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The Foot Chapter 17. Foot Anatomy 26 Bones 7 Tarsal 5 Metatarsal 14 Phalanges 38 Joints 4 Arches.

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Presentation on theme: "The Foot Chapter 17. Foot Anatomy 26 Bones 7 Tarsal 5 Metatarsal 14 Phalanges 38 Joints 4 Arches."— Presentation transcript:

1 The Foot Chapter 17

2 Foot Anatomy 26 Bones 7 Tarsal 5 Metatarsal 14 Phalanges 38 Joints 4 Arches

3 Bones of the Foot

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6 Tarsal Bones Talus Calcaneus Navicular Cuboid Cuniforms Medial Intermediate Lateral

7 Metatarsals & Phalanges

8 Sesamoid Bones 2 (medial and lateral) Under great toe Function pulley, increase leverage of tendons that control great toe

9 Joints of the Foot Tibiotalar Talocrural Subtalar Talonavicular Calcaneocubiod Metarsocunieform

10 Joints of the Foot Metatarsophalangeal Joint Proximal Interphalangeal Joint Distal Interphalangeal Joint

11 Regions of Foot Forefoot Metatarsals Phalanges Midfoot Navicular Cuboid 3 Cuniforms Hindfoot Calcaneus Talus

12 Regions of the Foot

13 Thick white band of fibrous tissue originating from the medial tuberosity of the calcaneus and ending at the proximal heads of the metatarsals Work with ligaments to support arches during weigh bearing and downward forces Plantar Fascia

14 Foot Arches Functions 1.Support body weigh in an economical fashion 2.Absorb the shock of weight bearing 3.Provide a space on the plantar aspect of foot for blood vessels, nerves, and muscles

15 Medial Longitudinal Arch Highest of 3 arches of foot Calcaneus, Talus, Navicular, Cuniforms & 1 st three metatarsals Supports –Ligaments: Spring ligament Plantar fascia –Tendons: Tibialis posterior Tibialis anterior

16 Lateral Longitudinal Arch Lower and flatter Calcaneus, Talus, Cuboid, 4 th & 5 th metatarsals Supports –Ligaments: Short plantar ligament Plantar fascia –Tendons: Peroneus longus

17 Transverse Arch Cuniforms, Cuboid, & 5 th metatarsal

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19 Shoe Wear Patterns Excessive Pronation –Wear out front of shoe under 2 nd metatarsal Excessive Supination –Wear out lateral border of shoe Common Misconception –Wearing out the back lateral corner of the shoe means you pronate –This is normal wear pattern

20 Gait

21 Pulse Posterior Tibial Artery Medial Malleolous Dorsalis Pedis artery Extensor Tendon Great Toe

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23 Foot Movements Dorsiflexion Plantar Flexion Pronation Inversion Eversion Supination

24 Muscles of Foot Intrinsic Muscles Relate to specific body part or bone Flexor hallucis longus Flexor hallucis brevis Flexor digitorum longus Extensor digitorum longus Abductor hallucis Abductor digiti minimi Tibialis posterior Extrinsic Muscles Muscle outside a body part, organ, or bone Gastrocnemius

25 Muscles of the Foot

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28 Common Injuries of the Foot

29 Fractures & Stress Fractures Impair ability to perform competitively NWB More swelling & pain than ligament sprain Point tenderness present Obvious deformity often present Usually occur acutely; result of traumatic episode

30 Jones Fracture Fracture to the diaphysis at the base of the 5 th metatarsal Repetitive stress, direct force, or inversion and PF of foot Healing slow; high nonunion rate

31 Retrocalcaneal Bursitis Swelling of the bursa at the back of the calcaneus under the Achilles tendon S/sxs: –Pain in heel –Painful to touch –Pain worse when rising on toes –Red, warm skin over back of heel

32 Plantar Fascia Wide, non-elastic ligamentous tissue that extends from the anterior portion of calcaneus to heads of metatarsals Supplies support to longitudinal arch

33 Plantar Fasciitis Strain/irritation of the plantar fascia Caused by: –Overuse –Unsupportive footwear –Tight Achilles tendon –Running on hard surfaces –Chronic irritation Pain, tenderness on bottom of foot near heal (especially in am) Untreated will lead to: –Bone imbalance –Heel spurs –Muscle strains –Shin splints

34 Correct training errors Ice Massage Evaluate shoes & activity level Arch support Heel cup or cushion Plantar Fasciitis Treatment

35 Arches

36 Pes Planus Flat foot Associated with excessive pronation Multiple causes: –Lack of shoe support –Weak muscles Pain & weakness in medial longitudinal arch Calcaneal eversion Navicular bulging Flattening of arch

37 Pes Cavus aka Clawfoot, hollow foot Associated with excessive supination Shock absorption poor General foot pain and metatarsalgia common Abnormally short Achilles tendon Calluses ball and heel

38 Arch Sprains Ligaments stretch, thus fail to hold bones of foot in position When arch weakened, it cannot absorb shock normally Causes: –Overuse –Overweight –Fatigue –Training on hard surfaces –Non-supportive shoes –Shoes in poor condition

39 Turf Toe Great toe strain Hyperextension of the first MTP joint of the big toe Treatment: –RICE & Support –Limit movement –Turf toe taping

40 Heel Spur Bony growth on calcaneus Causes painful inflammation Aggravated by exercise As foot flattens, plantar fascia is stretched & pulled where it attaches to calcaneus calcaneus reacts by forming spur of bony material

41 Heel Contusion Irritation of the lateral aspect of the heel Sudden stop-and-go or sudden change in movement

42 Heel ContusionTreatment Cold application before activity Ice & elevation after activity Absorb shock –Heel cups –Donut pad

43 Severs Disease Traction injury at the apophysis of the calcaneus where the Achilles tendon attaches Young, physically active athletes –Comparable to Osgood-Shlatters disease (at tibial tubercle of knee) Pain occurs during vigorous activity and does not continue during rest

44 Blisters Occur on any part of body where there is friction Most common on feet or heels Treatment Goals: –Relieve pain –Keep from enlarging –Avoid infection

45 BlistersTreatment Wash area thoroughly Use sterile blade to cut small hole in blister Squeeze out clear fluid Do not remove skin Prevention: –Wear work gloves –Break in new skin –Petroleum jelly/skin lube –Adhesive bandage

46 Prevention of Foot Injuries Selecting appropriate footwear Using shoe orthotic Foot hygiene

47 Rehabilitation of the Foot Towel pulls TheraBand ® Marble pick-up

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