The ankle (from the Latin clavicula, small key) is a part of the lower limb connecting the foot to the leg.

The ankle is the point of attachment between the horizontal axis of the foot and the vertical axis of the body.

Skeleton. The ankle is made up of several bones:

• Lower end of the tibia
• Lower end of the fibula, a bone in the leg also known as the fibula
• Upper end of talus, bone of the foot located on the calcaneus at the heel

Tallow-crurale articulation. It is considered the main ankle joint. It connects the talus and the tibiofibular mortise, a term designating the pinch area created by the junction of the tibia and the fibula (1).

Ligaments. Many ligaments connect the bones of the foot and those of the ankle:

• The anterior and posterior tibiofibular ligaments
• The lateral collateral ligament made up of 3 bundles: the calcaneofibular ligament and the anterior and posterior talofibular ligaments
• The medial collateral ligament consisting of the deltoid ligament and the anterior and posterior tibiotalar ligaments (2).

Muscles and tendons. Various muscles and tendons coming from the leg extend to the ankle. They are grouped into four distinct muscle compartments:

• The superficial posterior compartment comprising in particular the triceps sural muscle and the Achilles tendon
• The deep posterior compartment comprising the muscles of the posterior face of the tibia, the tendons of which run towards the inner face of the ankle
• The anterior compartment comprising the flexor muscles of the ankle
• The lateral compartment comprising the fibular brevis muscle and the fibular longus muscle

flexion. The ankle allows the dorsal flexion movement which corresponds to the approach of the dorsal face of the foot towards the anterior face of the leg (3).

Extension. The ankle allows the movement of extension or plantar flexion which consists in moving the dorsal face of the foot away from the anterior face of the leg (3).

Sprain. It corresponds to one or more ligament injuries occurring by extension of the external ligaments. The symptoms are pain and swelling in the ankle.

Tendinopathie. It is also known as tendonitis. The symptoms of this pathology are mainly pain in the tendon during exertion. The cause of these pathologies can be varied. Both intrinsic factors, such as genetic predispositions, as extrinsic, such as unsuitable practice of a sport, or the combination of several of these factors can be the cause (1).

Achilles tendon rupture. It is a tearing of tissue that causes the Achilles tendon to rupture. Symptoms are sudden pain and inability to walk. The origin is still poorly understood (4).

Physical treatment. Physical therapies, through specific exercise programs, are most often prescribed such as physiotherapy or physiotherapy.

Medical treatment. Depending on the condition and the pain perceived by the patient, painkillers may be prescribed. Anti-inflammatory drugs may be prescribed only if inflammation of the tendon is known.

Surgical treatment. Surgical treatment is usually performed when the Achilles tendon ruptures, and may also be prescribed in some cases of tendinopathy and sprains.

Physical examination. The diagnosis goes first of all by a clinical examination to note the superficial state of the ankle, the possibility of movement or not, and the pain perceived by the patient.

Medical imaging exam. To confirm a pathology, a medical imaging examination may be performed such as an x-ray, an ultrasound, a scintigraphy or an MRI.

In certain disciplines such as dance or gymnastics, athletes seek to develop hypermobility of the joints, which can be acquired through specific training. However, this hypermobility can have negative effects. Still poorly understood and diagnosed late, ligament hyperlaxity makes joints unstable, making them extremely fragile (5).