Connection lost. Please refresh the page.
Online
Get help How to study Login Register
Ready to learn?
Pick your favorite study tool

Joints and ligaments of the foot

Recommended video: Ligaments of the foot [25:31]
Comprehensive review of all major ligaments of the foot.

The foot is the region of the body distal to the leg that is involved in weight bearing and locomotion. It consists of 28 bones, which can be divided functionally into three groups, referred to as the tarsus, metatarsus and phalanges.

The foot is not only complicated in terms of the number and structure of bones, but also in terms of its joints. These joints enable many movements of the foot that are essential for many functions, such are walking, jumping etc.

In fact, when speaking about the complexity of the joints, the foot possess no more and no less than 31 joints in total. 

Key facts
Ankle joint Ligaments: medial collateral, lateral collateral
Innervation: sural, tibial, saphenous, deep fibular nerves
Muscles: tibialis anterior (dorsiflexion), gastrocnemius (plantar flexion)
Inferior (distal) tibial joint Ligaments: anterior, posterior and interosseus tibiofibular ligaments
Innervation: deep fibular, sural nerve
Muscles: no muscles act on this joint
Talocalcaneal joint Ligaments: medial, lateral, interosseus talocalcaneal, cervical ligament
Innervation: medial plantar, deep fibular nerves
Muscles: tibialis anterior, tibialis posterior, gastrocnemius, soleus (inversion); fibularis longus, fibularis tertius, fibularis brevis (eversion)
Talocalcaneonavicular joint Ligaments: talonavicular, plantar calcaneonavicular 
Innervation: medial plantar, deep fibular nerves
Muscles: tibialis anterior, tibialis posterior, gastrocnemius, soleus (inversion); fibularis longus, fibularis tertius, fibularis brevis (eversion)
Calcaneocuboid joint Ligaments: long plantar, plantar calcaneocuboid, bifurcate ligament
Innervation: lateral plantar, sural, deep fibular nerves
Muscles: tibialis anterior, tibialis posterior, gastrocnemius, soleus (inversion); fibularis longus, fibularis tertius, fibularis brevis (eversion)
Naviculocuneiform joint Ligaments: dorsal, plantar ligaments
Innervation: deep fibular, medial plantar, lateral plantar nerves
Muscles: fibularis longus and brevis, tibialis anterior and posterior (gliding, rotation)
Cuboideonavicular joint Ligaments: dorsal, plantar, interosseus ligaments
Innervation: deep fibular, medial plantar, lateral plantar nerves
Muscles: fibularis longus and brevis, tibialis anterior and posterior (gliding, rotation)
Intercuneiform and cuneocuboid joints Ligaments: dorsal, plantar, interosseus ligaments
Innervation: deep fibular, medial plantar, lateral plantar nerves
Muscles: Muscles: fibularis longus and brevis, tibialis anterior and posterior (gliding, rotation)
Tarsometatarsal joint Ligaments: dorsal tarsometatarsal, plantar tarsometatarsal, interosseus cuneometatarsal ligaments
Innervation: deep fibular, medial plantar, lateral plantar nerves
Muscles: short and long extensors of the toe (flexion, extension); tibialis anterior, fibularis longus (abduction, rotation)
Intermetatarsal Ligaments: intermetatarsal interosseus ligaments
Metatarsophalangeal Ligaments: plantar ligaments, deep transverse metatarsophalangeal ligaments, collateral ligaments
Innervation: plantar interdigital (branch of the lateral plantar nerve), medial dorsal cutaneous (branch of the superficial fibular nerve), deep fibular nerve
Muscles: flexor digitorum brevis, lumbricales, interossei (flexion); flexor hallucis longus and brevis (extension); abductor hallucis, plantar interossei (abduction); adductor hallucis, dorsal interossei, abductor digiti minimi (adduction)
Interphalangeal joints Ligaments: collateral ligaments
Innervation: plantar interdigital nerves (branch of the superficial fibular nerve)
Muscles: flexor digitorum longus and brevis (flexion); extensor digitorum longus and brevis (extension)

This article will discuss these joints, detailing their articular surfaces, the ligaments that stabilize them, and the muscles that produce movement at these joints. This will be followed by clinically relevant notes of common pathologic conditions affecting these structures.

Contents
  1. Ankle joint
    1. Ligaments
    2. Innervation
    3. Muscles
  2. Inferior (distal) tibiofibular joint
    1. Ligaments
    2. Innervation
  3. Talocalcaneal joint
    1. Ligaments
    2. Innervation
    3. Muscles
    4. Mnemonic
  4. Talocalcaneonavicular joint
    1. Ligaments
    2. Innervation
    3. Muscles
  5. Calcaneocuboid joint
    1. Ligaments
    2. Innervation
    3. Muscles
  6. Naviculocuneiform joint
    1. Ligaments
    2. Innervation
    3. Muscles
  7. Cuboideonavicular joint
  8. Intercuneiform and cuneocuboid joints
    1. Ligaments
    2. Innervation
    3. Muscles
  9. Tarsometatarsal joints
    1. Ligaments
    2. Innervation
    3. Muscles
  10. Intermetatarsal joints
  11. Metatarsophalangeal joints
    1. Ligaments
    2. Innervation
    3. Muscles
  12. Interphalangeal joints
    1. Innervation
    2. Muscles
  13. Clinical notes
    1. Ankle sprains
    2. Ankle joint fractures
    3. Congenital talipes equinovarus
  14. Sources
+ Show all

Ankle joint

The ankle joint, also known as the talocrural joint, is a hinge joint that involves the tibia and fibula of the leg and the talus of the foot. The body of the talus sits within a deep recess referred to as the mortise. This mortise is formed by the:

  • Medial malleolus of the tibia
  • Lateral malleolus of the fibula
  • Inferior aspect of the tibia

The ankle joint is uniaxial and allows both dorsiflexion and plantar flexion. The range of dorsiflexion is 10 degrees when the knee is straight and can increase to approximately 30 degrees when the knee is flexed. The normal range of plantar flexion is about 30 degrees.

The articular surfaces involved in the ankle joint are covered by hyaline cartilage. The talar articulating surface for the tibial medial malleolus is flat and comma shaped, whereas the articulating surface for the lateral malleolus of the fibula is concave and triangular. The articulating surface for the inferior tibia is convex in the parasagittal plane but slightly concave transversely. These articulations are held together by a fibrous capsule and by the medial and lateral collateral ligaments.

Ligaments

Medial collateral ligament

The medial collateral ligament, also known as the deltoid ligament, is a triangular band that attaches to the medial malleolus proximally and to the calcaneus, talus and navicular bones distally. The ligament consists of four main groups of fibres:

  • The tibionavicular fibres (anterior segment)
  • The tibiocalcaneal fibres (intermediate segment)
  • The anterior tibiotalar fibres (deep segment)
  • The posterior tibiotalar fibres (posterior segment)

The tendons of the tibialis posterior and flexor digitorum longus cross this ligament.

Lateral collateral ligament

The lateral collateral ligament consists of three separate ligaments:

As the name suggests, the anterior talofibular ligament connects the talus with the lateral malleolus of the fibula. It extends from the anterior aspect of the malleolus to the lateral surface of the talar neck. The posterior talofibular ligament runs horizontally from the distal aspect of the fibular malleolus to the lateral tubercle of the posterior process of the talus. The calcaneofibular ligament is a long cord that runs from a depression anterior to the fibular malleolus to a tubercle on the lateral aspect of the calcaneus.

Innervation

The ankle joint is innervated by the branches of the sural, tibial, saphenous and deep fibular nerves.

Occasionally, it is also supplied by the superficial fibular nerve.

Muscles

The tibialis anterior allows dorsiflexion at the ankle joint and is assisted by the tendons of the fibularis tertius, hallucis longus and extensor digitorum longus.

The soleus and gastrocnemius muscles allow plantar flexion with assistance from the tibialis posterior, flexor hallucis longus, plantaris and flexor digitorum longus muscles.

Inferior (distal) tibiofibular joint

The inferior, or distal, tibiofibular joint is a syndesmosis, a slightly mobile, fibrous joint joined together with connective tissue.

Ligaments

It consists of three separate ligaments:

  • The anterior tibiofibular ligament
  • The posterior tibiofibular ligament
  • The interosseus tibiofibular ligament

The anterior tibiofibular ligament is a flat band that descends between the tibia and fibula anterior to the syndesmosis. The posterior tibiofibular ligament descends posteriorly to the syndesmosis between the tibia and fibula. The distal part of this ligament, the inferior transverse ligament, is a yellow band that connects the medial and lateral malleoli. The interosseus tibiofibular ligament is a continuation of the interosseus membrane and is the strongest of the three ligaments.

Innervation

The inferior tibiofibular joint is innervated by branches of the deep fibular and sural nerves.

No muscles act on this joint.

Talocalcaneal joint

The subtalar joint consists of anterior and posterior articulations between the talus and calcaneus. The posterior articulation is referred to as the talocalcaneal joint.

Ligaments

This joint is stabilized by a fibrous capsule and four ligaments:

  • The medial talocalcaneal ligament
  • The lateral talocalcaneal ligament
  • The interosseus talocalcaneal ligament
  • The cervical ligament

The medial talocalcaneal ligament connects the medial tubercle of the talus with the substentaculum tali, a horizontal eminence on the calcaneus. The lateral process of the talus is connected to the lateral aspect of the calcaneus by the lateral talocalcaneal ligament. The interosseus talocalcaneal ligament runs between the sulcus tali, a groove on the inferior aspect of the talus, and the calcaneus sulcus. The cervical ligament ascends from the superior calcaneal surface to the inferolateral tubercle on the talar neck.

Innervation

The talocalcaneal joint is innervated by branches of the sural, medial plantar and posterior tibial nerves.

Muscles

The tibialis anterior, tibialis posterior, gastrocnemius and soleus muscles contribute together to perform heel inversion (movement of the sole of the foot towards the midline).

Eversion (movement away from the midline) results from the action of the fibularis longus, fibularis tertius and fibularis brevis muscles.

Mnemonic

In order to remember the muscles that participate in inversion and eversion of the foot you can use the mnemonic called "Second letter rule":

Eversion muscles

  • pEroneus longus
  • pEroneus brevis
  • pEroneus terius

Inversion muscles

  • tIbialis anterior
  • tIbialis posterior

Talocalcaneonavicular joint

The talocalcaneonavicular joint consists of two articulations: the anterior articulation of the subtalar joint and the articulation between the talus and the navicular, the talonavicular joint.

Ligaments

These two articulations are stabilized by a fibrous capsule and by the talonavicular and plantar calcaneonavicular ligaments. The calcaneonavicular part of the bifurcate ligament also helps to stabilize this joint.

The talonavicular ligament is a thin band connecting the dorsal aspect of the talar neck with the navicular bone and is covered by extensor tendons. The plantar calcaneonavicular ligament, also known as the spring ligament, runs from the anterior aspect of the sustentaculum tali to the plantar surface of the navicular bone.

Innervation

The innervation of the talocalcaneonavicular joint is provided by the medial plantar and deep fibular nerves.

Muscles

The muscles producing the movement of this joint are the same as the talocalcaneal joint.

Talonavicular joint (medial view)

Calcaneocuboid joint

The calaneocuboid joint is a saddle (biaxial) joint, and is formed by the distal surface of the calcaneus and the proximal aspect of the cuboid.

Ligaments

The three ligaments that stabilize this joint are:

  • The bifurcate ligament
  • The long plantar ligament 
  • The plantar calcaneocuboid ligament

The bifurcate ligament is a Y-shaped band, which attaches proximally to the anterior aspect of the calcaneus. Distally, it divides into two parts: the calacaneocuboid and the calcaneonavicular parts. The calcaneocuboid part attaches to the dorsomedial surface of the cuboid bone whilst the calcaneonavicular part attaches to the dorsolateral aspect of the navicular bone.

The longest ligament associated with the tarsus is known as the long plantar ligament. It runs from the plantar surface of the calcaneus bone to the tuberosity located on the plantar aspect of the cuboid bone. More superficial fibres continue on to attach to the bases of the second to fourth metatarsals.

The plantar calcaneocuboid ligament is located deep to the long plantar ligament and is separated from it by areolar tissue. It extends from the anterior tubercle of the calcaneus to the plantar aspect of the cuboid.

Innervation

Innervation of the calcaneocuboid joint is provided by the lateral plantar nerve (plantar aspect), sural and deep fibular nerves (dorsally).

Muscles

The muscles producing movement of this joint are the same ones that act on the talocalcaneal and talocalcaneonavicular joints, aiding in the gliding and rotational movements between the calcaneus and cuboid bones.

Naviculocuneiform joint

The naviculocuneiform joint is a compound joint and consists of articulations between the navicular and the three cuneiform bones.

Ligaments

Two ligaments help form connections between these bones: the dorsal ligaments and the plantar ligaments.

The dorsal and plantar ligaments connect the navicular bone with each cuneiform. The medial dorsal ligament continues as a capsule around the medial aspect of the joint.

Innervation

Innervation of the naviculocuneiform joint is provided by the deep fibular (dorsally), medial and lateral plantar nerves (plantar surface).

Muscles

Slight gliding and rotation occurs at this joint. These movements are produced by the action of the fibularis longus and brevis, tibialis anterior and tibialis posterior muscles. The long extensors and flexors of the toes also contribute to the production of these movements.

Cuboideonavicular joint

The cuboideonavicular joint is a syndesmosis that connects the cuboid and navicular bones.

This joint is stabilized by dorsal, plantar and interosseus ligaments.

The muscles that produce movement of this joint are the same as the naviculocuneiform joint.

Intercuneiform and cuneocuboid joints

The intercuneiform and cuneocuboid joints are synovial joints involving the cuneiform and cuboid bones.

Ligaments

The bones are connected together by dorsal, plantar and interosseus ligaments.

Both the dorsal and plantar ligaments consist of three transverse bands, which run between the cuneiform bones and between the lateral cuneiform and the cuboid bone. The interosseus ligaments connect non-articular surfaces of the bones.

Innervation

The innervation of these two joints is from the deep fibular nerve (dorsally), medial and lateral plantar nerves (plantar surface).

Muscles

The muscles that produce movement of these joints are the same as those for the the naviculocuneiform joint.

Tarsometatarsal joints

Metatarsal bones (inferior view)

The metatarsals form articulations with some of the tarsal bones of the foot to form the tarsometatarsal joints. The first metatarsal articulates with the medial cuneiform, the second with the intermediate cuneiform and the third metatarsal articulates with the lateral cuneiform. The lateral cuneiform also articulates with the fourth metatarsal and the cuboid bone forms articulations with both the fourth and fifth metatarsals.

Ligaments

There are three bands of ligaments involved in stabilising these joints:

  • The dorsal tarsometatarsal ligaments
  • The plantar tarsometatarsal ligaments and;
  • The interosseus cuneometatarsal ligaments

Eight dorsal tarsometatarsal ligaments connect the metatarsal bones to the cuboid and cuneiform bones. These ligaments form the following connections:

  • First metatarsal to the medial cuneiform
  • Second metatarsal to each cuneiform
  • Third metatarsal to the lateral cuneiform
  • Fourth metatarsal to the lateral cuneiform and cuboid
  • Fifth metatarsal to the cuboid

The plantar tarsometatarsal ligaments consist of both longitudinal and oblique bands.

The strongest of the three interosseus cuneometatarsal ligaments is the Lisfranc’s ligament. It runs from the second metatarsal to the lateral aspect of the medial cuneiform. The other two ligaments connect the lateral cuneiform with the second metatarsal and the lateral cuneiform with the base of the fourth metatarsal.

Innervation

The innervation of the tarsometatarsal joints is from the deep fibular nerve (dorsally), medial and lateral plantar nerves (plantar surface).

Muscles

Flexion and extension at the level of tarsometatarsal joints are produced by the short and long extensors and flexors of the toe.

Abduction and rotation can also occur at the first tarsometatarsal joint and are carried out by the tibialis anterior and fibularis longus muscles.

Intermetatarsal joints

The intermetatarsal joints are articulations formed between the metatarsal bones and are stabilized by intermetatarsal interosseus ligaments. These ligaments run between the lateral four metatarsal bones. Dorsal and plantar intermetatarsal ligaments are also involved in the stabilisation of this joint.

Metatarsophalangeal joints

The metatarsophalangeal joints are ellipsoid joints, which consist of articulations between the heads of the metatarsals and the bases of the proximal phalanges. On the plantar surface of the first metatarsal head, there are two longitudinal grooves separated by a ridge, the crista. These two grooves articulate with the two sesamoid bones within the joint capsule.

Metatarsophalangeal joints 3-5 (inferior view)

Ligaments

Ligaments of the metatarsophalangeal joints 3-5 (inferior view)

The sesamoid bones are connected together by the intersesamoid ligament. Other ligaments that stabilize the metatarsophalangeal joints include the:

  • Plantar ligaments
  • Deep transverse metatarsal ligaments
  • Collateral ligaments

The thick plantar ligaments lie between the collateral ligaments, are attached firmly to the phalangeal bases and loosely to the metatarsal heads. They blend with both the deep transverse metatarsal and collateral ligaments.

Four flat bands, the deep transverse metatarsal ligaments, unite the plantar ligaments and lie between the interossei and the lumbricals.

The collateral ligaments run from the dorsal tubercles of the metatarsal heads before widening and attaching to the bases of the proximal phalanges.

Innervation

The innervation of the metatarsophalangeal joints is provided by the plantar interdigital nerve, digital branches of the lateral plantar nerve, medial dorsal cutaneous branch of the superficial fibular nerve and the deep fibular nerve.

Muscles

The flexor digitorum brevis, lumbricals and interossei produce flexion at the lateral four metatarsophalangeal joints. Flexion of the hallux is produced by the action of flexor hallucis longus and brevis.

Extensor digitorum longus and brevis, as well as extensor hallucis longus are all involved in extension at the metatarsophalangeal joints.

Abduction is produced by the adductor hallucis and the plantar interossei, whilst adduction is carried out by the actions of abductor hallucis, the dorsal interossei and abductor digiti minimi.

Interphalangeal joints

The trochlear surface of the phalangeal heads articulates with the curved surface of the bases of the corresponding phalanges to form the interphalangeal joints. These hinge joints are stabilized by an articular capsule and two collateral ligaments.

Innervation

The innervation of the interphalangeal joints is from the plantar interdigital nerves and the medial dorsal cutaneous branch of the superficial fibular nerve. Occasionally, branches of the sural, deep fibular and intermediate dorsal cutaneous nerves innervate these joints.

Interphalangeal articulations of the foot (anterior view)

Muscles

Flexion is produced by flexor digitorum longus and brevis as well as by flexor hallucis longus in the hallux. Extensor digitorum longus and brevis, as well as extensor hallucis longus are involved in extension of the interphalangeal joints.

Now test your new knowledge on the joints and ligaments of the foot with our quiz!

Joints and ligaments of the foot: want to learn more about it?

Our engaging videos, interactive quizzes, in-depth articles and HD atlas are here to get you top results faster.

What do you prefer to learn with?

“I would honestly say that Kenhub cut my study time in half.” – Read more.

Kim Bengochea Kim Bengochea, Regis University, Denver
© Unless stated otherwise, all content, including illustrations are exclusive property of Kenhub GmbH, and are protected by German and international copyright laws. All rights reserved.

Register now and grab your free ultimate anatomy study guide!