interosseus membrane. ii) Insertion: 1 st cuneiform and 1 st metatarsal (1) Dorsiflexion of ankle. (2) Inversion of foot. (1) Tibialis anterior lies lateral to the tibia. (2) Tibialis anterior and Peroneus longus are known as the stirrup muscles. b) Extensor Digitorum Longus (1) Lateral tibial condyle. (2) Proximal, anterior shaft of fibula. (3) Interosseus membrane. ii) Insertion: Dorsal surface of middle and distal phalanges #2-5. (1) Extension of Toes #2-5. (2) Dorsiflexion of ankle. (3) Evert the foot. (1) The most distal and lateral part of this muscle does not attach onto the digits, therefore is given a separate name, the Peroneus tertius. 08/12 Blue Sky School of Professional Massage and Therapeutic Bodywork 2
c) Peroneus Tertius Distal 1/3 of anterior fibular and interosseus membrane. ii) Insertion: Dorsal base of the 5 th metatarsal. (1) Dorsiflexion of ankle. (2) Eversion of the foot. Peroneus Peroneus Peroneus Tertius (1) The three peroneus muscles are grouped together because they all evert the foot. (2) The Peroneus tertius is actually the most distal and lateral part of the Extensor digitorum longus. It is given a separate name because its fibers do not attach onto a phalanx. d) Extensor Hallucis Longus (1) Middle 1/3 of anterior fibula. (2) Interosseus membrane. ii) Insertion: Dorsal surface of the 1 st distal phalanx. (1) Extension of the 1 st toe. (2) Dorsiflexion of the ankle. (3) Inversion of the foot. (1) Hallucis refers to the big toe. 3) LATERAL COMPARTMENT a) Peroneus Longus (1) Head of the fibula. (2) Proximal 2/3 lateral fibula. ii) Insertion: 1 st cuneiform and 1 st metatarsal. 08/12 Blue Sky School of Professional Massage and Therapeutic Bodywork 3
(1) Eversion of foot. (2) Assist in Plantarflexion of ankle. (1) Peroneus longus and Peroneus brevis cross posterior to the lateral malleolus and they both plantarflex the foot. Peroneus tertius crosses anterior to the lateral malleolus and dorsiflexes the foot. b) Peroneus Brevis Distal 2/3 of the lateral fibula. ii) Insertion: Base of the 5 th metatarsal. (1) Eversion of foot. (2) Plantarflexion of ankle. v) Notes / relationship to other musculoskeletal structures: (1) Peroneus longus and brevis are also known as Peroneus longus and brevis. Peroneus Brevis Peroneus Longus 4) SUPERFICIAL POSTERIOR LEG a) Gastrocnemius (1) Medial head: medial condyle of femur. (2) Lateral head: lateral condyle of femur. ii) Insertion: Calcaneus via achilles tendon. (1) Plantar flexion of ankle. (2) Assists flexion of knee. (1) The Gastrocnemius and the Soleus are sometimes called the Triceps Surae. 08/12 Blue Sky School of Professional Massage and Therapeutic Bodywork 4
b) Soleus (1) Posterior tibia. (2) Head and proximal 1/3 of fibula. ii) Insertion: Calcaneus via achilles tendon. iv) Action: Plantar flexion of ankle. (1) The Gastrocnemius and the Soleus are sometimes called the Triceps Surae. c) Plantaris Distal posterior lateral condyle femur. ii) Insertion: Calcaneus. (1) Plantar flexion of ankle (weak). (2) Flexion of knee (weak). (1) The distal tendon of Plantaris often joins with the Gastrocnemius and Soleus. 5) DEEP POSTERIOR LEG a) Popliteus Lateral condyle of femur. ii) Insertion: Posteriomedial surface of proximal tibial shaft. iv) Action: Initiates flexion of knee by medial rotation of tibia to unlock the extended knee. (1) Known as the key that unlocks the knee. 08/12 Blue Sky School of Professional Massage and Therapeutic Bodywork 5
b) Tibialis Posterior (1) Proximal 1/2 of the posterior tibia and fibula. (2) Interosseus membrane. ii) Insertion: (1) Plantar surface of metatarsals #2-4. (2) All the tarsal bones except the talus. (1) Plantar flexion of the ankle. (2) Inversion of the foot. (1) Tom of the Tom, Dick and Harry muscles. c) Flexor Hallucis Longus (1) Middle half of posterior fibula. ii) Insertion: Plantar surface of the distal phalanx of toe #1. (1) Flexion of the big toe. (2) Plantar flexion of the ankle (weak). (3) Inversion of the foot. v) Notes / relationship to other musculoskeletal structures: (1) Harry of the Tom, Dick and Harry muscles. d) Flexor Digitorum Longus Middle 1/3 of the posterior tibia. ii) Insertion: Distal phalanges of toes #2-5. 08/12 Blue Sky School of Professional Massage and Therapeutic Bodywork 6
(1) Flexion of toes #2-5 (2) Plantar flexion of ankle (weak). (3) Inversion of foot. (1) Dick of the Tom, Dick and Harry muscles. 6) Motion ACTION ROM AGONIST SYNERGIST Flexion 135 Hamstrings Gastrocnemius Sartorius Gracilis Extension 0 Quadriceps Femoris Dorsiflexion 20 Tibialis anterior Ext. Digitorum Longus Plantarflexion 50 Gastrocnemius Soleus Tibialis Posterior Inversion 5 Tibialis Posterior Tibialis Anterior Eversion 5 Peroneus Longus Peroneus Brevis Peroneus Tertius Ext. Hallucis Longus Flex. Hallucis Longus Flex. Digitorum Longus Plantaris Flex. Hallucis Longus Flex. Digitorum Longus Ext. Hallucis Longus Peroneus Tertius Ext. Digitorum Longus 08/12 Blue Sky School of Professional Massage and Therapeutic Bodywork 7