1. © 2010 Delmar, Cengage Learning 1 © 2011 Delmar, Cengage Learning PowerPoint Presentation to Accompany

2. © 2010 Delmar, Cengage Learning 2 © 2011 Delmar, Cengage Learning Chapter 17 The Foot, Ankle, and Lower Leg

3. © 2010 Delmar, Cengage Learning 3 © 2011 Delmar, Cengage Learning Objectives Upon completion of this chapter, you should be able to: –Describe the anatomy of the foot and ankle –Cite primary extrinsic and intrinsic muscles of the lower leg –Explain the common injuries and conditions affecting the foot, ankle, and lower leg –Describe medial tibial stress syndrome and its treatment 3

4. © 2010 Delmar, Cengage Learning 4 © 2011 Delmar, Cengage Learning The Lower Leg Exposed to numerous types of trauma during athletic practices and events –Common injuries include: Contusions Strains Tendonitis and tendon ruptures Medial tibial stress syndrome Stress fractures and other fractures Compartment syndrome 4

5. © 2010 Delmar, Cengage Learning 5 © 2011 Delmar, Cengage Learning The Foot and Ankle 15% of sports injuries involve ankle ligaments, bones, and tendons Basic anatomy: 5

6. © 2010 Delmar, Cengage Learning 6 © 2011 Delmar, Cengage Learning Common Injuries of the Foot and Ankle Ankle sprains –First degree (mild) –Second degree (moderate) –Third degree (severe) Treatment: protection, rest, ice, compression, and elevation (PRICE), followed by rehabilitation 6

7. © 2010 Delmar, Cengage Learning 7 © 2011 Delmar, Cengage Learning Animation – Ankle Sprain Click Here to Play Ankle Sprain Animation

8. © 2010 Delmar, Cengage Learning 8 © 2011 Delmar, Cengage Learning Common Injuries of the Foot and Ankle (cont’d.) Arch sprains –Caused by overuse, overweight, fatigue, training on hard surfaces, and nonsupportive shoes Treatment: cold, compression, and elevation Blisters –Occur anywhere there is friction Treatment: relieve pain, keep from enlarging, and avoid infection 8

9. © 2010 Delmar, Cengage Learning 9 © 2011 Delmar, Cengage Learning Common Injuries of the Foot and Ankle (cont’d.) Great toe sprain –Big toe hyperextends Treatment: protection, rest, ice, compression, elevation, and support 9

10. © 2010 Delmar, Cengage Learning 10 © 2011 Delmar, Cengage Learning Common Injuries of the Foot and Ankle (cont’d.) Plantar fasciitis –Tissue becomes strained from overuse, unsupportive footwear, a tight Achilles tendon, or running on hard surfaces Treatment: correct training errors, icing, and massage 10

11. © 2010 Delmar, Cengage Learning 11 © 2011 Delmar, Cengage Learning Common Injuries of the Foot and Ankle (cont’d.) Heel bruise –Heel receives, absorbs, and transfers impact from sports activities –Ligaments, tendons, and fat pad are subject to stress and injury Treatment: cold application before activity, cold and elevation afterward, heel cups or pads 11

12. © 2010 Delmar, Cengage Learning 12 © 2011 Delmar, Cengage Learning Common Injuries of the Foot and Ankle (cont’d.) Heel spur –Bony growth on calcaneus that causes painful inflammation of soft tissue Treatment: taping or shoe inserts Fractures –Immediately impairs ability to perform –Often the site of point tenderness is present, and an obvious deformity may be seen 12

13. © 2010 Delmar, Cengage Learning 13 © 2011 Delmar, Cengage Learning Common Injuries to the Lower Leg Contusions –Occur most often over the shin May also involve muscular areas of the leg –Result of a direct blow Strains –Occur anywhere along the muscles –Normally result from a violent contraction, overstretching, or continued overuse 13

14. © 2010 Delmar, Cengage Learning 14 © 2011 Delmar, Cengage Learning Common Injuries to the Lower Leg (cont’d.) Muscle cramps –Sudden, involuntary contraction of a muscle –Contributing factors may include fatigue, fractures, dehydration, lack of nutrients, poor flexibility, improperly fitted equipment Treatment: passive stretching, fluid replacement, massage, rest, and ice 14

15. © 2010 Delmar, Cengage Learning 15 © 2011 Delmar, Cengage Learning Common Injuries to the Lower Leg (cont’d.) Achilles tendonitis –Caused by inflammation of the Achilles tendon –Tearing of tendon tissues caused by excessive stress Treatment: best is prevention (stretching), ice, anti- inflammatory medication, physical therapy, rest Achilles tendon rupture –Caused by poor conditioning and overexertion Treatment: must be surgically repaired 15

16. © 2010 Delmar, Cengage Learning 16 © 2011 Delmar, Cengage Learning Common Injuries to the Lower Leg (cont’d.) Medial tibial stress syndrome (shin splints) –Normally the result of doing too much too soon Treatment: ice, reducing activity level, and gentle stretching of posterior leg muscles Long-term treatment: biomechanical assessment of lower extremities, physical therapy, orthotic devices, anti-inflammatory medications, and a strengthening and flexibility program 16

17. © 2010 Delmar, Cengage Learning 17 © 2011 Delmar, Cengage Learning Common Injuries to the Lower Leg (cont’d.) Stress fractures –Incomplete crack in the bone –Signs include a “hot spot” of sharp, intense pain Compartment syndrome –Develops when there is swelling within one or more lower leg compartments Treatment: immediate transportation to the nearest medical facility (surgery will usually be needed) 17

18. © 2010 Delmar, Cengage Learning 18 © 2011 Delmar, Cengage Learning Common Injuries to the Lower Leg (cont’d.) Fractures –Tibia can be fractured by a direct blow, a twisting force, or occasionally from repetitive overuse –Fibula is normally fractured by a direct blow to the outside of the leg 18

19. © 2010 Delmar, Cengage Learning 19 © 2011 Delmar, Cengage Learning Additional Tests for the Foot, Ankle, and Lower Leg Standard methods of testing various structures of the lower extremity: –Anterior Drawer Test –Plantar Fascia Test –Talar Tilt Test –Tinel’s Sign 19

20. © 2010 Delmar, Cengage Learning 20 © 2011 Delmar, Cengage Learning Conclusion Injuries to the lower extremity are common in athletics Solid understanding of anatomy will help the examiner assess injuries Proper conditioning, equipment, and training are essential to the overall health of the athlete 20