1. Mr. Ryan Sports Medicine

2.  DORSIFLEX Tibialis anterior, Extensor hallucis longus, Extensor Digitorum Longus  PLANTARFLEX (7)- Gastrocnemius, Soleus, Flexor Digitorum Longus, Flexor Hallucis Longus, Tibialis Posterior, Peroneus Longus, Peroneus Brevis  FLEXION & EXTENSION OF THE PHALANGES

3.  INVERSION - tibialis posterior, flexor digitorum, flexor hallucis longus, and the tibialis anterior  EVERSION - Extensor digitorum longus, Peroneus longus, Peroneus brevis

4.  Phalanges- - Distal Middle Proximal *Metatarsalphalangeal  Metatarsals Ranked 1 through five medial to lateral  Tarsals Irregular bones of the foot.

5.  Balance and forward body propulsion.  Major Movement bones of the foot – Flexion, extenstion, abduction, and adduction.  Hallux – Big Toe Has two phalanges, and all other toes have three phalanges.

6.  Intermediate bone between phalanges and Tarsals (5 bones) Little movement Provides elasticity to the foot and are wt. bearing. First metatarsal is the largest, strongest, and most wt. bearing. 1 is medial, and 5 is lateral

7.  Support of the body and locomotion.  Calcaneus – Largest Tarsal Bone (Achilles tendon attachment). Conveys body wt. to the ground  Talus – Superior bone Creates the ankle joint Flexion extension (lateral and medial rotation limited due to ligaments and tendons).  Navicular- Anterior to talus Articulates with three cuniform bones Cuboid- -Lateral location anterior to the Calcaneus Cuneiforms – - at the base of the metatarsals

8.  found in locations where a tendon passes over a joint, such as the hand, knee, and foot. Functionally, they act to protect the tendon and to increase its mechanical effect.joint

9.  Anterior Metatarsal Arch and Transverse Arch – Lateral to medial arch along the tarsal and Metatarsal bones.

11.  Medial Longitudinal Arch- Along the midline border of the calcaneus up to the first metatarsal Supported by the Plantar Ligament

12.  Lateral Longitudinal Arch – Calcaneous to the fifth Metatarsal

13.  Bone Injuries Fifth Metatarsal Avulsion Fracture (Jones Fracture) Jones fracture is an injury that occurs over time non-impact Epiphyseal Injury of Distal Tibia and Fibula Stress Fractures

14.  Bone Injuries While bones have viscoelastic properties, bone is fairly rigid and serves as a poor shock absorber Brittle nature increases under tension rather than compression Cylindrical nature of bones make them very strong - resistant to bending and twisting

15. Bone Trauma Classifications  Periostitis - inflammation of the periosteum - result primarily of contusions and produces rigid skin overlying muscle (acute and chronic)  Acute bone fractures - partial or complete disruption that can be either closed or open (through skin) - serious musculoskeletal condition

16.  Type of fractures include, depressed, greenstick, impacted, longitudinal, oblique, serrated, spiral, transverse, comminuted, blowout, and avulsion  Stress fractureType of fractures include, depressed, greenstick, impacted, longitudinal, oblique, serrated, spiral, transverse, comminuted, blowout, and avulsion  Stress fractures- no specific cause but with a number of possible causes  Overload due to muscle contraction, altered stress distribution due to muscle fatigue, changes in surface, rhythmic repetitive stress vibrations  s- no specific cause but with a number of possible causes  Overload due to muscle contraction, altered stress distribution due to muscle fatigue, changes in surface, rhythmic repetitive stress vibrations

18.  Bone becomes susceptible early in training due to increased muscular forces and initial remodeling and resorption of bone  Progression involves, focal microfractures, periosteal or endosteal response (stress fx) linear fractures and displaced fractures  Typical causes include  Coming back to competition too soon after injury  Changing events without proper conditioning  Starting initial training too quickly  Changing training habits (surfaces, shoes….etc)  Variety of postural and foot conditions  Early detection is difficult, bone scan is useful, x-ray is effective after several weeks

19.  Major signs and symptoms include focal tenderness and pain, (early stages) pain with activity, (later stages) with pain becoming constant and more intense, particularly at night, (exhibit a positive percussion tap test)  Common sites involve tibia, fibula, metatarsal shaft, calcaneus, femur, pars interarticularis, ribs, and humerus  Management varies between individuals, injury site and extent of injury  More easily managed and healed if on compression side of bone vs. tension (may result in complete fx)

20.  Epiphyseal Conditions - three types can be sustained by adolescents (injury to growth plate, articular epiphysis, and apophyseal injuries)  Occur most often in children ages 10-16 years old  Classified by Salter-Harris into five types (see photo on next slide)  Apophyseal Injuries - Young physically active individuals are susceptible  Apophyses are traction epiphyses in contrast to pressure epiphyses.  Serve as sites of origin and insertion for muscles  Common avulsion conditions include Sever’s disease and Osgood-Schlatter’s disease

22.  P—Protection-braces, slings, crutches, taping- etc, at least 1 st three days  R—Rest-stress on injured tissue should be avoided  I—Ice-no longer than 20 minutes, at least 1 hour between icings  C—Compression-pressure applied to the injured body part does not allow swelling to build  E—Elevation-10 to 12 inches above the heart

23.  Names of ligaments give their attachment points e.g. calcaneofibular ligament.  Deltoid ligament (medial) is stronger than all lateral ligaments combined.