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
Download The PPT/PDF document "The Foot & Ankle Foot & Ankle" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
The Foot & Ankle
Slide2Foot & 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)
Slide3Slide4Slide5Foot & 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
Slide6Arches 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
Slide7Arches of the Foot
Slide8Pes Planus
Pes Planus = flat feet
Shallow or flat longitudinal arch
Slide9Foot & 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
Slide10Muscles
Slide11Ligaments of the Foot/Ankle
Lateral Ligaments
Anterior
Talofibular
Posterior
Talofibular
Calcaneofibular
Slide12Lateral Ligaments
Slide13Medial Ligaments
Medial Ligaments: Deltoid
Tibiocalcaneal
Anterior/Posterior
Tibitalar
Tibionavicular
Slide14Medial Ligaments
The deltoid ligament is stronger than all lateral ligaments combined
Slide15Foot/Ankle Injuries
Slide16Preventing Injuries
Good shoes
Ankle Tape
Shin Guards
Proper Strength/Conditioning Programs
Slide17Great 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
Slide18Arch 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
Slide19Ankle 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
Slide20Severity of Ankle Sprain
The severity of the sprain will depend on:
Amount of force
Amount of protective taping
Type of shoe
Strength of muscles
Slide21Ankle Sprain Evaluation
Symptoms:
Swelling
Discoloration
Loss of ROM
Slide22Treatment
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
Slide23Ankle 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
Slide24Ankle 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
Slide25Tendinitis
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
Slide26Achilles 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
Slide27Achilles 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
Slide28Achilles Tendon Rupture
Symptoms
Weakness, loss of plantar flexion, depression at attachment site
Treatment
Must be surgically reattached to calcaneus
Slide29Common Foot/Ankle Fractures
Jones Fracture
Avulsion Fracture
Epiphyseal Fracture
Stress Fracture
Slide30Jones Fracture
Most common avulsion fracture
5
th
metatarsal is fractures as a result of forced inversion
Peroneus brevis tendon pulls part of bone away
Slide31Distal Tibia & Fibula Avulsion Fracture
Medial & Lateral Malleolus is fractured
Caused by forced plantar flexion & inversion or eversion
Slide32Epiphyseal Fracture
Occurs to the tibia and fibula
Caused by forced plantar flexion & inversion
Slide33Stress Fracture
Occurs to the tibia, fibula, and metatarsals
Caused by repetitive stress due to running
Not visible in x-ray
Slide34Shin Splints
Aka: Medial Tibial Stress Syndrome
Muscle fibers on medial side of tibia becomes torn and irritated
Slide35Shin 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
Slide36Shin Splints
Treatment: PRICE
Slide37Anterior Compartment Syndrome
Lower leg is broken down into 4 compartments
Anterior Compartment Syndrome can sometimes be mistaken for shin splints
Slide38Anterior 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
Slide39Anterior Compartment Syndrome
Treatment:
Doctor
May need surgery
Incision in leg to relieve pressure
Slide40Hammer Toe
PIP joint of toe is flexed while MTP & DIP joints are hyper-extended
Slide41Plantar
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
Slide42Plantar
Faciitis
Symptoms: pain upon initial weight bearing, especially in the morning