75 Review Article Jefrey A. Russell, M.S., A.T.C., is from the University of Wolverhampton School of Sport, Performing Arts and Leisure, Walsall, United Kingdom. Islay McEwan, M.Sc., M.C.S.P., is from Manchester Metropolitan University, United Kingdom. Yiannis Koutedakis, Ph.D., is from the Department of Sport and Exercise Sciences, hessaly University, Trikala, Greece; and the School of Sport, Performing Arts and Leisure, Wolverhampton University, United Kingdom. Matthew A. Wyon, Ph.D., is from the University of Wolverhampton School of Sport, Performing Arts and Leisure, Walsall, United Kingdom. Correspondence: Jefrey A. Russell, M.S., A.T.C., University of Wolverhampton School of Sport, Performing Arts and Leisure, Gorway Road, Walsall WS1 3BD, United Kingdom; jrussell@kardia.org. Abstract he ankle is an important joint to un- derstand in the context of dance because it is the connection between the leg and the foot that establishes lower extremity stability. Its function coordinates with the leg and foot and, thus, it is crucial to the dancer’s ability to perform. Fur- thermore, the ankle is one of the most commonly injured body regions in dance. An understanding of ankle anatomy and biomechanics is not only important for healthcare providers working with danc- ers, but for dance scientists, dance instruc- tors, and dancers themselves. he bony architecture, the soft tissue restraints, and the locomotive structures all integrate to allow the athletic artistry of dance. Yet, there is still much research to be carried out in order to more completely under- stand the ankle of the dancer. A nkle injuries account for a large percentage of all musculosk- eletal conditions sufered by participants in a variety of physical activities, 1 and are the most common of all injuries in many sports. 2 Some athletic activities require extremes of ankle motion (e.g., soccer and gymnastics). However, classical ballet alone necessitates the combination of moving the ankle into absolutely maximum dorsilexion (when a balle- rina stands in the demi-plié position) and into absolutely maximum plantar lexion (when she stands in the en pointe position). he very nature of these positions and the repetition with which they are practiced predispose the classical ballet dancer to a host of potential musculoskeletal stresses in the ankle. 3-10 Dancers clearly are athletes, 11-14 sustain extreme physical stresses like athletes, 15 and experience high injury rates during dance participation. 3-6,16-25 Various studies place the incidence of ankle injuries between 4.7% and 54% of all injuries sufered by danc- ers. 3-5,18,20,21 his review article presents the anatomical and biomechanical principles of the ankle that are relevant to clinicians, scientists, and educators who work with dancers. Normal Joint Anatomy and Mechanics Normal Bony Anatomy he ankle, or talocrural joint, is a trochoid synovial joint. hough it is often considered a hinge, or gingly- mus joint, 26,27 several authors indicate that its axis is more complicated than a simple uniaxial hinge. 28-33 he distal tibia and ibula form the joint’s box- like mortise; this is an area rather than a speciic anatomical structure. he three articular surfaces of the ankle mortise are: 1. Medial: the lateral portion of the medial malleolus, 2. Superior: the tibial plafon and, 3. Lateral: the medial surface of the lateral malleolus. The mortise contains the superior portion of the talus. his includes its articular surface, which is also called the trochlea, or dome. he talar troch- lea is wedge-shaped when viewed from the superior direction. 34-36 It is usually more narrow posteriorly than anteri- orly, 37 although Barnett and Napier reported that a number of their talar specimens exhibited parallel sides (i.e., the anterior and posterior trochlear widths were equal). 28 he talar dome sometimes is de- scribed as a truncated cone lying side- ways, with the smaller circumference forming the medial edge of the dome and the larger circumference forming the lateral edge. 38 Barnett and Napier suggested that the articular surface of the talus is even more complex. hey Clinical Anatomy and Biomechanics of the Ankle in Dance Jefrey A. Russell, M.S., A.T.C., Islay McEwan, M.Sc., M.C.S.P., Yiannis Koutedakis, Ph.D., and Matthew A. Wyon, Ph.D., Proofs to: jrussell@kardia.org