Many of us remember lyrics to a children’s song about connecting bones. We may not recall that it’s called “Dem Bones” or that it originated as a spiritual song, but we probably can recite at least some of the lyrics:
“The foot bone connected to the heel bone.
“The heel bone connected to the ankle bone.
“The ankle bone connected to the shin bone.
“The shin bone connected to the knee bone.
“Now shake dem skeleton bones.”
The order of connected bones plays an important medical role for the body’s lower extremities, with the ankle right in the middle of the action. As a result, associated physical problems can be more than ankle deep, according to Dr. Elizabeth Barnica of Mercy Clinic Podiatry in Carthage and Joplin, which also has podiatrist Dr. Jared Stanton.
Dr. Barnica pointed out that knee, ankle and foot problems can affect each other, so it’s important to make sure they’re structurally aligned. If not, it could mean a visit to an orthopedic surgeon in addition to a podiatrist like her or Dr. Stanton.
Chronic ankle conditions can result from a variety of foot structure issues such as flat feet, where the arch collapses and places enough stress on the ankle that it can slip out of joint and become dislocated. Knee problems also can affect feet and ultimately ankles.
Tendons around the ankle connect to muscles in the leg and help the foot function. These tendons are prone to tendinitis and tears. Nerve pain also can affect the ankle.
“In my experience, the calf muscle is tight in most adults,” she said. “If your calf muscle is tight, you tend to overcompensate with other motions that can affect the heel, Achilles tendon and knee because the calf muscle complex spans across three joints.”
A tight calf muscle can affect walking, Dr. Barnica said.
“A person’s gait is supposed to be heel-toe. If toes aren’t pulled up enough for the heel to hit the ground first, the body will try to compensate for the reduced motion by hyperextending the knee and putting weight on the inside of the foot, called pronating.”
The result can be knee instability and/or plantar fasciitis, an inflammation of a thick band of tissue that connects the heel bone to the toes.
Prevention to help avoid those conditions includes proper stretching, particularly for calf muscles, and regular exercise, according to Dr. Barnica.
Referrals are not required to make an appointment with Dr. Barnica, but some insurance coverage requires a referral for specialists.