발목 주변 근육 정리

[이영호]

1. 발목의 구조

http://cafe.daum.net/panicbird/OUdz/33

2. 발목의 운동

dorsiflexion 20도, plantar flexion 40~45도

거골하 관절  inversion 20도, eversion 10도

3. 발목의 근육

 1) Tibialis anterior

Tibialis anterior
Details
Origin	Upper 1/2 & Lateral Condyle of Tibia
Insertion	medial cuneiform and first metatarsal bones of the foot
Artery	anterior tibial artery
Nerve	Deep Fibular (peroneal) nerve (L5)
Actions	Dorsiflexion and Inversion of the foot
Antagonist	Fibularis longus, Gastrocnemius, Soleus, Plantaris, Tibialis posterior

2) Tibialis posterior
Details
Latin	Musculus tibialis posterior
Origin	Tibia and fibula
Insertion	Navicular and medial cuneiform bone
Artery	Posterior tibial artery
Nerve	Tibial nerve
Actions	Inversion of the foot and plantar flexion of the foot at the ankle
Antagonist	Fibularis brevis

3) soleus

Details
Latin	Musculus soleus
Origin	fibula, medial border of tibia (soleal line)
Insertion	tendo calcaneus
Artery	sural arteries
Nerve	tibial nerve, specifically, nerve roots L5–S2
Actions	plantarflexion
Antagonist	tibialis anterior

4) extensor hallucis longus

Details
Latin	musculus extensor hallucis longus
Origin	Arises from the middle portion of the fibula on the anterior surface and the interosseous membrane
Insertion	Inserts on the dorsal side of the base of the distal phalanx of the big toe
Artery	anterior tibial artery
Nerve	deep fibular nerve deep peroneal nerve, L5 (L4-S1)
Actions	Extends the big toe and assists in dorsiflexion of the foot at the ankle. Also is a weak evertor/ invertor
Antagonist	Flexor hallucis longus, Flexor hallucis brevis

5) extensor digitorum longus

Details
Latin	musculus extensor digitorum longus
Origin	Anterior lateral condyle of tibia, anterior shaft of fibula and superior 3⁄4 of interosseous membrane
Insertion	Dorsal surface; middle and distal phalanges of lateral four digits
Artery	anterior tibial artery
Nerve	deep fibular nerve
Actions	extension of toes and dorsiflexion of ankle
Antagonist	Flexor digitorum longus, Flexor digitorum brevis

6) flexor hallucis longus

Details
Latin	Musculus flexor hallucis longus
Origin	fibula, posterior aspect of middle 1/3
Insertion	Plantar surface; base of distal phalanx of hallux
Artery	Peroneal artery (peroneal branch of the posterior tibial artery)
Nerve	tibial nerve, S1 & S2 nerve roots
Actions	flexes all joints of the big toe, plantar flexion of the ankle joint
Antagonist	Extensor hallucis longus muscle

7) flexor digitorum longus

Details
Latin	Musculus flexor digitorum longus
Origin	Posterior surface of the body of the tibia
Insertion	Plantar surface; base of the distal phalanges of the four lesser toes
Artery	posterior tibial artery
Nerve	Tibial nerve
Actions	Primary action is Flex digits
Antagonist	Extensor digitorum longus, Extensor digitorum brevis

8) fibularis longus

Details
Latin	Musculus peronaeus longus, musculus fibularis longus
Origin	Upper lateral shaft of fibula[1]
Insertion	first metatarsal, medial cuneiform[1]
Artery	fibular (peroneal) artery
Nerve	Superficial fibular (peroneal) nerve[1]
Actions	plantarflexion, eversion, support arches[1]
Antagonist	Tibialis anterior muscle

9) fibularis brevis

Details
Latin	Musculus fibularis brevis, musculus peronaeus brevis
Origin	Lower two-thirds of lateral fibula
Insertion	Fifth metatarsal
Artery	Fibular artery (peroneal artery)
Nerve	Superficial fibular nerve
Actions	Plantarflexion, eversion

10) fibularis tertius

Details
Latin	Musculus peronaeus tertius, musculus fibularis tertius
Origin	distal anterior surface of the fibula also the interosseous membrane
Insertion	dorsal surface of metatarsal 5
Artery	anterior tibial artery
Nerve	deep fibular nerve
Actions	dorsiflexion and eversion of the foot

11) extensor hallucis brevis

Details
Latin	musculus extensor hallucis brevis
Origin	calcaneus
Insertion	proximal phalanx of digit 1 (hallux, or the great toe)
Artery	dorsalis pedis artery
Nerve	deep fibular nerve
Actions	Extend hallux
Antagonist	Flexor hallucis brevis muscle

12) extensor digitorum brevis

Details
Latin	Musculus extensor digitorum brevis
Origin	Dorsal surface of calcaneus
Insertion	Proximal dorsal region of middle phalanges 2, 3 and 4
Artery	Dorsalis pedis artery
Nerve	Deep fibular nerve
Actions	Extends digits 2 through 4
Antagonist	Flexor digitorum longus, Flexor digitorum brevis

13) plantar muscle

Plantar	1st layer abductor hallucis flexor digitorum brevis abductor digiti minimi 2nd layer quadratus plantae lumbrical muscle 3rd layer flexor hallucis brevis adductor hallucis flexor digiti minimi brevis 4th layer dorsal interossei plantar interossei

4. 발목의 흔한 질환

http://cafe.daum.net/panicbird/OUdz/38

5. 근막이완

 1) 롤핑

     http://cafe.daum.net/panicbird/OJs0/281

 2) CMP건

    - http://cafe.daum.net/panicbird/Qibc/88

    - http://cafe.daum.net/panicbird/Qibc/89

 3) 폼롤러를 이용한 근막이완.....

6. 주요 근육 스트레칭 

1) 스트레칭 기본개념

*** 각 동작은 5초씩 3회가 기본(7초가 넘어가면 보상기전이 발생하므로)

*** 모든 동작은 다음 동작을 위한 예비동작 임, 건너 뛰지 말 것

 http://cafe.daum.net/panicbird/QtNi/299

2) Tibialis anterior, Extensor Halucis Longus and Extensor Digitorum Longus)

3) Tibialis posterior, soleus, Flexor Hallucis Longus and Flexor Digitorum Longus

  Tibialis posterior                                                       soleus

3) fibularis longus & brevis

4) plantar muscle

7. 관절가동  

1) 총괄

 http://cafe.daum.net/panicbird/OUdz/3

2) distal tibilfibular joint의 기능부전시 관절가동기법

 https://youtu.be/mw-B9E7Hxcw

3) ankle joint 견인기법 

https://youtu.be/3Q5Jh35psOA

4) proximal tibilfibular joint 전후방 활주기법

https://youtu.be/HA4tGb0Wc4s

5) 발목 관절 안정성의 핵심(ankle heel lock)

http://cafe.daum.net/panicbird/OUdz/5

8. 인대 약침, 가열식 화침

 http://cafe.daum.net/panicbird/RNu8/21

9. stabilizing ex.

 가. 배측 굴곡

나. 저측 굴곡

다. 내번

라. 외번

10. 근력 불균형 검사

1)근력 검사의 고려사항

http://cafe.daum.net/panicbird/QzZ4/15

2) 내번

3) 족저굴곡

4) 장단비골근

11. isolation ex.

 가. Tibialis posterior ex.

 나. short foot ex.

12. functional ex.
 가. 한다리 서기 15초 3번

나. balance ex.

 다. 발 앞꿈치로 걷기, 뒤꿈치로 걷기

13. 정렬운동

 여러 운동 참조......

14. 행동수정

 가. 손상 직후 뜨거운 목욕이나 음주, 특히 과도한 체중 부하 또는 운동금지
 나. 초기에는 내번-외번 운동제한

[문형철]

드디어 큰 그림을 이해하기 시작하고 정리가 시작되었구나 !!

굿잡 ㅎㅎㅎ