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Leg Problems : Outline Gross Anatomy Achilles Problems Compartment Syndromes Shin Splints (MTSS)
LEG PROBLEMS CON’T Stress Fractures Signs, Symptoms and Treatments Prevention programs
GAIT CYCLE 25% stance
Pronation: is the impact absorption phase of gait. We either pronate too much, not enough or just right.
As weight is transferred from the outside of the foot to the inside of the foot, the leg internally rotates. As weight shifts from inside to out, external rotation of the leg occurs.
Reminder – Muscles of the leg.
P. Longus P. Brevis P. Tertius Ext. Digitorum Longus Ext. Hallucis Longus Tib. Anterior Tib. Posterior Flex. Digitorum Longus Flex. Hallucis Longus Achilles Tendon
COMPARTMENT SYNDROMES Traumatic and Exertional
Pressure in comp. Volume demands in Compartment. Compromise of capillary profusion. Muscle swells and dumps fluid.
Muscles are attempting in work in a hypoxic environment. Not only is this difficult, it is painful and muscles continue to swell in a hypoxic environment.
Nerves are the first structures to show signs of hypoxia
Compartment Evaluation Test strength x 10 Stretch muscle Palpate for firmness Examine skin.
Left Leg Anterior
Anterior Compartment Area of Sensory Deprivation
Left Leg LATERAL
Sensory deprivation to plantar foot. Pain on palpation middle to lower third of postero- medial tibia. Deep Posterior
Measuring Compartment Pressures
It is not how high the pressure is during running; it is how long it takes to return to normal. 20 Ideal Bad Insertion
GENERAL TREATMENT GUIDELINES Stretching, gradual motion before activity. Icing after activity. Stretching, stretching Modification of activity
PERIOSTITIS: an inflammation of the outer covering of the bone. FASCIITIS: and inflammation of the fascial covering of the muscle.
Shin Splints and M.T.S.S…..History of excessive weight bearing (jumping,running, or standing for prolonged periods of time, in combination with improper shoes.
Shin Splints and M.T.S.S. Associated with varus alignment (bowlegs) of the lower extremity and excessive pronation. Improper footwear may be a factor.
GENERAL TREATMENT Icing Stretching Strengthening Motion Control of foot.
SHIN SPLINTS Tibialis Posterior is eccentrically working to slow down the internal rotation of the leg on the foot during pronation of the foot. Muscle thought to pull away from bone.
MEDIAL TIBIAL STRESS SYNDROME Soleus muscle slows down the internal rotation of the tibia on the foot during pronation. Pain in lower medial third.
ACHILLES TENDON Gastrocnemius, Soleus, Plantaris Tendon and Paratenon
Grade I No discomfort prior to activity. No limitations. Stiffness after activity.
Grade II Discomfort before activity. Pain during activity. Pain and tightness after. Nodules
Grade III Pain and stiffness before activity. Pain limits quality and quantity of activity. Very painful after.
Achilles Tendon Rehab
I CING BEFORE AND AFTER ACTIVITY
Stretching of Achilles. Squeezing lump out of tendon. Curtail injurious activity and substitute other fitness activities. Heel lifts in shoes.
Achilles Paratenonitis Irritation of the paratenon. Caused by overuse. Rubbing of paratenon on the achilles tendon. Pain, crepitation. STOP! Icing, stretching.
ACHILLES RUPTURE Previous multiple minor trauma. Passive stretch plus active contraction TEAR!
EXAMINATION History Palpation Thompson Test Strength Testing
Ruptured Achilles Tendon Tear 1” above heel or at musculotendinous junction. Palpate for gaps. Manually test for strength. Have athlete do single leg toe raise.
Impact absorbed by shoe, muscles, bones (joints). Too strong of a muscle pull on one sideof the bone
ACTIVITY PAIN s.p. Pain at onset, reduced on warm-up, after pain c.s. Pain escalates as activity continues. s.f. Pain before activity, same during and the same after.
NIGHT PAIN s.p. No night pain. c.s. No night pain. s.f. Deep aching pain that wakes athlete.
REPEATED MUSCLE CONTRACTIONS s.p. No effect. c.s. Cause a slowing and a weakening of contraction (x10) s.f. No effect.
SENSORY CHANGES s.p.No Changes. c.s Potential changes corresponding to compartment. s.f.No Change.
MUSCLE STRETCH s.p.No change. c.s. Stretching a muscle within the affected compart. will increase pain. s.f. No change.
The Lower Leg. ANATOMY Bones Tibia Fibula MUSCLES The muscles are in four compartments with 2-4 muscles in each compartment Compartments are.
Common Injuries Sports Medicine I. Heel Bruise Absorbs impact from sports activities Absorbs impact from sports activities Disabling contusion Disabling.
Injuries to the Lower Leg, Ankle, and Foot. Anatomy Provide stable base of support and a dynamic system for movement Bones of the lower leg consist.
Ankle and Leg Injuries ROP SPORTS MEDICINE Stacy Camou.
Ankle and Lower Leg Chapter 17.
Foot, Ankle, & Lower Leg Injuries. Great Toe Sprain At the 1 st Metatarsal-phalangeal joint Hyper extension or hyper flexion Pain, tenderness, and/or.
© 2010 Delmar, Cengage Learning 1 © 2011 Delmar, Cengage Learning PowerPoint Presentation to Accompany.
SECTA Sports Medicine. Common Injuries of the Foot & Ankle Ankle sprains: The most common injury Mostly due to excessive inversion and plantar flexion.
Foot, Ankle, Lower Leg Injuries
The Ankle & Lower Leg.
Lower Leg. Anatomy Bone Tibia 2 nd longest bone in body Weight bearing bone wide at top and bottom Fibula non weight bearing no protection at mallious.
Lower Leg/Ankle Injuries. Great Toe Sprain Aka – turf toe MOI ▫Excessive force applied to great toe (flexion or extension) Force causes sprain/strain.
Ankle and Lower Leg Chapter 15.
Foot, Ankle, and Lower Leg Chapter 15. The Foot The three major groups of bones are –Tarsals –Metatarsals –Phalanges A grand total of 28 bones in the.
Athletic Injuries ATC 222 Foot, Ankle, and Leg Chapters 14 and 15.
Ankle and Lower Leg Chapter 19.
Ankle Orthopedic Exams. Medial Aspect Medial Tendons.
Ankle and Lower Leg.
Chapter 19: The Ankle and Lower Leg
Injuries to the Lower Leg, Foot and Ankle. Lower Leg Injuries Caution! Graphic Picture.
Preventing Injury in the Lower Leg and Ankle Achilles Tendon Stretching –A tight heel cord may limit dorsiflexion and may predispose athlete to ankle injury.
Injuries to the Lower Leg, Ankle, and Foot. Anatomy Provide stable base of support and a dynamic system for movement Tibia and fibula Talus Calcaneus.
Lower Leg and Ankle. Walking Gait Stance Phase Heel-strike Midstance Toe-off Swing Phase.
Chapter 17 - The Foot, Ankle, & Lower Leg
The Ankle & Lower Leg Bones: Tibia (Medial Malleolus) Fibula (Lateral Malleolus) TalusCalcaneus (Heel Bone) Ankle Ligaments (Lateral & Medial)
Plantar warts Caused by a virus that is contracted through direct contact. Showers and locker rooms Located on the bottom “plantar” aspect of the foot.
Ankle Sprain MOI: 85% inversion, 15% eversion Deltoid stronger than lateral ligaments Fibula longer than tibia S/S: pain, swelling, discoloration,
The Foot & Ankle. 1/4/20162 Bony Anatomy of the Foot.
Posterior and Anterior Anatomy of the Leg and Ankle
Ankle and Foot Assessment
Chapter 11 The Ankle and Foot Joints
MOST COMMON INJURY GROSS AND FUNCTIONAL ANATOMY OF THE ANKLE JOINT.
MUSCULAR SYSTEM DISORDERS OF ASSOCIATED STRUCTURES SLO 5.
HARMELING PHYSICAL THERAPY
Foot & Lower Leg.
Objectives Understand: Identify: Recognize:
5 th MT Avulsion Fx MOI › Ankle forced into inversion, muscle contract so forcefully to stabilize the lateral aspect of ankle, that peroneus.
© 2010 Delmar, Cengage Learning 1 © 2011 Delmar, Cengage Learning BELLWORK Name as many injuries to the foot, ankle, or lower leg that you have heard of.
H. Muscles that move the foot and toes 1. Anterior compartment a. Tibialis anterior- dorsiflexes and inverts foot 1. Originates from lateral condyle of.
The Ankle and Lower Leg Injuries. Prevention: –Heel cord stretching Before and after activity –Strength training Achieving static & dynamic joint stability.
Prevention and Treatment of Injuries
Causes, Symptoms, and Treatment
HE92: Sports Medicine Final Fall Semester Review #2.
WINDSOR UNIVERSITY SCHOOL OF MEDICINE
Dr. SREEKANTH THOTA DEPARTMENT OF ANATOMY Lower limb LEG.
INJURY DIAGNOSIS AND TREATMENT REMEMBER, WE ARE NOT DOCTORS!! We can help NARROW down injuries and give basic first aid… ALWAYS CONSULT A DOCTOR!
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