Presentation is loading. Please wait.

Presentation is loading. Please wait.

Chapter 17 The Foot, Ankle, and Lower Leg. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2 Common Injuries  Ankle sprains  Arch sprains.

Similar presentations


Presentation on theme: "Chapter 17 The Foot, Ankle, and Lower Leg. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2 Common Injuries  Ankle sprains  Arch sprains."— Presentation transcript:

1 Chapter 17 The Foot, Ankle, and Lower Leg

2 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2 Common Injuries  Ankle sprains  Arch sprains  Blisters  Turf toe  Contusions  Tendonitis  Tendon ruptures  Plantar fasciitis  Heel bruise  Heel spur  Fractures –Stress  Medial Tibial Stress Syndrome

3 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 3  Arches –Medial Longitudinal arch –Lateral Longitudinal arch –Transverse FOOT ANATOMY

4 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 4 Medial Arch  Most important  Highest arch  Composed of the – –Calcaneus –Talus –Navicular –Cuneiforms –Metatarsals 1-3

5 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 5 Lateral Arch  Lower & flatter than the medial arch  Composed of the - –Calcaneus –Talus –Cuboid –Metatarsals 4 & 5

6 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 6 Transverse Arch  Composed of the –Cuneiforms Medial Intermediate Lateral –Cuboid –Navicular –Talus –Calcaneus

7 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 7 Ankle Joints  Formed by a combination of two joints Talocrural joint –Hinge joint w/most movement in dorsiflexion & plantar flexion Subtalar joint  Malleoli

8 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 8 Ligaments  Connect bone to bone  Injuries are called sprains  Named for bones they connect  Main Ligaments –Anterior talofibular –Anterior tibiofibular –Calcaneofibular –Posterior talofibular –Deltoid

9 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 9 Lower Leg Anatomy  Consists of two bones –Tibia –Fibula  Muscles –Intrinsic –Extrinsic

10 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 10 MUSCLES  Intrinsic Muscles – –Cause movement of the toes –Help support the arches  Extrinsic Muscles – –Aid in movement of the ankle & foot

11 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 11 Muscles – moving the foot  Gastrocnemius – plantar flexes foot, flexes leg, supinates foot  Soleus – plantar flexes foot  Tibialis posterior – plantar flexes foot, inverts foot  Tibialis anterior – dorsally flexes foot

12 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 12 Muscles – moving the foot  Peroneus tertius – dorsally flexes foot  Peroneus longus - everts, plantar flexes foot  Peroneus brevis – everts foot, plantar flexes foot  Plantaris – plantar flexes foot, knee flexion

13 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 13 Muscles – moving the toes  Flexor hallucis brevis – plantar flexes the great toe  Flexor hallucis longus – plantar flexes the great toe  Extensor hallucis longus – extends great toe, dorsiflexes ankle & great toe

14 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 14 Muscles – moving the toes  Flexor digitorum longus – plantar flexes toes, extends foot  Extensor digitorum longus – extends toes, dorsiflexes the foot

15 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 15 Common Injuries  Ankle sprains – most common injury –Usually a result of excessive inversion or plantar flexion  Ligament most often injured –Anterior talofibular ligament –  Other ligaments involved –Calcaneofibular ligament –Posterior talofibular ligaments

16 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 16 Common Injuries  Ankle Sprains – signs & symptoms –Three Categories First Degree (mild) Second Degree (moderate) Third Degree (severe)  Treatment – PRICE  Rehabilitation – –ROM exercises –Stretching exercises –Strengthening exercises

17 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 17 Arch Sprains  Results from overstretched ligaments in the arch –Most arch sprains to the lateral & medial arches  Causes –Overuse –Overweight –Fatigue –Training on hard surfaces –Wearing poor fitting/nonsupportive shoes  Treatment –Cold, compression & elevation

18 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 18 Blisters  Occur anywhere on the body where there is friction –Most often found on the feet –Fluid forms creating pressure on the nerve endings = Pain – OUCH!! –Broken blisters = open wound = may get infection Red/warm skin Pus from the blistered area

19 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 19 Blisters  Treatment –Relieve pain, keep from enlarging, and avoid infection –Cover w/bandage and change daily  Prevention –Eliminate friction Appropriate shoes & socks

20 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 20 Great Toe Sprain (turf toe)  Caused by foot sliding backward on a slippery surface – hyperextending the toe  Treatment –PRICE –Constant foot/toe support

21 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 21 Plantar Fasciitis  Inflammation of the plantar fascia  Plantar fascia – wide, ligamentous tissue extending from the anterior portion of the calcaneus to the heads of the metatarsals

22 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 22 Plantar Fasciitis  Causes: –Overuse –Unsupportive footwear –Tight Achilles tendon –Running on hard surfaces  Who: –Cross-country & Track Athletes –Basketball & Volleyball

23 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 23 Plantar Fasciitis  Signs & Symptoms: –Pain & tenderness on the bottom of the foot near the heal  Treatment: –Correcting training errors –Icing –Massage

24 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 24 Heel Bruise  One of the most disabling contusions in athletes  Treatment: –Cold therapy before activity –Cold & elevation after –Heel cups/cushions/pad

25 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 25 Heel Spur  A bony growth on the calcaneus causing painful inflammation  Aggravated by exercise  Treatment: –Located by pressing on the heel –Arch taping –Shoe inserts

26 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 26 Fractures  Athletes with a fracture generally cannot bear weight, have more swelling & pain than with a ligament sprain  Signs & Symptoms: –Point tenderness –Obvious deformity

27 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 27 Contusions  Contusions occur most often over the shin  The shin is sensitive to direct trauma  Possible damage to the peroneal nerve

28 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 28 Strains  Strains – occur anywhere along muscles & normally result from a violent contraction, overstretching, or continued overuse  Most common leg strain is to the gastrocnemius muscle

29 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 29 Muscle Cramps  Cramp – sudden, involuntary contraction of a muscle  Cause – unknown –Contributing factors Fatigue Fractures Dehydration Lack of nutrients Poor flexibility Improperly fitted equipment

30 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 30 Muscle Cramps  Treatment: –Passive stretching –Fluid replacement –Massage –Rest & ice

31 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 31 Achilles Tendonitis  A painful condition – inflammation of the Achilles Tendon  Achilles tendon connects the gastrocnemius & soleus muscles to the calcaneus  Achilles tendonitis can make walking almost impossible

32 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 32 Achilles Tendonitis  Signs & Symptoms: –Symptoms gradually develop –Pain & Crepitus –Redness  Treatment: –Prevention! Stretching before activity

33 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 33 Achilles Tendon Rupture  Cause: –Poor conditioning & overexertion –Direct trauma  Treatment: –Must be surgically repaired –Rehab may take up to one year

34 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 34 Medial Tibial Stress Syndrome (Shin Splints)  Catchall term for pain occurring below the knee on either the anterior or the medial side of the leg  Associated with repetitive activity on a hard surface or forceable excessive use of the leg muscles

35 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 35 Medial Tibial Stress Syndrome (Shin Splints)  Treatment: –Icing –Reducing activity level –Stretching of the posterior leg muscles  Shin Splints – worse in the morning as the soft tissue tightens over night

36 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 36 Stress Fractures  An incomplete crack in the bone  Microscopic fractures that may eventually lead to a full fracture if left untreated  Bone scan – definitive diagnosis

37 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 37 Stress Fractures  Signs & Symptoms –Palpation of shin & definite hot spot found – sharp, intense pain  Stress fractures feels better in the morning – bone was rested

38 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 38 Compartment Syndrome  Develops when there is swelling within one or more of the compartments in the lower leg –Anterior Compartment –Peroneal Compartment –Deep Posterior Compartment –Superficial Posterior Compartment

39 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 39 Compartment Syndrome  Anterior Compartment –Contains the tibialis anterior; extensor digitorum longus, peroneus tertius, & extensor hallucis muscles  Peroneal Compartment –Contains the peroneus longus and peroneus brevis muscles

40 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 40 Compartment Syndrome  Deep Posterior Compartment –Contains the popliteus, flexor digitorum longus, flexor hallucis longus, and tibialis posterior muscles  Superficial Posterior Compartment –Contains the gastrocnemius, soleus, and the plantaris muslces

41 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 41 Compartment Syndrome  Signs & Symptoms –Sudden or gradual onset of symptoms involving the leg –Swelling –Point tenderness & pain in the affected muscle group –Numbness, weakness & inability to use the affected muscle (later stages)  Treatment –Surgery

42 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 42 Foot/Ankle Rehabilitation  Exercises can be used both for rehabilitation and for prevention of injury  Complete Healing Absence of pain – Best determination of complete healing Full range of motion Strength Power Endurance

43 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 43 Foot Muscle Strengthening  Curl toes on top of a towel spread on the floor, causing the towel to bunch up

44 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 44 Tibialis Anterior Muscle  With one foot, step on an elastic band. Lift up the other foot with the elastic band wrapped around it.

45 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 45 Peroneus Brevis Muscle  With one foot, step on an elastic band; evert the other foot.  The closer the two feet are, the greater the resistance  The further away, the less resistance

46 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 46 Tibialis Posterior  Use a foot loop. Cross the leg muscle to be worked over the front of the other foot, which is placed above the band. Move the two feet in opposite directions.

47 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 47 Achilles Tendon Stretch  Place the foot not to be stretched forward. Both feet point straight ahead. Slowly squat.  Repeat with the back foot turned out about 35 to 45 degrees.  Repeat with the back foot turned in about 30 to 45 degrees.

48 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 48 Special Tests  Certain tests can be performed that aid in the evaluation of injury.

49 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 49 Thompson Test  With the subject prone and legs bent at 90 degrees, the certified athletic trainer places hand and fingers around the lower leg.  Lower leg muscles are squeezed. If the Achilles tendon is intact, the foot will plantar flex. If the foot does not move, the Achilles tendon is ruptured.

50 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 50 Anterior Drawer Test  The top of the ankle is stabilized with one hand, and the heel pulled up with the other.  Forward movement indicates a torn anterior talofibular ligament.

51 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 51 Plantar Fascia Test  Pressing in the area of the injury near the medial calcaneus helps determine how much of the plantar fascia is affected.

52 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 52 Talar Tilt Test  With the subject sitting and the ankle in a neutral position, grasp the calcaneus while holding the lower leg and apply direct inversion stress. The test is positive if the talus tilts out (injured calcaneofibular ligament).

53 Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 53 Tinel’s Sign  Tap the tibial nerve just below the lateral malleolus. Radiating pain indicates an inflamed tibial nerve.


Download ppt "Chapter 17 The Foot, Ankle, and Lower Leg. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2 Common Injuries  Ankle sprains  Arch sprains."

Similar presentations


Ads by Google