Chapter 8: The Foot

The Foot The two primary roles of the foot are propulsion and support 80% of the population has some form of foot issue 26 bones in the foot 14 phalanges 5 metatarsals 7 tarsals 2 sesamoids

Observation of Gait Observing the gait pattern is a key component of the evaluation of foot biomechanics. Look for any signs of foot dysfunction or inappropriate motion. The stance phase and the swing phase

Injuries to the foot

Fractures Signs and symptoms: Pain and swelling at the injury site Possible deformity Discoloration or redness Athlete heard a pop or snap Unable to bear weight effectively Hesitation to ambulate

Fractures, cont. Tests: Tap Compression Translation Treatment: Refer to physician for x-ray

Stress Fractures Signs and Symptoms: Similar to a true fracture Gradual onset Complain of sensation of having a “rock in my shoe” Treatment: Refer to physician for a bone scan Walking boot for 4-6 weeks Possible surgery Custom orthotics to correct mechanics

Dislocation Signs & Symptoms: Pain and swelling at injury site Obvious deformity Decreased ability or inability to bear weight Treatment: Refer to physician to rule out fracture and reduce injury RTP as symptoms resolve

Arch Strain/Sprain Signs & Symptoms: Pain and tenderness over injury site Swelling (medial aspect of arch) Pain with running and cutting Treatment: RICE therapy Stretching Taping

Spring Ligament Sprain Signs & Symptoms: Pain and tenderness distal to the heel of the foot on the medial aspect of the arch Pain with weight bearing Slight swelling over injury site Treatment: RICE Therapy Taping Refer to physician if symptoms persist

Plantar Fasciitis Signs & Symptoms: Pain at the distal aspect of the heel Pain with first steps in the morning Tightness and decreased ROM at the midfoot Slight swelling Treatment: Stretching the midfoot and toes will increase flexibility and ROM in the fascia

Heel Contusion Signs & Symptoms: Point tender on heel Slight discoloration Pain with ground contact Treatment: A heel cup or heel taping technique

Turf Toe Signs & Symptoms: Pain at first MTP joint Pain with flexion or extension Pain with running, especially push- off Slight swelling and discoloration Treatment: Rest is the most important treatment

Bunion & Bunionette Signs & Symptoms: Pain, especially with shoes on Redness and swelling Obvious protrusion of the first or fifth metatarsal Treatment: Surgical intervention if conservative treatment is unsuccessful

Ingrown Toenail Signs & Symptoms: Pain at the edge of the nail Swelling and redness in adjacent skin May have yellow/green discharge Treatment: Removal of the nail may be necessary

Subungal Hematoma Signs & Symptoms: Pain at injury site Discoloration under the nail Pain with movement or compression of nail Treatment: Removal of the excess fluid

Questions for Discussion How can you be sure that an athlete is ready to return to play after suffering a turf toe injury? What treatment options could you provide to an athlete with chronic ingrown toenails?