Massage.
LandmarkLegDraft

Medial malleolus

The bony bump on the inner side of the ankle, formed by the lower end of the tibia.

BoneTibia
RegionLeg

Find it

  1. Client supine or prone.
  2. Place your fingers on the inner ankle: the large, rounded bump is the medial malleolus.
  3. Trace the groove behind it and ask the client to point the foot and turn the sole inward: the tendons of tibialis posterior and flexor digitorum longus tighten in the groove.
  4. Keep pressure light behind the malleolus, where the posterior tibial artery and tibial nerve pass.

No muscle attaches to the medial malleolus itself; it anchors the deltoid ligament of the ankle. Tendons of tibialis posterior, flexor digitorum longus and flexor hallucis longus pass behind it into the foot.

The great saphenous vein runs just in front of it, another reason for light, broad strokes around the ankle.

Muscles attaching or palpated here

  • Extensor hallucis longus — Thin muscle on the front of the lower leg, partly hidden by its neighbours, that lifts the big toe and helps lift the foot.
  • Flexor digitorum longus — Deep muscle on the inner back of the leg that curls the four small toes and helps point the foot.
  • Flexor hallucis longus — Deep muscle on the outer back of the leg that bends the big toe and gives the push-off in walking, running and rising onto the toes.
  • Soleus — Broad, flat calf muscle lying under the gastrocnemius that points the foot and keeps the body from tipping forward when standing.
  • Tibialis anterior — Long muscle beside the shin bone that lifts the foot up (dorsiflexion) and turns the sole inwards (inversion).
  • Tibialis posterior — The deepest muscle at the back of the leg; it turns the sole inwards, helps point the foot and is a major support for the inner arch.

Sources

  1. Wikipedia: Malleolus
  2. Gray's Anatomy (1918), The Tibia (Bartleby, archived)