The ankle is an excellent example of interplay between bone and ligamentous structures and their protective relationship upon one another. The ankle joint is maintained by the shape of the talus (first bone of the foot) and its tight fit between the tibia and fibula. In the neutral position, there are strong bony constraints. With increasing plantar flexion, the bony constraints are decreased and the ligaments are more susceptible to strain and injury. The three major ligament groups that support the ankle include the tibiofibular ligaments, the deltoid ligament complex medially and the lateral ligament complex.