General Information 99 of people have perfect feet at birth At age 1 8 have foot problems Age 5 40 Age 20 80 Age 20 for athletes 90 Anatomy of the foot The foot contains 197 ligaments 33 joints ID: 490601
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Slide1
The FootSlide2
General Information
99% of people have perfect feet at birth
At age 1 8% have foot problems
Age 5 40%
Age 20 80%
Age 20 for athletes 90%Slide3
Anatomy of the foot
The foot contains
197 ligaments
33 joints
19 muscles
28 bonesSlide4
Anatomy of the foot
Bones
14 phalanges (5 distal, 4 middle, 5 proximal)
5 Metatarsals
7 tarsals (calcaneus, talus,
navicular
, cuboid)
3 cuneiforms (medial, intermediate, lateral)
2
seamoids
Image http
://s1.hubimg.com/u/6424248_f520.jpg Slide5
Anatomy of the foot
4 arches
Medial longitudinal arch-
originates along the medial border of the calcaneus and extends forward to the distal head of the first metatarsal. Main support: plantar
calcaneonavicular
ligament
Lateral Longitudinal arch-
formed by calcaneus, cuboid and fifth metatarsal
Anterior metatarsal-
shaped by distal heads of the metatarsals
Transverse arch-
extends across the transverse tarsal, primarily the cuboid and internal cuneiform
http://lh5.ggpht.com/_
RIjx_Mg4ZVM/TKnx7LKzd2I/AAAAAAAACFY/JjFz7jexwtU/image_thumb18.png?imgmax=800Slide6
Nerves
Tibial
nerve- posterior of leg and sole of foot
Common
peroneal
nerve
Intermediate dorsal cutaneous nerve
Sural
nerve
Deep fibular nerve
http://
eastpennfoot.files.wordpress.com/2012/11/nerves-of-foot-and-ankle1.jpgSlide7
Blood Supply
Anterior and posterior
tibial
arteries http
://
image.shutterstock.com/display_pic_with_logo/230998/230998,1234652248,4/stock-vector-blood-supply-to-foot-labeled-24964279.jpgSlide8
Muscles
Dorsal Flexors (true ankle movement)
Tibialis
Anterior
Extensor
digitorum
longus
Peroneus
Tertius
Muscles
Extensor
Hallicus
Longus
and
brevisSlide9
Muscles
Plantar Flexors- (Ankle motion)
Gastrocnemis
,
soleus,
plantaris
,
peroneus
longus
and
brevisSlide10
Muscles
Eversion- foot motion
Peroneus
brevis
and
longus
Peroneus
tertius
Extensor
digitorum
longusSlide11
Muscles
Inversion
Tibialis
anterior and posteriorSlide12
Muscles
Flexors of the toe (plantar of foot)
Flexor
digitorum
longus
Flexor
digitorum
brevis
Flexor
hallicus
longusSlide13
Muscles
Extensors of the toes- dorsum of foot
Extensor
digitorum
longus
and
brevis
Extensor
hallicus
longusSlide14
Foot Landmark Test
Navicular
Longitudinal arch
Phalanges
Metatarsal arch
Plantar fascia insertion
Base of the 5
th
metatarsalSlide15
Causes of foot problems
Shoes
Sole should be under arch
Good fit
Don’t trade
Only wear sport shoes for sport- they wear out quickly
Buy in late afternoon
Break should be at toes
Jump, run and jog in shoes before buying
Wear same socks that you wear during sport when buyingSlide16
Improper use of foot
Stride- should be 2-3 inches across longitudinal line. Improper- jock or cross over walk
Toes should be straight at all times. Improper- pigeon toes- toes turned in. Duck walk- caused by tight
hamstrings
Pronator- Heel turns in
Supinator- heel turns outSlide17
Examination of injuries
Signs of injury
Favoring foot, walking with limp or unable to bare weight
Swollen, deformity, discoloration
Whether the foot changes color when baring weight
Whether the foot is well aligned and maintained its shapeSlide18
Examination of foot
Find out history
How, what, when, where
Did you feel anything pop
Type of pain. Burning, tingling
Can you point to pain
When is pain most severe
Type of surface training on
footwearSlide19
Common foot injuries
Contusions
Causes- outside blow, dorsum of foot
S/
Sx
- stinging type of pain, point tenderness, swelling and discolorations
Tx
- eliminate possibility of fracture
Start at toes- tap test, palpation, feel cold or numb
Metatarsals- push bottom up, push top down. Pain one way contusion, pain both fracture
RICE, Donut pad.Slide20
Common foot injuries
Hammer toes-
Causes- heredity, improper shoes
S/
Sx
- overlapping toes
Tx
- surgery, tape wedging, metatarsal arch pad, donutSlide21
Common foot injuries
Hammer toes-
http://www.google.com/imgres?imgurl=http://www.gothamfootcare.com/uploads/1/1/0/5/11057160/6453431_orig.jpg&imgrefurl=http://www.gothamfootcare.com/hammertoes.html&h=300&w=460&sz=12&tbnid=QpxrMzwwDtEaTM:&tbnh=93&tbnw=143&zoom=1&usg=__liFKru9FFYByleY_doC7wWX9y4A=&docid=6Ng2URDSrXdiLM&sa=X&ei=YxFPUszMM4OVygHEoIHQBw&ved=0CEEQ9QEwCQ
http://www.google.com/imgres?imgurl=http://drshoe.files.wordpress.com/2007/12/hammertoes.gif&imgrefurl=http://drshoereviews.com/2007/12/18/hammertoes-full-length-insoles/&h=480&w=290&sz=104&tbnid=IcZPzGzZI8UgFM:&tbnh=114&tbnw=69&zoom=1&usg=__EycCQmmAHvNjUJO8ot2LBm6B_DM=&docid=J1MGR9WFrZdYBM&sa=X&ei=ChJPUp66EcKSyAGW3oCQDQ&ved=0CD0Q9QEwBwSlide22
Common foot injuries
Soft corn
Cause- sweaty feet, narrow shoes
S/
sx
- skin grayish in color
Tx
- clean, part toes with lambs wool
Go bare footSlide23
http://www.google.com/imgres?imgurl=http://www.zfootdoc.com/corn2.jpg&imgrefurl=http://www.zfootdoc.com/corns.htm&h=960&w=1280&sz=52&tbnid=-r0cVnbkal77UM:&tbnh=120&tbnw=160&zoom=1&usg=__o5ChWt6VF-bu8JmmZVz2MhhFOtg=&docid=OYtyLGbbFP84gM&sa=X&ei=fBJPUrb3FfKkyAGg5YDYDA&ved=0CC8Q9QEwAQot when possible.Slide24
Common foot injuries
Athletes foot
Causes- fungus
S/
sx
- itches, flaking white
Tx
- over counter medicine, keep dry and cleanSlide25
http://www.webmd.com/skin-problems-and-treatments/picture-of-athletes-footSlide26
Common foot injuries
Plantar Warts-
Causes- HPV, enters though break in skin
S/
Sx
- on weight bearing areas of foot, painful wart
Tx
- OTC meds, freeze off, will return. Pad to playSlide27
http://www.mayoclinic.com/health/medical/IM03165Slide28
Common foot injuries
Bunion-
Causes- heredity, proper shoes
Tx
- tape, surgery
http://www.google.com/imgres?imgurl=http://www.ankleandfootnorthwest.com/images/Bunion%2520web%2520logo.jpg&imgrefurl=http://www.ankleandfootnorthwest.com/bunions.html&h=392&w=269&sz=117&tbnid=-CFktBAPRdnIQM:&tbnh=157&tbnw=108&zoom=1&usg=__Gxr1004tRYXzZxhkHXRKQ2QeCpo=&docid=DMNPDxVZRJgTDM&sa=X&ei=XhZPUuL-F6ibygHil4GICA&ved=0CDEQ9QEwAgSlide29
Common foot injuries
Metatarsal Arch injuries
Causes- stress (prolonged hard surface training), ready position, high longitudinal arch, high heels
S/
sx
- Three stages: Stage I- wants shoes and socks off, massages foot, warm in middle of metatarsal arch. Stage II- little pain in arch, puffy,
calus
, toes cramping. Stage III- growth on planter
nreve
between 2-3 or 4-5, shocking pain, comfort when bare foot and non weight baring.
Tx
- Tear padSlide30
http://www.google.com/imgres?imgurl=https://www.staffordfootcare.com/shop/images/652/Met%2520Pad%2520Teardrop.jpeg&imgrefurl=https://www.staffordfootcare.com/shop/metatarsal-pads-with-leather-cover-tear-drop/&h=480&w=640&sz=53&tbnid=dXIh3vA_xHZh5M:&tbnh=119&tbnw=159&zoom=1&usg=__5D0qdF__L0iOzsIs8Y7ZYXW-9_A=&docid=sFJNQnJhdmr4GM&sa=X&ei=pBdPUvlfpITKAd_HgeAF&ved=0CC0Q9QEwAASlide31
Common Foot injuries
Longitudinal arch injuries- 5 types of problems
Acute arch sprain
Causes- Shoe that has little support, deep c cut shoe, hard playing surface, Overweight, mechanical, ankle sprain, tight
achilles
Test-
Feiss
- measure length of drop of arch.
Functional Test- Weight bearing
TX- RICE, Strength, Tape, arch support
Exercise- marble pick up, towel curls, stretch
achilles
.
Slide32
Chronic sprain- arch is permanently down
Arch support at all times
Congenital flat foot- no arch
Supple foot- arch when
nonweight
bearing but none when standing
Rigid foot- High ArchSlide33
common FOOT INJURIES
Plantar Fasciitis
Causes- shoes, high long. Arch, tight soleus are Achilles tendon
S/
Sx
- heel point tender, pain and limited dorsal flexion, tight
achilles
, morning walking pain.
Tx
- heel lift, NSAID, RICE, stretch
achilles
, tape, night splint, can lead to bone spursSlide34
Common foot injuries
TOE- sprains, dislocations, fractures
Causes- shoes, direct blow,
S/
sx
- discolorations, swelling
Fx
test- toe tap.
Tx
- RICE, boot giant toe, other buddy tape, tape sprain to giant toe, tape giant toe sprainSlide35
Common foot injuries
Turf toe- sprain to the Distal phalangeal joint.
Causes- turf, toe jams into shoe, shoe not fitting properly
S/
sx
- swelling and pain in giant toe
Tx
- RICE, tape, boot if severeSlide36
Common foot injuries
Blister-
Causes- friction
S/
Sx
- collection of fluid under first layer of skin
Tx
- protect try to leave
alone, donut
, 2
nd
skin, skin lube.