1. Foot Injuries

2. © 2011 McGraw-Hill Higher Education. All rights reserved.
Normal Gait
Two phases:
Stance or support phase which starts at initial heel strike and ends at toe-off
Swing or recovery which represents time from toe-off to heel strike
Figure 18-10
© 2011 McGraw-Hill Higher Education. All rights reserved.

3. © 2011 McGraw-Hill Higher Education. All rights reserved.
Stance Phase
Accounts for 60% of gait cycle
Involves weight bearing in closed kinetic chain
Five periods
Initial contact (double limb support)
Loading response (double limb support)
Mid stance (single limb support)
Terminal stance (single limb support)
Pre swing
Swing Phase
Period of non-weight bearing
Three periods
Initial swing
Mid swing
Terminal swing
Figure 18-11
© 2011 McGraw-Hill Higher Education. All rights reserved.

4. © 2011 McGraw-Hill Higher Education. All rights reserved.
Running and walking gait have same components
During running gait
Loading and mid-stance = more rapid
After toe off – period of no ground contact
Stance phase = 33% of gait cycle
© 2011 McGraw-Hill Higher Education. All rights reserved.

5. Three phases of gait: heel strike, mid-support, toe off

6. CALLUSES
develop from friction
excess skin on the ball/heel of the foot
problems- can develop blisters underneath
Care
make sure shoes fit correctly
shave off excess skin (pumice stone, file or callus shaver) stop at the pink layer

7. BLISTERS
Caused by rubbing of top (epidermis) and bottom (dermis) layers
H2O gets between the two layers
Prevention:
2 layers of socks
shoes that fit correctly
vaseline
smooth feet develop easier
band aid/moleskin

8. Care
1) don’t pop unless you need to
dry-no
wet-yes
2) small incision with sterile object
3) drain fluid
4) antibiotic into blister
5) cover with band aid/donut
6) (optional) uncover at home to dry out

9. INGROWN TOENAILS
Caused by:
the toe nail growing into the tissue
cutting the nail to short
shoes that are to small
Prevent
cut toenails straight across
Care
cotton under nail
V notch
scrape down the center of the nail

10. HEEL BRUISE Care: RICE tape job crutches heel cup
contusion to the fat pad under the calcaneous
Care:
RICE
tape job
crutches
heel cup

11. TURF TOE
results from playing on artificial surfaces and flexible footwear
toe is snagged and hyper extended
Care
RICE
Tape
Crutches/splint
Steel insole or hard soled shoes

12. JONES FX
Fracture at the base of the 5th metatarsal
Mechanism
inversion w/ plantar flexion
Assessed as a sprain,
won’t heal, x-ray taken and then found

14. STRESS FX
Usually seen in the metatarsals
easily prevented
Prevention:
Rest
Decrease mileage
Shoes
Change Surfaces
Care
Refer for X-ray

15. PES PLANUS
flat feet, fallen arch
Care
Arch supports
Orthotics
Shoes

16. PES CAVUS
High arch
Cause
Tight achillies, posterior musculature
Care:
Stretch posterior calf
Deep-tissue massage
Heel lifts

17. FALLEN TRANSVERSE ARCH
Metatarsal heads fall
Cause:
surface
shoes
posture
genetics
Care:
Orthotics
RICE
Refer if necessary for x-rays

18. BUNIONS
‘Hallux Valgus’
1st metatarsal/phalange joint swells and forms callus, this causes the toe to be pushed laterally
Cause:
Shoes
Genetics

19. BUNIONETTE
Bunion on 5th metatarsal
Care:
tape
exercise
wedge
surgery

20. METATARSALGIA General pain in ball of foot Cause: Surface Shoes Socks
Genetics
Injury
Care:
RICE
Crutches
Splint/Boot
Change in surface/sport

21. MORTONS NEUROMA
Nerve protrusion between MP joints
Care:
Donut
RICE
Don’t play with it!

22. Hyperflexion of PIP joint with hyperextension of DIP
HAMMER TOES
Hyperflexion of PIP joint with hyperextension of DIP
Usually happens on 2nd and 3rd digits
Cause:
shoes (short/long)
Care:
Change shoes
Tape
Surgery

23. CLAW TOES
One toe or all toes
Contraction of the flexor tendons
Toes end up constantly flexed
Cause:
Injury
Shoes
Care:
Surgery to fix extensor tendon

24. HEEL BURSITIS
calcaneal bursitis
Also called; Haglund’s deformity and “pump bump”
Care:
RICE
Donut
Surgery-complications?

25. EXOSTOSES
bone spurs
Cause:
Rubbing from shoes
Injury
Tendonitis
Care:
Donut-Stop rubbing
Shoes
Surgery-Complications?

26. PLANTAR FASCITIS
Caused from tight posterior muscles
Care:
RICE
Splints (day and night)
Massage (posterior calf and foot)
Shoes