The ankle is an important joint to understand in the context of dance because it is the connection between the leg and the foot that establishes lower extremity stability. Its function coordinates with the leg and foot and, thus, it is crucial to the dancers ability to perform. Furthermore, the ankle is one of the most commonly injured body regions in dance. An understanding of ankle anatomy and biomechanics is not only important for healthcare providers working with dancers, but for dance scientists, dance instructors, and dancers themselves. The bony architecture, the soft tissue restraints, and the locomotive structures all integrate to allow the athletic artistry of dance. Yet, there is still much research to be carried out in order to more completely understand the ankle of the dancer.
Get full access to this article
View all access options for this article.
References
1.
FongDT-P, HongY, ChanL-K, YungPS-H, ChanK-M. A systematic review on ankle injury and ankle sprain in sports. Sports Med.2007;37(1):73–94.
2.
HootmanJM, DickR, AgelJ. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train.2007;42(2):311–9.
3.
NilssonC, LeandersonJ, WykmanA, StrenderL. The injury panorama in a Swedish professional ballet company. Knee Surg Sports Traumatol Arthrosc.2001;9(4):242–6.
4.
RovereCD, WebbLX, CristinaAG, VogelJM. Musculoskeletal injuries in theatrical dance students. Am J Sports Med.1983; 11 (4): 195–8.
5.
WashingtonEL. Musculoskeletal injuries in theatrical dancers: site, frequency, and severity. Am J Sports Med.1978;6(2):75–98.
6.
GarrickJG, RequaR. Ballet injuries: an analysis of epidemiology and financial outcome. Am J Sports Med.1993;21(4):586–90.
7.
HamiltonWG. Sprained ankles in ballet dancers. Foot Ankle.1982;3(2):99–102.
8.
HamiltonWG. Stenosing tenosynovitis of the flexor hallucis longus tendon and posterior impingement upon the os trigonum in ballet dancers. Foot Ankle.1982;3(2):74–80.
9.
HamiltonWG. Foot and ankle injuries in dancers. Clin Sports Med.1988;7(1):143–73.
10.
HamiltonWG, GeppertMJ, ThompsonFM. Pain in the posterior aspect of the ankle in dancers: differential diagnosis and operative treatment. J Bone Joint Surg Am.1996;78(10):1491–500.
11.
FittSS. Dance Kinesiology (2nd ed). New York: Schirmer Books, 1996.
12.
KoutedakisYJamurtasA. The dancer as a performing athlete. Sports Med.2004;34(10):651–61.
13.
StretanskiME. Classical ballet: the full contact sport. Am J Phys Med Rehabil.2002;81(5):392–3.
14.
StretanskiMF. Medical and rehabilitation issues in classical ballet. Am J Phys Med Rehabil.2002;81(5):383–91.
15.
ContiSF, WongYS. Foot and ankle injuries in the dancer. J Dance Med Sci.2001;5(2):43–50.
16.
BronnerS, OjofeitimiS, RoseD. Injuries in amodern dance company: effect of comprehensive management on injury incidence and time loss. Am J Sports Med.2003;31(3):365–73.
BarnettCH, NapierJR. The axis of rotation at the ankle joint in man: its influence upon the form of the talus and the mobility of the fibula. J Anat.1952;86(1):1–9.
29.
HicksJH. The mechanics of the foot. I. The joints. J Anat.1953;87(4):345–57.
30.
LundbergA. Kinematics of the ankle and foot: in vivo roentgen stereopho-togrammetry. Acta Orthop Scand.1989;60 (Supp 1233):1–24.
31.
LundbergA, GoldieI, KalinB, SelvikG. Kinematics of the ankle/foot complex: plantar flexion and dorsiflexion. Foot Ankle.1989;9(4):194–200.
32.
LundbergA, SvenssonOK, NémethG, SelvikG. The axis of rotation of the ankle joint. J Bone Joint Surg Br.1989;71:94–9.
33.
SammarcoGJ, BursteinAH, FrankelVH. Biomechanics of the ankle: a kinematic study. Orthop Clin N Am.1973;4 (1): 75–96.
34.
StiehlJB. Anthropomorphic studies of the ankle joint. In: StiehlJB (ed): Inman's Joints of the Ankle (2nd ed). Baltimore: Williams and Wilkins, 1991, pp. 1–6.
35.
SarrafianSK. Anatomy of the Foot and Ankle: Descriptive, Topographic, Functional (2nd ed). Philadelphia: J.B. Lippincott Company, 1993.
SammarcoGJ, TablanteEB. Foot and ankle in dance. In: SataloffRT, BrandfonbrenerAG, LedermanRJ (eds): Performing Arts Medicine (2nd ed). San Diego USA: Singular Publishing Group, 1998, pp. 301–320.
38.
JohnsonJE. Functional morphology of the trochlea. In: StiehlJB (ed): Inman's Joints of the Ankle (2nd ed). Baltimore: Williams and Wilkins, 1991, pp. 7–13.
39.
SammarcoGJ, HockenburyRT. Biomechanics of the foot and ankle. In: NordinM, FrankelVH, eds. Basic Biomechanics of the Musculoskeletal System (3rd ed). Philadelphia: Lippincott Williams & Wilkins, 2001, pp. 222–255.
40.
SinghAK, StarkweatherKD, HollisterAM, JatanaS, LupichukAG. Kinematics of the ankle: a hinge axis model. Foot Ankle.1992;13(8):439–46.
41.
LoganBM, SinghD, HutchingsRT. McMinn's Color Atlas of Foot and Ankle Anatomy (3rd ed). Philadelphia: Mosby, 2004.
42.
BonninJG. Injuries to the Ankle (facsimile of the 1950 edition). Darien, CT, USA: Hafner Publishing Co., 1970.
43.
SieglerS, BlockJ, SchneckCD. The mechanical characteristics of the collateral ligaments of the human ankle joint. Foot Ankle.1988;8(5):234–42.
44.
AttarianDE, McCrackinHJ, DeVitoDP, McElhaneyJH, GarrettWEJr. Biomechanical characteristics of human ankle ligaments. Foot Ankle.1985;6(2):54–8.
45.
AndersonKJ, LeCocqJF. Operative treatment of the injury to the fibular collateral ligament of the ankle. J Bone Joint Surg Am.1954;36(4):825–32.
46.
FerranNA, MaffulliN. Epidemiology of sprains of the lateral ankle ligament complex. Foot Ankle Clin N Am.2006;11(3):659–62.
47.
MakhaniJS. Lacerations of the lateral ligaments of the ankle. J Int Coll Surg.1962;38(5):454–66.
48.
StiehlJB. Biomechanics of the ankle joint. In: StiehlJB (ed): Inman's Joints of the Ankle (2nd ed). Baltimore: Williams and Wilkins, 1991, pp. 39–63.
49.
BartoníčekJ. Anatomy of the tibiofibular syndesmosis and its clinical relevance. Surg Radiol Anat.2003;25:379–86.
50.
BahrRPenaF, ShineJ, LewWD, EngebretsenL. Ligament force and joint motion in the intact ankle: a cadaveric study. Knee Surg Sports Traumatol Arthrosc.1998;6:115–21.
51.
RenstromP, WertzM, IncavoS, . Strain in the lateral ligaments of the ankle. Foot Ankle.1988;9(2):59–63.
52.
ColvilleMR, MarderRA, BoyleJJ, ZarinsB. Strain measurement in lateral ankle ligaments. Am J Sports Med.1990;18(2):196–200.
53.
NiggBM, SkarvanG, FrankCB, YeadonMR. Elongation and forces of ankle ligaments in a physiological range of motion. Foot Ankle.1990;11(1):30–40.
54.
CawleyPW, FranceER. Biomechanics of the lateral ligaments of the ankle: an evaluation of the effects of axial load and single plane motions on ligament strain patterns. Foot Ankle.1991;12(2):92–9.
55.
DonatelliRA. Normal anatomy and biomechanics. In: DonatelliRA (ed): The Biomechanics of the Foot and Ankle (2nd ed). Philadelphia: FA. Davis, 1996, pp. 3–33.
56.
WeseleyMS, KovalRKleigerB. Roentgen measurement of ankle flexion-extension motion. Clin Orthop.1969;65:167–74.
57.
ReeseNB, BandyWD. Joint Range of Motion and Muscle Length Testing.Philadelphia: WB. Saunders, 2002.
58.
NovellaTM. Simple techniques for quantifying choreographically essential foot and ankle extents of motion. J Dance Med Sci.2004;8(4):118–22.
59.
KitaokaHB, AlexanderIJ, AdelaarRS, . Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int.1994;15(7):349–53.
60.
BackerM, KofoedH. Weight-bearing and non-weightbearing ankle joint mobility. Med Sci Res.1987;15:1309–10.
61.
BackerM, KofoedH. Passive ankle mobility: clinical measurement compared with radiography. J Bone Joint Surg Br.1989;71(4):696–8.
62.
HamiltonWG. A profile of the musculoskeletal characteristics of elite professional ballet dancers. Am J Sports Med.1992;20(3):267–73.
63.
WeislerER, HunterDM, MartinDF, CurlWW, HoenH. Ankle flexibility and injury patterns in dancers. Am J Sports Med.1996;24(6):754–7.
64.
NovellaTM. An easy way to quantify plantarflexion in the ankle. J Back Musculoskel Rehabil.1995;5:191–9.
65.
LinC-F, SuF-C, WuH-W. Ankle biomechanics of ballet dancers in relevé en pointé dance. Res Sports Med.2005;13:23–35.
66.
DaselerEH, AnsonBJ. The plantaris muscle: an anatomical study of 750 specimens. J Bone Joint Surg Am.1943;25(4):822–7.
67.
JoshiSD, JoshiSS, AthavaleSA. Morphology of peroneus tertius muscle. Clin Anat.2006;19(7):611–4.
68.
TrepmanE, GellmanRE, SolomonR, . Electromyographic analysis of standing posture and demi-plié in ballet and modern dancers. Med Sci Sports Exerc.1994;26(6):771–82.
69.
TrepmanE, GellmanRE, MicheliLJ, De LucaCJ. Electromyographic analysis of grand-plié in ballet and modern dancers. Med Sci Sports Exerc.1998;30(12):1707–20.
70.
LawsK. Physics and the Art of Dance: Understanding Movement.New York: Oxford University Press, 2002.
71.
StormontDM, MorreyBF, AnK-N, CassJR. Stability of the loaded ankle: Relation between articular restraint and primary and secondary static restraints. Am J Sports Med.1985;13(5):295–300.
72.
MacintyreJ, JoyEA. Foot and ankle injuries in dance. Clin Sports Med.2000;19(2):351–68.
73.
ShahS, LuftmanJ, VigilDV. Stress injury of the talar dome and body in a ballerina: a case report. J Dance Med Sci.2005;9(3):91–5.
74.
BrownTD, MicheliLJ. Foot and ankle injuries in dance. Am J Orthop.2004;33(6):303–9.
75.
KleigerB. Anterior tibiotalar impingement syndromes in dancers. Foot Ankle.1982;3(2):69–73.
76.
O'DonoghueDH. Impingement exostoses of the talus and tibia. J Bone Joint Surg Am.1957;39(4):835–52.
77.
ChristmanRA. The normal foot and ankle. In: ChristmanRA (ed): Foot and Ankle Radiology.St. Louis: Churchill Livingstone, 2003, pp. 130–42.
