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The Foot & Ankle Foot & Ankle The Foot & Ankle Foot & Ankle

The Foot & Ankle Foot & Ankle - PowerPoint Presentation

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Uploaded On 2020-06-16

The Foot & Ankle Foot & Ankle - PPT Presentation

There are 28 bones in the lower legfoot including Tibia amp Fibula Malleolus medial amp lateral ends of the tibia amp fibula commonly referred to as the ankle bones Talus sits on top of the calcaneus forms the ankle joint along with tibia amp fibula ID: 779009

amp ankle tendon foot ankle amp foot tendon plantar anterior symptoms achilles fracture pain running ligaments lateral medial tibia

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Presentation Transcript

Slide1

The Foot & Ankle

Slide2

Foot & Ankle

There are 28 bones in the lower leg/foot including:

Tibia & Fibula: Malleolus – (medial & lateral) ends of the tibia & fibula (commonly referred to as the ankle bones)

Talus: sits on top of the calcaneus (forms the ankle joint along with tibia & fibula)

Calcaneus: heel bone (Achilles Tendon attaches posteriorly to it)

5 Tarsals:

Navicular, Cuboid, and 3 Cuneiforms

5 Metatarsals: #1-#5; #1 is the big toe

14 Phalanges

2 Sesamoid (small bones under 1

st

metatarsal)

Slide3

Slide4

Slide5

Foot & Ankle

Ankle injuries are among the most common injuries (most frequently injured joint)

Lower leg roles:

Balance

Shock absorption

movements

Foot/Ankle Movements:

Plantar and dorsiflexion

Inversion and eversion

Pronation and supination

Slide6

Arches of the Foot

The foot has 3 arches

Metatarsal Arch: across the heads of metatarsals

Transverse Arch: in front of the heel from the 5

th

metatarsal to navicular bone

Longitudinal Arch: runs the length of the foot from the calcaneus to metatarsal heads

Slide7

Arches of the Foot

Slide8

Pes Planus

Pes Planus = flat feet

Shallow or flat longitudinal arch

Slide9

Foot & Ankle Muscles

Peronues

Brevis & Longus

Provide stability to the lateral aspect of ankle

Gastrocnemius

Provides plantar flexion allowing for running and jumping

Attaches by the Achilles Tendon onto the posterior of the calcaneus

Soleus

Muscle underneath the gastrocnemius that assists in plantar flexion

Tibialis

Anterior

Provides dorsiflexion of the ankle

Slide10

Muscles

Slide11

Ligaments of the Foot/Ankle

Lateral Ligaments

Anterior

Talofibular

Posterior

Talofibular

Calcaneofibular

Slide12

Lateral Ligaments

Slide13

Medial Ligaments

Medial Ligaments: Deltoid

Tibiocalcaneal

Anterior/Posterior

Tibitalar

Tibionavicular

Slide14

Medial Ligaments

The deltoid ligament is stronger than all lateral ligaments combined

Slide15

Foot/Ankle Injuries

Slide16

Preventing Injuries

Good shoes

Ankle Tape

Shin Guards

Proper Strength/Conditioning Programs

Slide17

Great Toe Sprain

Aka: Turf Toe

Functions of Great Toe:

Kick a ball, push off when running, balance

Cause: excessive forced flexion/extension

Symptoms: pain, swelling, discolored, inability to walk or run normally

Treatment: rice, tape/padding

More common on turf than grass

Slide18

Arch Sprain

Sprain of the transverse and longitudinal arch

Caused by: running on hard surfaces, improper footwear, overuse

Symptoms: pain, difficulty walking/running, discoloration over plantar surface

Treatment: PRICE, padding, strengthen muscles, & stretch Achilles Tendon

Slide19

Ankle Sprains

Inversion and Eversion Sprains

Inversion Sprains are much more common (85% of all sprains):

Deltoid ligament (medial) is much stronger than lateral ligaments

Lateral malleolus prevents eversion from occurring

Slide20

Severity of Ankle Sprain

The severity of the sprain will depend on:

Amount of force

Amount of protective taping

Type of shoe

Strength of muscles

Slide21

Ankle Sprain Evaluation

Symptoms:

Swelling

Discoloration

Loss of ROM

Slide22

Treatment

If there is no decrease in ROM or strength – athlete can be taped and return to play

If there is a decrease in ROM: PRICE

If there is crepitus, rapid swelling, deformity: refer to doctor

This could be a sign of a possible

fx

Slide23

Ankle Dislocation

The talus dislocates from tibia & fibula

Anterior Dislocation

The heel of foot strikes ground forcefully

Posterior Dislocation

A blow to anterior aspect of leg while ankle is plantar flexed

Slide24

Ankle Dislocation

Symptoms:

Pain/refusal to move

Not allow touching of foot

Deformity & inability to use foot

Rapid swelling

Treatment:

911

Ligaments, Nerves, Blood Vessels all injured

Slide25

Tendinitis

Occurs from repetitive running, jumping, and landing

Achilles Tendon is susceptible

Symptoms

Swelling, tenderness, crepitus, pain upon palpation (dorsiflexion)

Treatment

Rest, ice, refer to doctor & gentle stretching

Slide26

Achilles Tendon

Tendon may get thicker as the body responds to injury

Limits ROM and decreased ability in running/jumping

Severe Damage: feel crepitus or tendon may completely rupture

Slide27

Achilles Tendon Rupture

Athlete falls and feels like they have been shot in back of leg

Caused by:

Forced dorsiflexion

Blow over Achilles tendon

Sudden contraction of gastrocnemius

Slide28

Achilles Tendon Rupture

Symptoms

Weakness, loss of plantar flexion, depression at attachment site

Treatment

Must be surgically reattached to calcaneus

Slide29

Common Foot/Ankle Fractures

Jones Fracture

Avulsion Fracture

Epiphyseal Fracture

Stress Fracture

Slide30

Jones Fracture

Most common avulsion fracture

5

th

metatarsal is fractures as a result of forced inversion

Peroneus brevis tendon pulls part of bone away

Slide31

Distal Tibia & Fibula Avulsion Fracture

Medial & Lateral Malleolus is fractured

Caused by forced plantar flexion & inversion or eversion

Slide32

Epiphyseal Fracture

Occurs to the tibia and fibula

Caused by forced plantar flexion & inversion

Slide33

Stress Fracture

Occurs to the tibia, fibula, and metatarsals

Caused by repetitive stress due to running

Not visible in x-ray

Slide34

Shin Splints

Aka: Medial Tibial Stress Syndrome

Muscle fibers on medial side of tibia becomes torn and irritated

Slide35

Shin Splints

Caused by:

Tight calf muscle, improper footwear, improper conditioning/out of shape for running

Symptoms

Pain/inability to walk/run, pain over distal medial tibia, swelling on lateral side

Slide36

Shin Splints

Treatment: PRICE

Slide37

Anterior Compartment Syndrome

Lower leg is broken down into 4 compartments

Anterior Compartment Syndrome can sometimes be mistaken for shin splints

Slide38

Anterior Compartment Syndrome

Muscles in the anterior aspect of the lower leg are enclosed in connective tissue

Swelling can cause severe pain & pressure

Cause: overuse or impact

Symptoms:

Hot, red skin

Loss of foot motion

Severe pain

Slide39

Anterior Compartment Syndrome

Treatment:

Doctor

May need surgery

Incision in leg to relieve pressure

Slide40

Hammer Toe

PIP joint of toe is flexed while MTP & DIP joints are hyper-extended

Slide41

Plantar

Faciitis

Irritation of fascia on the bottom of the foot – commonly at the attachment on the calcaneus

Causes: excessive running or standing on hard surfaces; sudden increase in activity; improper footwear; and tight Achilles Tendon

Slide42

Plantar

Faciitis

Symptoms: pain upon initial weight bearing, especially in the morning