3 Bony AnatomyMedial view: tarsals and metatarsals
4 Medial Ligaments of Ankle Deltoid Ligamentrarely injured in sportsmechanism of injury typically eversion with dorsiflexionlonger time to heal than lateral ankle ligaments
5 Lateral Ligaments of Ankle 3 primary ligaments:anterior talofibularposterior talofibularCalcaneofibularNOT as large & strong as the deltoid.Mechanism of injury is inversion associated with plantar flexion.
6 Lower Leg Anatomy3 CompartmentsAnterior, Lateral, & Posterior
7 Fractures Mechanism Signs/symptoms: most often caused by direct trauma to the tibia, fibular or bone(s) of the footrepeated “microtrauma” can result in a stress fracturegrowth plate injures can occur in the adolescent -- known as “Salter-Harris” fracturesSigns/symptoms:swelling/deformity, discolorationbroken bone end protrudingathlete reports a snap/popinability to bear weightstress fractures often become more painful at night
8 Fractures First Aid: treat for shock apply sterile dressing to any open woundscarefully immobilize using appropriate splinting techniquecontact EMS and arrange for transport
12 Ankle Sprains Details one of the most common injuries to this region Due to skeletal and ligamentous variables, lateral sprains are more common.80-85% of all ankle sprains are to the lateral ligaments --inversion sprainsEversion sprains, while less frequent, are often severe.Syndesmosis Sprain: Sprain of the ligaments connecting the tibia and fibula.
13 Signs/symptoms:1st deg. -- pain, mild disability, pt. tenderness, little or no swelling2nd deg. -- pain, mild to moderate disability, pt. tenderness, loss of function, some laxity, swelling3rd deg. -- pain & severe disability, pt. tenderness, loss of function, laxity, severe swelling
14 Ankle Sprains First Aid: ice, compression and elevation apply a horseshoe - or doughnut-shaped paduse crutches, partial or full weight bearingany questions regarding severity, refer to a physician for further evaluation and diagnosis
15 Ankle Sprain Prevention Research indicates that taping is only good for a short period of time. Braces may be as effective as tape and at a much lower costBest prevention is to strengthen the muscles of the lower leg as well as develop proprioception.
17 Tib/Fib Syndemosis Sprain Signs and SymptomsOften treated as lateral ankle sprain, which is inappropriate, hindering recovery.The difference is the mechanism of injury. Tib-fib sprains involve dorsiflexion followed by axial loading with external rotation of the foot.Symptoms – positive sprain test, but athlete is in great pain.Slower healingSometimes physicians will cast.
18 Achilles TendonAchilles tendon commonly injured -- more often in older (30+) male athletecan be either an acute or chronic, overuse injuryacute injuries often associated with blunt traumachronic injuries often associated with sudden increase in training intensity
19 Common Injuries Signs/symptoms First Aid: swelling and deformity pop or snappain in lower legloss of function, especially in plantar flexionFirst Aid:immediate application of ice and compressionimmobilize with appropriate splintarrange for transport to a medical facility
22 Compartment Syndromeusually involves the anterior compartment of the lower legChronic form is related to overuse of the muscles of the compartmentTrauma, such as being kicked in the leg, can result in swelling within the compartment as well.In either case, swelling puts pressure on vessels and nerves.
24 Compartment Syndrome Signs/symptoms/First Aid: pain/swelling and loss of sensation and/or motor control in the lowerloss of pulse in the footinability to extend the big toe or dorsiflex the foot apply ice & elevate -- do NOT apply compressionloss of pulse or sensation -- medical emergency - transport to medical facility
25 Shin Splints Signs/symptoms: First Aid: lower leg pain -- typically a chronic injury that progressively worsenspain is often bilateral“Shin splints” is generic pain in the lower legs, typically caused by change in surface or workout.First Aid:apply ice and have the athlete restuse of NSAIDs may be helpfulseek a professional to identify the cause
26 Foot Disorders Plantar Fasciitis plantar fascia spans from the metatarsal heads to the calcaneal tuberosityBall of foot to heel.this tissue can become inflamed and painfulpainful in the morning when first rising from bedpoint tenderness in the region of the calcaneal tuberosity
27 Common Injuries Treatment of Plantar Fasciitis and Heel Spurs often related to chronic plantar fasciitisinvolves ossification at the site of attachment to the calcaneusTreatment of Plantar Fasciitis and Heel Spursrest and NSAIDsstretching of the Achillesdoughnut pad beneath the heel spur
28 Common Injuries Morton’s Neuroma growth (enlargement) of the interdigital nerve usually between the 3rd and 4th metatarsal headspain will radiate into the 3rd and 4th toestight fitting shoes have been identified as a major causative factorgoing barefoot often relieves the symptomsthe neuroma may have to be treated surgically
29 Common Injuries Care for Neuroma Teardrop pad can be placed between met heads to increase space, decreasing pressure on neuromaShoes with wider toe box would be appropriatethe neuroma may have to be treated surgically
30 Common Injuries Foot disorders Arch problems two groups of arch problems: pes planus and pes cavusPes Planus = flat archPes Cavus = high arch
31 Common Injuriescorrective taping may provide temporary support for the archIn some cases, the athlete may benefit from a properly constructed orthosis.Orthotics should be constructed by a trained professional.
32 Common Injuries Blisters & calluses very common formations, result from friction between layers of skinwhen a blister forms, fluid collects between skin layers, occasionally the fluid will contain bloodif the blister is large, it should be drainedWhen draining a blister, use sterile instruments, latex gloves and eye protection