1. Basic Athletic Training Chapter 6 Foot, Ankle, and Lower Leg

2. Chapter Objectives
Name the anatomy of the foot, ankle, and leg including bones, joints, muscles, and ligaments
Identify the components of an evaluation format
Compare the common injuries associated with the foot, ankle, and leg
Demonstrate the principles of rehabilitation for the foot, ankle, and leg
Describe the preventive/supportive techniques and protective devices for the lower extremity

3. Anatomy Foot, Ankle and Leg Anatomy Bones Ligaments Joints
Muscles and their functions
Arches
Range of motion
Dermatomes
Myotomes

4. Evaluation Format (H)istory
Mechanism of injury (How did it happen?)
Location of pain (Where does it hurt?)
Sensations experienced (Did you hear a pop or snap?)
Previous injury (Have you injured this anatomical structure before?)
(O)bservation—compare the uninjured to the injured lower extremity and look for bleeding, deformity, swelling, discoloration, scars, and other signs of trauma

5. Evaluation Format
(P)alpation—the physical inspection of an injury. Palpate the anatomical structures/joints above and below the injured site, then palpate affected area. Using bilateral comparison, these items should be palpated:
Neurological (motor and sensory)
Circulation (pulse and capillary refill)
Anatomical structures (palpate)
Fracture test (palpation, compression, and distraction)

6. Evaluation Format
(S)pecial Tests—look for joint instability, disability, and pain. Assess disability in the following areas:
Joint stability
Muscle/tendon
Accessory anatomical structures
Inflammatory conditions
Range of motion (active, assistive, passive, and resistive)
Pain or weakness in the affected area

7. Conditions that Indicate an Athlete Should be Referred for Physician Evaluation
Gross deformity
Significant pain
Increased swelling
Circulation or neurological impairment
Joint instability
Suspected fracture or dislocation
Abnormal sensations such as clicking, popping, grating, or weakness
Persistent pain within the lower leg compartments
Any doubt regarding the severity or nature of the injury

8. Ottawa Ankle Rules
Refer for X-ray when patient exhibits one or more of the following signs/symptoms:
Inability to walk four steps immediately after the injury
Tenderness on the posterior edge or tip of the medial or lateral malleolus
Tenderness on the navicular
Tenderness on the base of the fifth metatarsal

9. Common Injuries Ankle sprains Blisters and calluses Arch sprains
Shin splints (Medial Tibia Stress Syndrome)
Great toe sprain (turf toe)
Plantar fasciitis (plantar aponeurosis)

10. Common Injuries Heel bruise Heel spur Compartment syndrome
Achilles tendon strain
Stress fractures
Muscle cramps

11. Rehabilitation Included in any rehabilitation protocol is:
Range of motion exercises
Resistive exercises
Cardiovascular/fitness activities
Sport specific activities
Return to competition guidelines
Full range of motion
Strength, power, and endurance are proportional to the athlete’s size and sport
No pain during running, jumping, or agility movements

12. Musculoskeletal Disorders
Consult with the following for further definitions of disorders:
Taber’s Medical Dictionary
Signs and Symptoms of Athletic Injuries

13. Protective Devices Achilles brace Ankle brace Boots Bunion pads
Corn and callus pads
Heel cups
Orthosis
Shin guards
Shoes
Shin splints brace
Turf toe brace
Heel lifts

14. Preventive/Supportive Techniques
Wrapping techniques for compression
Ankle
Wrapping techniques for support
Ankle cloth
Taping techniques for the ankle, foot, and lower leg
Great toe
Medial longitudinal arch

15. Questions ?