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The Foot

The Foot. Chapter 17. Foot Anatomy. 26 Bones 7 Tarsal 5 Metatarsal 14 Phalanges 38 Joints 4 Arches. Bones of the Foot. Bones of the Foot. Bones of the Foot. Tarsal Bones. Talus Calcaneus Navicular Cuboid Cuniforms Medial Intermediate Lateral. Metatarsals & Phalanges.

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The Foot

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  1. The Foot Chapter 17

  2. Foot Anatomy • 26 Bones • 7 Tarsal • 5 Metatarsal • 14 Phalanges • 38 Joints • 4 Arches

  3. Bones of the Foot

  4. Bones of the Foot

  5. Bones of the Foot

  6. Tarsal Bones • Talus • Calcaneus • Navicular • Cuboid • Cuniforms • Medial • Intermediate • Lateral

  7. Metatarsals & Phalanges

  8. Sesamoid Bones • 2 (medial and lateral) • Under great toe • Functionpulley, increase leverage of tendons that control great toe

  9. Joints of the Foot • Tibiotalar • Talocrural • Subtalar • Talonavicular • Calcaneocubiod • Metarsocunieform

  10. Joints of the Foot • Metatarsophalangeal Joint • Proximal Interphalangeal Joint • Distal Interphalangeal Joint

  11. Regions of Foot • Forefoot • Metatarsals • Phalanges • Midfoot • Navicular • Cuboid • 3 Cuniforms • Hindfoot • Calcaneus • Talus

  12. Regions of the Foot

  13. Plantar Fascia • Thick white band of fibrous tissue originating from the medial tuberosity of the calcaneus and ending at the proximal heads of the metatarsals • Work with ligaments to support arches during weigh bearing and downward forces

  14. Foot Arches • Functions • Support body weigh in an economical fashion • Absorb the shock of weight bearing • Provide a space on the plantar aspect of foot for blood vessels, nerves, and muscles

  15. Medial Longitudinal Arch • Highest of 3 arches of foot • Calcaneus, Talus, Navicular, Cuniforms & 1st three metatarsals • Supports— • Ligaments: • Spring ligament • Plantar fascia • Tendons: • Tibialis posterior • Tibialis anterior

  16. Lateral Longitudinal Arch • Lower and flatter • Calcaneus, Talus, Cuboid, 4th & 5th metatarsals • Supports— • Ligaments: • Short plantar ligament • Plantar fascia • Tendons: • Peroneus longus

  17. Transverse Arch • Cuniforms, Cuboid, & 5th metatarsal

  18. Shoe Wear Patterns • Excessive Pronation • Wear out front of shoe under 2nd metatarsal • Excessive Supination • Wear out lateral border of shoe • Common Misconception • Wearing out the back lateral corner of the shoe means you pronate • This is normal wear pattern

  19. Gait

  20. Posterior Tibial Artery Medial Malleolous Dorsalis Pedis artery Extensor Tendon Great Toe Pulse

  21. Dorsiflexion Plantar Flexion Pronation Inversion Eversion Supination Foot Movements

  22. Muscles of Foot Intrinsic Muscles Extrinsic Muscles Muscle outside a body part, organ, or bone Gastrocnemius • Relate to specific body part or bone • Flexor hallucis longus • Flexor hallucis brevis • Flexor digitorum longus • Extensor digitorum longus • Abductor hallucis • Abductor digiti minimi • Tibialis posterior

  23. Muscles of the Foot

  24. Muscles of the Foot

  25. Muscles of the Foot

  26. Common Injuries of the Foot

  27. Fractures & Stress Fractures • Impair ability to perform competitively • NWB • More swelling & pain than ligament sprain • Point tenderness present • Obvious deformity often present • Usually occur acutely; result of traumatic episode

  28. Jones Fracture • Fracture to the diaphysis at the base of the 5th metatarsal • Repetitive stress, direct force, or inversion and PF of foot • Healing slow; high nonunion rate

  29. Retrocalcaneal Bursitis • Swelling of the bursa at the back of the calcaneus under the Achilles tendon • S/sxs: • Pain in heel • Painful to touch • Pain worse when rising on toes • Red, warm skin over back of heel

  30. Plantar Fascia • Wide, non-elastic ligamentous tissue that extends from the anterior portion of calcaneus to heads of metatarsals • Supplies support to longitudinal arch

  31. Plantar Fasciitis • Strain/irritation of the plantar fascia • Caused by: • Overuse • Unsupportive footwear • Tight Achilles tendon • Running on hard surfaces • Chronic irritation • Pain, tenderness on bottom of foot near heal (especially in am) • Untreated will lead to: • Bone imbalance • Heel spurs • Muscle strains • Shin splints

  32. Plantar Fasciitis—Treatment • Correct training errors • Ice • Massage • Evaluate shoes & activity level • Arch support • Heel cup or cushion

  33. Arches

  34. Pes Planus • Flat foot • Associated with excessive pronation • Multiple causes: • Lack of shoe support • Weak muscles • Pain & weakness in medial longitudinal arch • Calcaneal eversion • Navicular bulging • Flattening of arch

  35. Pes Cavus • aka Clawfoot, hollow foot • Associated with excessive supination • Shock absorption poor • General foot pain and metatarsalgia common • Abnormally short Achilles tendon • Calluses ball and heel

  36. Arch Sprains • Ligaments stretch, thus fail to hold bones of foot in position • When arch weakened, it cannot absorb shock normally • Causes: • Overuse • Overweight • Fatigue • Training on hard surfaces • Non-supportive shoes • Shoes in poor condition

  37. Turf Toe • Great toe strain • Hyperextension of the first MTP joint of the big toe • Treatment: • RICE & Support • Limit movement • Turf toe taping

  38. Heel Spur • Bony growth on calcaneus • Causes painful inflammation • Aggravated by exercise • As foot flattens, plantar fascia is stretched & pulled where it attaches to calcaneus calcaneus reacts by forming spur of bony material

  39. Heel Contusion • Irritation of the lateral aspect of the heel • Sudden stop-and-go or sudden change in movement

  40. Heel Contusion—Treatment • Cold application before activity • Ice & elevation after activity • Absorb shock— • Heel cups • Donut pad

  41. Sever’s Disease • Traction injury at the apophysis of the calcaneus where the Achilles tendon attaches • Young, physically active athletes • Comparable to Osgood-Shlatter’s disease (at tibial tubercle of knee) • Pain occurs during vigorous activity and does not continue during rest

  42. Blisters • Occur on any part of body where there is friction • Most common on feet or heels • Treatment Goals: • Relieve pain • Keep from enlarging • Avoid infection

  43. Blisters—Treatment • Wash area thoroughly • Use sterile blade to cut small hole in blister • Squeeze out clear fluid • Do not remove skin • Prevention: • Wear work gloves • Break in new skin • Petroleum jelly/skin lube • Adhesive bandage

  44. Prevention of Foot Injuries • Selecting appropriate footwear • Using shoe orthotic • Foot hygiene

  45. Rehabilitation of the Foot • Towel pulls • TheraBand® • Marble pick-up

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