Foot Ankle and Lower Leg Injuries

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Foot Ankle and Lower Leg Injuries Powered By Docstoc
					 Foot, Ankle, and
Lower-Leg Injuries
                  Anatomy- Bones
   28 bones (called phalanges)
   Each toe has three bones (proximal, middle, distal) except the big
    toe which only has the proximal and distal
   Toe joints are interphalangeal joints
   Bones under big toe are called sesamoids which ease muscular
    movement over a bony surface (assist flexion)
   Metatarsals are long bones of the foot (numbered 1 to 5)
   Metatarsophalangeal joints are joints between the metatarsals and
   Midfoot contains small several bones that joint together at the joint
    and produce small movements
   Calcaneus is the heel bone
   Medial malleolus is the end of the tibia on the medial side and the
    end of the fibula
   Lateral malleolus is the end of the fibula at the lateral aspect
   Arches of the Foot
       3 arches on planter (bottom)
        of foot
       Purpose of arches shock
       Transverse arch in front of
        the heel and goes to the fifth
        metacarpal to the navicular
       Longitudinal arch runs from
        the calcaneus to the
        metatarsal heads
       Metatarsal arch runs along
        the metatarsal heads
                Anatomy- Muscles
   Peroneal muslces
    (proneus brevis and
    proneus longus) attatch to
    the lateral aspect and
    under side of the foot to
    stabilize the lateral aspect
    of the foot
   Gastrocnemius attaches
    by the Achilles tendon and
    allows the athletes to
    propel themselves when
        Anatomy- Ligaments
 Lateral  ligaments include anterior
  talofibular, posterial talofibular,
  calcaniofibular ligaments hold bony
  structures together on lateral side (weaker
  than medial side)
 Medial ligaments includes deltoid
  covers the entire medial side, maintains
  stability (especially during eversion)
   Wear shoes!!!  they
    provide ankle and foot
   Supportive ankle tapping to
    prevent ankle eversion
   Wear shin guards to
    prevent contusions of the
    lower leg
   Strengthing and
    conditioning programs
   If physicians find a
    weakness in the leg they
    should be replaced in
Ligament Injuries
   Great Toe Sprains
       Excessive force is applied to the
        great (big) toe during flexion or
       Cause: stubbing your toe,
        suddenly stopping when
        running, and landing awkwardly.
       Symptoms: pain, tenderness,
        unable to move toe, swelling,
        and bruising
       Treatment: PRICE
       Ligament injuries Cont…
 Arch   Sprain
     Causes: prolonged stress on the feet,
     Symptoms: pain, tenderness, and sometimes
      bruising on bottom of foot
     Treatment: PRICE
           Ligament Injuries Cont…

   Lateral and Medial Ankle sprains
       When the ankle is inverted the lateral ligaments are injured,
        when everted the deltoid ligaments are injured
       85% of ankle sprains are caused by excessive inversion
       The ankle is the most often sprained part of the body
       Causes: awkwardly planting the foot, stepping on an irregular
        surface, during athletic events when one player steps on
       Symptoms: swelling, pain, and joint may throb, difficulty walking,
        discoloration, redness, and warmth
       Treatment: PRICE!
         Ligament Injuries Cont…
   Ankle dislocation
       Causes: foot is forcefully
        flexed downwards injuring the
        posterior aspect, or the heel
        strikes the ground forcefully
        injuring the anterior aspect
       Symptoms: pain, athlete will
        refuse to move, inability to
        move the foot, deformity,
        rapid swelling
       Treatment: call 911, splint the
        lower leg/ankle, ice, team
        physician should relocate the
      Muscle and Tendon Injuries
   Achilies tendonitis
      Inflammation of the achilles tendon
      Causes: repetitive running jumping
       and landing, causes the cells in the
       tendon to break down prematurely
      Symptoms: gradual onset of pain,
       tenderness, swelling, redness,
       crepitus, and you can sometime feel
       it creaking when you press your
       fingers into the tendon and ankle
      Treatment: ice and pressure, refer to
       physician, gentle stretching and
       strengthening exercises
Muscle and Tendon Injuries Cont…
   Achilles Tendon Rupture
       Largest tendon in the body
       Grow weak and thin with age
       Illnesses such as arthritis and
        diabetes and some antibiotics
        increase the chance of this injury
       Most commonly occurs in middle-
        aged male athletes
       Causes: forceful push off while
        knee is straight, trip or stumble, fall
        from high heights
       Symptoms: severe pain on tendon
        sound of a loud pop or snap, feel
        gap in tendon, swelling and
        stiffness, bruising, weakness
       Treatment: iced, call 911, surgery
        Bone Injuries
   Fifth Metatarsal Avulsion Fracture (Jones
       Most common avulsion fracture
       When the ankle is forced into inversion the
        muscles contract forcefully to stabilize the lateral
        aspect of the ankle and the proneus brevis
        tendon pulls apart of the bone away at its
       Symptoms: swelling, bruising, pain in the middle
        out side of the foot
       Treatment: cast, doctor
             Bone Injuries Cont…
   Epiphyseal Injury of Distal Tibia and Fibula
       Growth plates become injured when ankle is forced
        into planter flexion and inversion
       Symptoms: pain, swelling, difficulty walking
       Treatment: splint, refer to a doctor
   Stress Fracture
       Most commonly occurs on tibia, fibula, and
       Causes: repetitive stress, usually running
       Symptoms: pain, swelling,
       Treatment: rest, refer to physician, sometimes casted
           Other Common Injuries
 Shin splints
     Causes: wearing bad shoes, being
      out of shape for the type of running
      event, tight calf muscles
     Symptoms: pain, swelling, lumps
     Treatment: PRICE
 Anterior Compartment Syndrome
     Muscles on the anterior aspect of
      the tibia are enclosed by
      connective tissue and if overused
      or severely impacted the tissue
     Symptoms: pain, hot, red, loss of
      movement, area is hard
     Treatment: refer to physician
      immediately where they will make
      an incision
Other Common Injuries Cont…
   Contusions
       Impact of a ball stick or foot
        on shin
       Symptoms: swelling, pain,
        discoloration, limp, loss of
       Treatment: ice and rest
   Toe abnormalities
       Hammer Toe- the middle
        joint of the toe is flexed and
        the metatarssal and distal
        phalangeal joint is
       Halux Valgus (Bunion) –
        excessive pressure on the
        great toe toward the
        midline from poor footwear
Other Common Injuries Cont…
   Ingrown Toenail –
    where the nail grows
    into the surrounding
    soft tissue from poor
    trimming of the nail.
    (trim nail straight
    across and not too
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