In Texas, that all depends on a legal battle between medical doctors and podiatrists, who both claim the ankle as their turf. The debate has raged to the point that the two sides disagree in court on whether the ankle actually exists.
A state appeals court recently sided with medical doctors when it determined that the state board that licenses podiatrists exceeded its authority in defining the ankle as part of the foot.
"You don't have an ankle," said Mark Hanna, a lawyer for the Texas Podiatric Medical Association. "The foot actually includes the ankle. If you took the foot off the leg, there is nothing lying there that's the ankle."
Not so, said Dr. David Teuscher, an orthopedic surgeon in Beaumont who said treating the ankle is complicated enough to require medical school training.
"If they say the ankle doesn't exist, why do they want to operate on it?" asked Teuscher, immediate past president of the Texas Orthopaedic Association. "Everyone knows what an ankle is."
The Texas State Board of Podiatric Medical Examiners bypassed the Legislature to create its ankle-is-part-of-the-foot definition in 2001. Podiatrists say they've been treating ankles for decades and accuse medical doctors of trying to limit competition. The Texas Medical Association argues podiatrists should stick to corns, calluses and diabetic foot care.
The physicians group interprets last Friday's ruling as saying the ankle and foot are separate. The podiatrists group says the ruling doesn't go that far and plans to appeal. About 900 podiatrists await the outcome.