Most common lower leg injury Classified as to degree of ligamentous severity Lateral ankle sprain Mechanism Inversion and plantar flexion Anterior talofibular ligament ATF usually first structure to injury ID: 908899
Download Presentation The PPT/PDF document "Foot and Ankle Injuries Ankle Sprains" 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
Foot and Ankle Injuries
Slide2Ankle Sprains
Most common lower leg injury
Classified as to degree of
ligamentous
severity
Slide3Lateral ankle sprain
Mechanism:
Inversion and plantar flexion
Anterior
talofibular
ligament (ATF) usually first structure to injury
Calcaneofibular
ligament (CF) is usually secondary
Posterior
talofibular
ligament (PTF) rarely injured
Slide4Lateral ankle sprain
Signs/Symptoms:
Obvious mech. of injury
Report of “popping” or “tearing” of tissue
Rapid swelling and point tenderness over soft tissue
Be careful of possible fracture
Slide5Medial ankle sprain
Less common
Mechanism:
Eversion
Deltoid ligament injury
Slide6Medial ankle sprain
Signs/Symptoms:
Pain and swelling not as evident
Point tenderness over deltoid
Slide7Syndesmosis
ankle sprain
Separation/widening of distal
tibiofibular
joint
Injury to Anterior/Posterior
tibiofibular
ligaments
Usually very disabling
“High” ankle sprain
Mechanism:
Dorsiflextion
with inversion or
eversion
Slide8Syndesmosis ankle sprain
Signs/Symptoms:
Similar to lateral/medial ankle sprains
Point tender at bony junction – top of ankle
Swelling over medial/lateral
malleoli
Slide9Fractures
May occur anywhere in foot
Common at the base of 5
th
Metatarsal (Jones Fracture)
Usually result of forceful landing from jumping
May be considered an avulsion fracture from an inversion ankle sprain
Treatment is extremely controversial
Slide10Turf Toe
First
Metatarsaophalangeal
(MTP) Sprain
Common with artificial surfaces
Mechanism:
Hyperextending
the MTP join or
Contact
with the shoe
end
Slide11Turf Toe
Signs/Symptoms:
Pain and Tenderness
Swelling on the Plantar joint aspect
Discomfort with toe extension
Treatment
Cryotherapy
, NSAIDS, Rest
Protection from mechanism
Slide12Chronic Conditions
Slide13Bunions (
Hallux
valgus
)
Inflammation and thickening of the medial aspect of the MTP joint of the
hallux
MTP joint becomes inflamed and causes lateral displacement of the
hallux
As the condition progresses the 1
st
toe may overlap the 2
nd
toe
Predisposing factors
High heels, pointed shoe box, poor shoe fit
Management
Strapping of the
hallux
Wider toe box
Surgical correction
Slide14Plantar Fasciitis
(Bone spur)
Most common
hindfoot
problem in runners
Main support for longitudinal arch
Structurally weak near the origin attachment
Predisposing factors
Significant increase in training
Excessive tightness in Achilles tendon
Abnormal change in body weight
Pes
cavus
(high arch)
Slide15Plantar Fasciitis (Bone spur)
Signs/Symptoms
Pain is usually most sever during the first step in the morning
Discomfort is reduced throughout the duration of the day
Extreme point tenderness over origin
Management
Therapeutic modalities (e-
stim
, ultrasound)
Achilles tendon stretching
NSAIDS
Heel lifts, taping,
orthodics
Night splints
MD referral
Slide16Achilles Tendonitis
Result of repetitive jumping or running (
Loooooong
distance runners)
Signs/Symptoms
Thickening of surrounding tissues
Crepitation
with
tendinous
movement
Reduced ROM
Management
Ice therapy, NSAIDS
Active stretching, Heel lifts
Complete resolution of symptoms prior to return
A chronic weakness will progress to rupture
Slide17Medial
Tibial
Stress Syndrome
(Shin splints)
Early, painful component of first part of a training activity
Associated with repetitive activity on hard surfaces
Contributing factors
Muscled inflexibility
Pes
Planus
(Low arch)
Poor footwear
Dramatic change in training or surface
Signs/Symptoms
Pain along medial
tibial
border
Usu. Lower 1/3 of shin
Common for bilateral symptoms
Slide18Medial
Tibial
Stress Syndrome
(Shin splints)
Management
Rule out stress fractures
Cryotherapy
, NSAIDS
Modification in training
Pain free stretching of ankle/foot
Change in footwear
Slide19Acute and Chronic
Slide20Compartment Syndrome
Acute compartment syndrome results from a direct blow to the lower leg.
Chronic compartment syndrome results from increase in the intramuscular pressure during exercise
Most common in Anterior Leg Compartment
Slide21Compartment Syndrome
Signs/Symptoms
Decreased distal pulse
Swelling
Pain and tenderness
Numbness, significant muscle weakness
Tight skin
Chronic – symptoms will reduce post-exercise
Slide22Compartment Syndrome
Treatment/Management
ACUTE
Medical Emergency
Immediate Referral to MD
Ice
CHRONIC
Ice, NSAIDS, Stretching, Alter activities
If severe (or not improving) refer to MD
Surgical
Fascia Release