304 Dance Anatomy and Kinesiology
horizontally anteriorly from the lateral (fibular) mal-
leolus to the lateral talus and limits anterior move-
ment of the talus relative to the fibula, or posterior
movement of the fibula relative to the talus. It also
can limit adduction and inversion of the foot, espe-
cially when the foot is plantar flexed. The posterior
talofibular ligament (PTFL) is directed posteriorly
from the posterior portion of the lateral malleolus
to the talus and prevents excessive posterior slippage
of the talus on the fibula or anterior slippage of the
fibula on the talus. The calcaneofibular ligament
runs downward and slightly backward from the distal
end of the lateral malleolus to attach onto the lateral
aspect of the calcaneus. It spans both the ankle joint
and subtalar joint and is very important for prevent-
ing inversion and adduction of the foot when the
foot is dorsiflexed (Hintermann, 1999).
As a whole, the lateral collateral ligaments are
important in coupling movements between the tibia
and foot, particularly eversion of the foot and inter-
nal rotation of the tibia. They are also very vital for
lateral ankle stability and, more specifically, for pre-
venting excessive inversion of the foot. Their rela-
tive contribution appears to shift with the position
of the foot, such that the PTFL and calcaneofibular
ligament are taut and provide primary stability in
ankle-foot dorsiflexion, while the ATFL becomes
taut and is particularly responsible for providing
stability in plantar flexion. With the frequent use
of plantar flexion in dance and the fact that this is
the weakest of the lateral collateral ligaments, it is
not surprising that the ATFL is commonly injured
in dancers. These lateral ligaments are so essential
for ankle stability that when they are seriously
or repeatedly injured, the ankle often becomes
chronically unstable (see Ankle Sprains on p. 360
for more information), and abnormal movement
may be present when manual stress tests are per-
formed by a physician (see Tests and Measurements
6.1) (Malone and Hardaker, 1990; Sammarco and
Tablante, 1997).Spring Ligament
The subtalar joint also has its own joint capsule and
additional ligaments, including the spring ligament
and interosseous talocalcaneal ligaments, that pro-
vide additional stability. The spring ligament (plantar
calcaneonavicular ligament) shown in figure 6.5 is a
broad ligament that spans between the sustentacu-
lum tali of the calcaneus and the undersurface of the
navicular. It forms a taut sling under the head of
the talus, thereby helping to support the weight of the
body received by the talus and to maintain the medial
longitudinal arch. Permanent stretching of this liga-ment is believed to contribute to a lowered medial
longitudinal arch and a “flatfoot.”
The tarsal tunnel, formed by a concave groove
(sulcus) in the inferior talus and superior calca-
neus, runs from the medial to the lateral sides of
the ankle and is filled with short and strong bands
called the interosseous talocalcaneal ligaments (L.
inter, between + os, bone). These ligaments function
to bind these bones together and contain abundant
neural receptors that are believed to be important
for the quick responses necessary for maintaining
balance and helping to prevent injuries such as ankle
sprains (Smith, Weiss, and Lehmkuhl, 1996).Transverse Tarsal Joint
Classification and MovementsThe transverse tarsal joint lies just in front of the
talus and calcaneus and forms a shallow “S” when
viewed from above (figure 6.3). The transverse tarsal
joint is actually a combination of the talonavicular
(between the talus and navicular) and calcaneocu-
boid (between the calcaneus and cuboid) joints. The
talonavicular is generally classified as a modified
ball-and-socket joint, while the calcaneocuboid is
classified as a gliding joint (Hamilton and Luttgens,
2002; Moore and Dalley, 1999) or saddle joint (Hall-
Craggs, 1985; Magee, 1997). Although the shape of
each joint by itself would tend to allow more free
motion, the navicular and cuboid bones articulate
with each other in a manner that allows very little
motion between them and hence restricts overall
motion and makes both joints act functionally as a
single segment. Together, these joints allow inver-
sion-eversion and lesser degrees of plantar flexion-
dorsiflexion and abduction-adduction.
These movements at the transverse tarsal joint
can be used to provide additional range to the same
movements of the rearfoot or to move the forefoot
in a direction opposite to that of the rearfoot. An
example of the former occurs when plantar flexion
of the transverse tarsal joint is added to that of the
subtalar joint and ankle joint to allow the dancer to
“point” the foot further. An example of the latter
occurs with walking, where transverse tarsal inver-
sion can be used to keep the lateral forefoot from
rising off the ground when eversion of the subtalar
joint and internal rotation of the tibia are occurring.
However, this ability to counterrotate the forefoot
is greater when the rearfoot everts and dramatically
diminishes as the subtalar joint inverts. Hence, when
extreme inversion of the foot occurs such as when
one steps wrong off of a curb or lands wrong from
a jump, the forefoot has limited ability to counter-