Basic Athletic Training Chapter 6 Foot, Ankle, and Lower Leg

Chapter Objectives Name the anatomy of the foot, ankle, and leg including bones, joints, muscles, and ligaments Identify the components of an evaluation format Compare the common injuries associated with the foot, ankle, and leg Demonstrate the principles of rehabilitation for the foot, ankle, and leg Describe the preventive/supportive techniques and protective devices for the lower extremity

Anatomy Foot, Ankle and Leg Anatomy Bones Ligaments Joints Muscles and their functions Arches Range of motion Dermatomes Myotomes

Evaluation Format (H)istory Mechanism of injury (How did it happen?) Location of pain (Where does it hurt?) Sensations experienced (Did you hear a pop or snap?) Previous injury (Have you injured this anatomical structure before?) (O)bservation—compare the uninjured to the injured lower extremity and look for bleeding, deformity, swelling, discoloration, scars, and other signs of trauma

Evaluation Format (P)alpation—the physical inspection of an injury. Palpate the anatomical structures/joints above and below the injured site, then palpate affected area. Using bilateral comparison, these items should be palpated: Neurological (motor and sensory) Circulation (pulse and capillary refill) Anatomical structures (palpate) Fracture test (palpation, compression, and distraction)

Evaluation Format (S)pecial Tests—look for joint instability, disability, and pain. Assess disability in the following areas: Joint stability Muscle/tendon Accessory anatomical structures Inflammatory conditions Range of motion (active, assistive, passive, and resistive) Pain or weakness in the affected area

Conditions that Indicate an Athlete Should be Referred for Physician Evaluation Gross deformity Significant pain Increased swelling Circulation or neurological impairment Joint instability Suspected fracture or dislocation Abnormal sensations such as clicking, popping, grating, or weakness Persistent pain within the lower leg compartments Any doubt regarding the severity or nature of the injury

Ottawa Ankle Rules Refer for X-ray when patient exhibits one or more of the following signs/symptoms: Inability to walk four steps immediately after the injury Tenderness on the posterior edge or tip of the medial or lateral malleolus Tenderness on the navicular Tenderness on the base of the fifth metatarsal

Common Injuries Ankle sprains Blisters and calluses Arch sprains Shin splints (Medial Tibia Stress Syndrome) Great toe sprain (turf toe) Plantar fasciitis (plantar aponeurosis)

Common Injuries Heel bruise Heel spur Compartment syndrome Achilles tendon strain Stress fractures Muscle cramps

Rehabilitation Included in any rehabilitation protocol is: Range of motion exercises Resistive exercises Cardiovascular/fitness activities Sport specific activities Return to competition guidelines Full range of motion Strength, power, and endurance are proportional to the athlete’s size and sport No pain during running, jumping, or agility movements

Musculoskeletal Disorders Consult with the following for further definitions of disorders: Taber’s Medical Dictionary Signs and Symptoms of Athletic Injuries

Protective Devices Achilles brace Ankle brace Boots Bunion pads Corn and callus pads Heel cups Orthosis Shin guards Shoes Shin splints brace Turf toe brace Heel lifts

Preventive/Supportive Techniques Wrapping techniques for compression Ankle Wrapping techniques for support Ankle cloth Taping techniques for the ankle, foot, and lower leg Great toe Medial longitudinal arch

Questions ?