Foot and Ankle Injuries

Plantar Fasciitis Inflammation of the plantar fascia ( band that connects calcaneus to metatarsal- phalangeal joint) MOI 1. high arches 2. excessive pronation 3. obesity/weight gain 4. overuse – stand,walk,run

Plantar Fasciitis MOI causes the fascia to stretch! Signs/Symptoms: 1. pain upon taking first step in the morning. 2. pain and inflammation on medial attachment of calcaneus 3. can lead to a heel spur Treatment 1. rest and ice to decrease inflammation 2. stretch calf muscles 3. arch supports – orthotics 4. oral anti-inflammatory medication

Heel Spur Develops when plantar fasciitis goes untreated Common problem in distance runners -15+miles per week Calcium growth at site of attachment Treatment – rest and ice ** stretch intrinsic muscles of foot and calf muscles

Sever’s Disease

Sever’s Disease MOI - achilles tendon continually pulls at insertion site thus pulling on the growth plate of the calcaneus. Occurs in 10-15 year olds Associated with running and repetitive jumping Poor or flimsy footwear Treatment 1. rest 2. stable footwear

Jones Fracture Base of the 5th metatarsal fracture Attachment of peroneal tendon

Jones Fracture – 5th metatarsal Fracture of the 5th metatarsal ½”-3/4” from the base Often mistaken as a sprain or avulsion fracture Danger – non-union fracture due to poor blood supply MOI: 1. inversion injury to ankle of foot 2. overuse – repetitive stress – Sprinters! Signs/Symptoms: severe pain when walking, swelling and bruising Treatment – 6-8 weeks casted non-weight bearing

Treatment for Jones Fracture Severe fracture – surgical screw Depends on severity of fracture

Great Toe Sprain Known as turf toe Sprain to the metatarso- phalangeal joint(MTP) of the 1st toe MOI: hyperflexion Great toe is involved in the final push off the ground and receives the pressure of 8 times the body weight

3 degrees of turf toe 1st – no time loss, ice, tape, strengthen toe box of footwear 2nd – time lost, crutches, ice, tape, strengthen toe box of footwear 3rd – season ending injury, possible surgery Treatment – contrast bath

Anatomical image of Achilles tendon

Posterior/Inferior aspect of lower leg Gastrocnemius and soleus unite into a tough band of fibrous tissue and attaches to the calcaneus Largest and strongest tendon of the body that allows you to stand on toes when walking, running and jumping Bursae sac cushions the tendon

Achilles tendonitis Inflammation of the tendon MOI: 1. overuse from running/walking, running hills 2. tight calf muscles 3. heels to sneakers Signs/Symptoms: pain and inflammation Treatment: rest, ice, stretch

Achilles tendon tear Micro-tears or large tear MOI: sudden movement or gradual wearing from overuse Signs/Symptoms: 1. pain and inflammation over site of tear 2. impaired movement Treatment: 1. rest and ice 2. NSAID 3. heel lift 4. gentle stretching * NO CORTISONE SHOTS – weakens the tendon

Achilles Tendon Rupture

Achilles Tendon Rupture Complete tear of the tendon Signs/Symptoms: 1. hear a “pop” sound 2. feels like you have been shot in the leg Causes: sudden bursts from jumping, pivoting, and sprinting Common in the” Weekend Warrior” Thompson’s Test – squeeze the calf and the foot does not move. Treatment: SURGERY -long term immobolize and rehabilitation

Ruptured Achilles tendon

Causes of Fractures ACCIDENTS – car, motorcycle, falls, struck by an object Aging – decrease in balance, coordination, eyesight and hearing can result in falls Bone Fatigue – prolonged repetitive forces (professional football players, marathon runners, Olympic gymnasts)

Avulsion fracture of fibula

Fractures of fibula and/or tibia

Tibia Fractures Neck of tibia Limb lengthening