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Foot and Ankle Injuries. Ankle Sprains. Most common lower leg injury Classified as to degree of ligamentous severity. Lateral ankle sprain . Mechanism: Inversion and plantar flexion Anterior talofibular ligament (ATF) usually first structure to injury

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ankle sprains
Ankle Sprains
  • Most common lower leg injury
  • Classified as to degree of ligamentous severity
lateral ankle sprain
Lateral ankle sprain
  • Mechanism:
    • Inversion and plantar flexion
  • Anterior talofibular ligament (ATF) usually first structure to injury
  • Calcaneofibular ligament (CF) is usually secondary
  • Posterior talofibular ligament (PTF) rarely injured
lateral ankle sprain1
Lateral ankle sprain
  • Signs/Symptoms:
    • Obvious mech. of injury
    • Report of “popping” or “tearing” of tissue
    • Rapid swelling and point tenderness over soft tissue
    • Be careful of possible fracture
medial ankle sprain
Medial ankle sprain
  • Less common
  • Mechanism:
    • Eversion
  • Deltoid ligament injury
medial ankle sprain1
Medial ankle sprain
  • Signs/Symptoms:
    • Pain and swelling not as evident
    • Point tenderness over deltoid
syndesmosis ankle sprain
Syndesmosis ankle sprain
  • Separation/widening of distal tibiofibular joint
  • Injury to Anterior/Posterior tibiofibular ligaments
  • Usually very disabling
  • “High” ankle sprain
  • Mechanism:
    • Dorsiflextion with inversion or eversion
syndesmosis ankle sprain1
Syndesmosis ankle sprain
  • Signs/Symptoms:
    • Similar to lateral/medial ankle sprains
    • Point tender at bony junction – top of ankle
    • Swelling over medial/lateral malleoli
  • May occur anywhere in foot
  • Common at the base of 5th Metatarsal (Jones Fracture)
    • Usually result of forceful landing from jumping
    • May be considered an avulsion fracture from an inversion ankle sprain
    • Treatment is extremely controversial
turf toe
Turf Toe
  • First Metatarsaophalangeal (MTP) Sprain
  • Common with artificial surfaces
  • Mechanism:
    • Hyperextending the MTP join or
    • Contact with the shoe end
turf toe1
Turf Toe
  • Signs/Symptoms:
    • Pain and Tenderness
    • Swelling on the Plantar joint aspect
    • Discomfort with toe extension
  • Treatment
    • Cryotherapy, NSAIDS, Rest
    • Protection from mechanism
bunions hallux valgus
Bunions (Halluxvalgus)
  • Inflammation and thickening of the medial aspect of the MTP joint of the hallux
  • MTP joint becomes inflamed and causes lateral displacement of the hallux
  • As the condition progresses the 1st toe may overlap the 2nd toe
  • Predisposing factors
    • High heels, pointed shoe box, poor shoe fit
  • Management
    • Strapping of the hallux
    • Wider toe box
    • Surgical correction
plantar fasciitis bone spur
Plantar Fasciitis (Bone spur)
  • Most common hindfoot problem in runners
  • Main support for longitudinal arch
  • Structurally weak near the origin attachment
  • Predisposing factors
    • Significant increase in training
    • Excessive tightness in Achilles tendon
    • Abnormal change in body weight
    • Pescavus (high arch)
plantar fasciitis bone spur1
Plantar Fasciitis (Bone spur)
  • Signs/Symptoms
    • Pain is usually most sever during the first step in the morning
    • Discomfort is reduced throughout the duration of the day
    • Extreme point tenderness over origin
  • Management
    • Therapeutic modalities (e-stim, ultrasound)
    • Achilles tendon stretching
    • NSAIDS
    • Heel lifts, taping, orthodics
    • Night splints
    • MD referral
achilles tendonitis
Achilles Tendonitis
  • Result of repetitive jumping or running (Loooooong distance runners)
  • Signs/Symptoms
    • Thickening of surrounding tissues
    • Crepitation with tendinous movement
    • Reduced ROM
  • Management
    • Ice therapy, NSAIDS
    • Active stretching, Heel lifts
    • Complete resolution of symptoms prior to return
    • A chronic weakness will progress to rupture
medial tibial stress syndrome shin splints
Medial Tibial Stress Syndrome(Shin splints)
  • Early, painful component of first part of a training activity
  • Associated with repetitive activity on hard surfaces
  • Contributing factors
    • Muscled inflexibility
    • PesPlanus (Low arch)
    • Poor footwear
    • Dramatic change in training or surface
  • Signs/Symptoms
    • Pain along medial tibial border
    • Usu. Lower 1/3 of shin
    • Common for bilateral symptoms
medial tibial stress syndrome shin splints1
Medial Tibial Stress Syndrome(Shin splints)
  • Management
    • Rule out stress fractures
    • Cryotherapy, NSAIDS
    • Modification in training
    • Pain free stretching of ankle/foot
    • Change in footwear
compartment syndrome
Compartment Syndrome
  • Acute compartment syndrome results from a direct blow to the lower leg.
  • Chronic compartment syndrome results from increase in the intramuscular pressure during exercise
  • Most common in Anterior Leg Compartment
compartment syndrome1
Compartment Syndrome
  • Signs/Symptoms
    • Decreased distal pulse
    • Swelling
    • Pain and tenderness
    • Numbness, significant muscle weakness
    • Tight skin
  • Chronic – symptoms will reduce post-exercise
compartment syndrome2
Compartment Syndrome
  • Treatment/Management
    • Medical Emergency
    • Immediate Referral to MD
    • Ice
    • Ice, NSAIDS, Stretching, Alter activities
    • If severe (or not improving) refer to MD
      • Surgical Fascia Release