Precise knowledge of clinical anatomy and kinesiology, and orthopedic/myofascial palpation and inspection, and movement analysis skills, are all essential foundations for diagnosis, and for determining where--and where not--to needle.

This unique class prepares students to get the most from the Calf, Ankle Foot module & Review/Practicum Lab.

Clinical anatomy and the jing-jin ("sinew meridians" or myofascial tracts)

• We will improve our abilities to accurately locate key bony landmarks, muscles, tendons, joints, neural and vascular tissues, through palpation on ourselves and each other, and through review of clinical anatomy.
• Through palpation, observation and movement exercises, we will explore functions of key muscles and their jing-jin associations, as well as functional vs. dysfunctional movement patterns.
• We will review safety considerations, including needling angle and depth, to avoid injuring the many critical structures in this body region.

Enhanced orthopedic palpation and inspection skills

• We will enhance our abilities to feel different tissue types and layers: skin, fascia, muscle, nerve, blood vessel, and bone, with both our hands and needle-tip sensation.
• We will practice inspection and palpation for tissue abnormalities including myofascial trigger points, tendinopathies and joint disorders.

Review of anatomical structure and kinesiologic function

Calf and Ankle

• Bony landmarks: be able to locate by palpation, if possible; know which muscles attach to them, if applicable
  • Tibial condyles
  • Fibular head
  • Malleoli
    • Tibial
    • Fibular
  • Calcaneus
  • Talus
    • Sustentaculum tali and tarsal tunnel (know contents)
• Joints: be able to find the joint lines and ligaments by palpation
  • Tibio-fibular joints
    • Superior
    • Inferior (syndesmosis)
  • Calcaneo-fibular joint and ligament
  • Talo-fibular joint and ligaments
    • Anterior talo-fibular ligament
    • Posterior talo-fibular ligament
    • Sinus tarsi
  • Tibio-talar joint and deltoid ligament

• Myofascial structures that move and stabilize the ankle. Be able to locate by palpation, if possible; know compartments, attachments and primary functions

• • Ankle plantar flexors
    • Superficial posterior compartment
      • Gastrocnemius: medial and lateral heads
      • Soleus
      • Achilles tendon
      • Plantaris muscle and tendon
    • Deep posterior compartment (also invertors)
      • Tibialis posterior
      • Flexor hallucis longus
      • Flexor digitorum longus
  • Ankle evertors/lateral compartment: fibularis (aka peroneal) group
    • Longus
    • Brevis
    • Tertius
  • Ankle extensors/dorsiflexors/anterior compartment
    • Anterior compartment
      • Tibialis anterior
      • Extensor hallucis longus
      • Extensor digitorum longus
      • (Fibularis tertius)

• Neurovascular tracts and critical structures. Know pathways and distributions; be able to locate by palpation where superficial

• • Popliteal artery
  • Deep saphenous vein
  • Tibial nerve
  • Sural nerve
  • Saphenous nerve
  • Peroneal nerves
    • Common
    • Superficial
    • Deep

Foot

• Bony landmarks: be able to locate by palpation; know which muscles attach to them, if applicable
  • Hindfoot
    • Calcaneus
    • Talus
  • Midfoot
    • Navicular
    • Cuneiforms
    • Cuboid
  • Forefoot
    • Metatarsals
    • Phalanges
    • 1st ray sesamoid
• Joints: be able to find the joint lines and ligaments by palpation
  • Plantar calcaneonavicular or “spring” ligament
  • Calcaneocuboid joint
  • Lisfranc/mid-foot joint
  • Toes
    • 5th metatarsal base
    • Metatarso-phalangeal joints
    • Proximal interphalangeal joints
    • Distal interphalangeal joints

• Myofascial structures that move and stabilize the foot. Be able to locate by palpation; know attachments and primary functions

• • Abductor hallucis
  • Adductor hallucis
  • Flexor hallucis brevis
  • Abductor digiti minimi