If the mechanical ankle axis is above the anatomical ankle axis, where are the pressures on the leg during plantar flexion?

When the mechanical ankle axis is positioned above the anatomical ankle axis, this creates a situation where the orientation of the leg and foot changes significantly during the movement of plantar flexion. In this position, during plantar flexion, the pressure is predominantly directed anteriorly and proximally.

As the foot moves into plantar flexion, the heel lifts off the ground, and the forefoot moves downward. The mechanical advantage shifts, causing increased pressure to be exerted on the anterior surface of the lower leg, particularly in the more proximal regions. This results from the body's response to maintain balance and control as the center of gravity shifts forward over the foot.

Therefore, anterior-proximal is the correct answer because it accurately describes where the pressures are distributed in relation to the altered mechanical axis during the movement of plantar flexion. This understanding is critical for assessing gait mechanics and designing orthotic interventions that can accommodate these changes in pressure dynamics.