Foot, Ankle, & Lower Leg Injuries

Great Toe Sprain  At the 1 st Metatarsal-phalangeal joint  Hyper extension or hyper flexion  Pain, tenderness, and/or swelling is on dorsal or plantar surface of MTP joint

Ingrown Toe Nail

 Nail grows into surrounding tissue  Cause : poor trimming of toe nails; rounded instead of straight; or too short

Inversion Ankle Sprain Lateral ligaments usually injured due to stretching mechanism 85% of ankle sprains are inversion Fibula prevents severe eversion Deltoid ligament is stronger

Inversion Ankle Sprain  Deformities  Swelling, discoloration, pain & point tenderness  ROM decreased  Strength decreased  Orthopedic Test : Anterior Drawer Test – Grade I, II, III

InversionAnkleSprain

Ankle Sprains  So What structures are normally injured? –Grade 1: Anterior Talofibular –Grade 2: ATF & Calcaneofibular –Grade 3: ATF, CF, & Posterior Talofibular

Jones’ Fracture

 Avulsion fracture of the 5 th metatarsal head in inversion sprain  Xrays needed to rule out fracture if suspected

Achilles Tendonitis  Irritation or inflammation of the Achilles Tendon  Swelling, tenderness, heat, crepitus (crunchiness), pain  If worsens, can lead to complete tear

Achilles’ Rupture

Achilles Tendon Rupture  Athlete usually falls, grabbing leg in pain  Feels as if they were shot in the back of their leg  Extreme pain, swelling, deformity or depression, weakness or complete loss of plantar flexion  Orthopedic Test: Thompson’s Test

Thompson’s Test

 GASTROCNEMIUS  STRAIN

Shin Splints  Called Medial Tibial Stress Syndrome  It is inflammation of the periosteum lining of the tibia  Caused from the Soleus muscle insertion –Pronation –Out of shape or overuse –Change in running distance, surface, footwear, or form

Shin Splints (cont.)  Dull achy pain, can be present before, during, and after activity  Point tender on medial border of tibia  Pain with resisted plantar flexion (due to Soleus) involvement

Stress Fractures  Caused by repetitive stress  Usually to tibia, fibula, and metatarsals (but can occur in any bone)  Complain of most intense pain after activity and during night  Pain and swelling on bone at fracture site

Stress Fracture  Bone scan is  needed to  diagnose

Using those X-ray Eyes  Percussion test  Bump test  Squeeze Test  Vibration (tuning fork)  Compression/Distraction