1. THE FOOT, ANKLE, AND LOWER LEG
Chapter 17

2. Yay Feet!!!

3. Awwww…

4. Old Feet

5. Injured feet

6. Hobbit Feet???

7. Unfortunately Looking Feet

8. A Few Facts…
Foot and Ankle injuries account for about 15% of overall sports related injuries.
There are more than 20,000 ankle sprains in the U.S. each day! (That’s a lot of icing! )
The foot and ankle act as shock absorbers during all running and jumping that we do. They can absorb around a million pounds of pressure during a single hour of strenuous exercise.

9. Cont…
When a 150 pound runner, runs 3 miles, they are putting more than 150 tons of pressure on each foot!

10. Yao Ming

11. Basic Anatomy 3 arches of the foot
Medial Longitudinal – The highest of the three arches
Transverse – Across the midfoot
Lateral Longitudinal – Along the fifth ray

12. Anatomy Break-down…
Each foot has 26 bones. (7 tarsals, 5 metatarsals, and 14 phalanges)
Each foot has 38 joints.
Movement occurs at a joint. Think about how much movement that is, and how many different sites there are for potential injury!

13. Bones of the Foot/Ankle

14. Joints
Talocrural Joint – Where the tibia, fibula, and talus join together
Subtalar Joint – Where the Calcaneous and Talus join together. This is the joint that we are trying to immobilize when taping the ankle in order to stabilize or prevent a sprain
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15. Muscles
Intrinsic Muscles: Muscle that relates to a specific body part or bone
Plantar flexors, dorsiflexors, abductors, and adductors of the toes
Extrinsic Muscles – Located outside a body part, organ, or bone.
Gastrocnemius – Calf muscle

16. Ankle/Foot Injuries
Strains, Sprains, Dislocations, and Fractures, Contusions, and Tendonitis.
Sprain is the most common!!!
Mechanism of Injury – What motion caused the injury?
Usually a combination of excessive inversion and plantar flexion at the same time.
This is an inversion ankle sprain which accounts for about 90% of all ankle sprains

17. Cont…
Less common is the Eversion ankle sprain which involves the ligaments on the inside of the ankle. Eversion ankle sprains account for less than 10% of ankle sprains.

18. Sprains Injuries to one or more ligaments in the ankle
Most commonly injured: Anterior Talofibular
Sprains are diagnosed by grades which correlate to varying degrees

19. Grade I
First Degree – Mild. One or more ligaments are stretched. There is minor discomfort, point tenderness, and little or no swelling. No loss of stability, or movement of the joint.

20. Grade II
Second Degree – moderate. One or more ligaments are partially torn. There is some limit of motion, significant swelling, pain, point tenderness, and loss of function

21. Grade III
Third Degree – severe. On or mor eligaments have been completely ruptured resulting in joint instability. Extreme pain, loss of function, point tenderness, and RAPID swelling.

22. Treatment
Protection
Rest
Ice
Compression
Elevation
Mri

23. Why Ice vs. Heat?
Ice is a vasoconstrictor – It restricts blood vessels thus reducing and preventing swelling
Swelling = Pain
Ice should be applied for 15 minutes about every hour and a half
Heat is a vasodilator – increases blood flow to an area. *Should never be applied to an acute injury (within 24 hours).

24. Rehab Phase I – ROM, ABC’s, circles, etc. Phase II- strengthening
Phase III – functional strengthening