Anatomical Confusion and a Mysterious Injury

By Ben Benjamin, PhD
May 29, 2009

Anatomical Confusion and a Mysterious Injury

By Ben Benjamin, PhD
May 29, 2009

True or False: The terms "cruciate crural ligament" and "extensor retinaculum" refer to the same structure in the foot.

Answer: True.

Various anatomical structures in the body go by several names, depending on the text you are using. This can be confusing, but it's a fact of anatomical study.

True or False: The extensor retinaculum is the primary injured structure in most sprained ankles, and is frequently missed as a cause of ankle pain.

Answer: False.

The extensor retinaculum is not the primary structure that is injured in most sprained ankles. However, when a serious sprain occurs, it is one of the structures frequently injured, and it is true that this injury is often missed and goes untreated.

The extensor retinaculum looks like a bracelet draped around the foot. There are actually two of them in the ankle; they hold the extensor tendons of the foot in place as we dorsiflex our toes and feet. If the retinaculum were not there, all of our extensor tendons of the toes, our anterior tibialis tendon and others would pop off of the foot each time we brought our toes back toward our nose. On the underside of the retinaculum are little channels of tissue, one for each tendon, through which the tendons slide as they are held in place. A pretty ingenious arrangement, if I do say so.

When we get a serious ankle sprain, or if we fall over on the ankle or bang it, a small tear may appear in the extensor retinaculum. We may feel pain when we tie our shoes, when we touch the top of the foot, or if we plantar flex the foot.

If the extensor retinaculum becomes injured, daily gentle movement of the ankle and toes are needed to prevent the formation of unwanted adhesive scar tissue. Transverse massage or friction therapy are effective methods of treatment for this condition.