1. Unit 5:Understanding Athletic-Related Injuries to the Lower Extremity
Foot and Ankle, Anatomy and Injuries
Sports Medicine

2. The Foot and Ankle

3. The Foot (Bones)
Bones = 26
14 phalanges
5 metatarsals
7 tarsals

4. Toes (Phalanges)
Designed to give wider base for balance and propelling the body forward.
1st toe (Hallux)
Two sesamoid bones located under the 1st MP joint.

5. Metatarsals
5 Bones
1st metatarsal is the largest and strongest and functions as the main body support during walking and running.
Palpable at the ball of the foot.
5th metatarsal most common fractured.

6. Tarsals 7 bones Aids in the support of the body.
Calcaneous = largest tarsal bone, supports talus and shapes heel, and provides attachment for achilles tendon.

7. Joints of the Foot Interphalangeal joint (IP)
Flexion / Extension
Metarsalphalangeal joint (MP)
Abduction / Adduction

8. Bones of the Ankle Tibia Fibula Talus
Main weight bearing bone of LOWER LEG
Forms medial malleolus
Fibula
Non-weight bearing
Mainly muscle and ligament attachment
Forms lateral malleolus
Talus
Main weight bearing bone of the ANKLE

9. Lateral Ligaments of the Ankle
Resist ankle inversion
Anterior talofibular (ATF)
Most commonly sprained
Calcaneofibular (CF)
Posterior talofibular (PTF)

10. Medial Ankle Ligaments
Deltoid
Resists ankle eversion
Low rate of injury

12. Muscles of the Foot and Ankle
Posterior Muscles (2)
Gastrocnemius
plantarflexion of ankle
Soleus

13. Arches of the Foot

14. Arch Chart

15. Arches of the Foot

16. Supinated Arches (High Arches)

17. Supinated Arches

18. Supinated Arches

19. Pronated Arches (Flat Feet)

20. Pronated Arches

21. Orthotics

22. Orthotics

23. Orthotics

24. Foot and Ankle Injuries

25. Ankle Sprain Cause: Excessive inversion or eversion of the ankle
Signs and Symptoms (S/S): Point tenderness, swelling, discoloration,
laxity, inability to walk or run properly (extent
based on degree).
Treatment (TX): PRICE, rehabilitation immediately (Grade
III requires immobilization)
Prevention: Strengthening exercises, proper
shoes/ equipment

27. Lateral Ankle Sprain Treatment
1st Degree Ankle Sprain
2nd Degree Ankle Sprain
3rd Degree Ankle Sprain
PRICE
Return to Play
(Toe raise, heel walk, Full go w/ full ROM (range of motion)
Tape to Play
Reevaluate 24hrs
(Horseshoe w/ compression wrap)
Crutches 24 hours
Reevaluate 24hrs
Refer to Dr.
X-rays
PRICE (Horseshoe w/ compression wrap)
Crutches
Posterior Splint

28. Horseshoe
Brace

29. Ankle Special Tests Anterior Drawer Test
Tests for ligament instability
Mainly tests ATF integrity but can also test the CF and PTF depending on severity
Ankle must be relaxed
Ankle in slight plantar flexion

30. Ankle Dislocation Injury cause: S/S:
Anterior – Heel strikes ground forcefully
Posterior – blow to anterior lower leg
S/S:
PN deformity, inability to move foot, rapid
swelling, refusal to allow moving or touching foot
TX:
Splint, ICE, 911 or transport to hospital

32. Turf Toe Sprain of the 1st MP joint Mx: S/S
Hyperextension/ hyperflexion of great toe
Common on artificial surface
Flexible types of footwear can contribute
S/S
Pain over the first MP joint

34. Compartment Syndrome (Miss. Katelyn’s favorite injury type)
Cause:
Increased pressure within one of four compartments of lower leg causes compression of the structures in the leg.
S/S:
Deep aching pain, tightness, and swelling. Pain with stretching.
TX:
Acute~ immediate surgery
Chronic~ activity modification & ice and some times surgery
Prevention:
Stretching (Hard to prevent)

39. Toe Abnormalities Hammer Toes MX: TX: Poor shoe choices
Middle joint (PIP) flexed, other joints (MP, DIP) hyperextended
TX:
Refer, orthotics or surgery

40. Bunion / Hallux Valgus MX: S/S: TX: Prevention:
Bony enlargement of the head of the 1st metatarsal caused from wearing improperly fitting shoes
S/S:
Obvious deformity, tenderness, and swelling
TX:
Proper shoe selection, protection devices, surgery may be necessary
Prevention:
Properly fitting shoes

43. Ingrown Toenail MX: S/S: TX: Prevention:
Improper shoe fitting and nail cutting
S/S:
Increased pain, swelling, redness around the nail bed
TX:
Hot, soapy water, antibiotics, raise nail up
Prevention:
Proper shoes, proper nail trimming

45. Ankle Taping – Heel Locks

46. Ankle Taping – Full Ankle