Athletic Injuries of the Foot ROP SPORTS HEALTH CARE MRS. CAMOU.
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Transcript of Athletic Injuries of the Foot ROP SPORTS HEALTH CARE MRS. CAMOU.
Skeletal Anatomy – 26 Bones• Tarsal bones (7)
– Calcaneous– Talus– Navicular– Cuboid– Cuneiforms
• Medial• Intermediate• Lateral
• Metatarsals (5)– 1-5: medlat
• Phalanges (14)– Proximal (1-5)– Intermediate (2-5)– Distal (1-5)
Skeletal Anatomy
• Forefoot– Phalanges– Metatarsals
• Midfoot– Cuneiforms– Navicular– Cuboid
• Rearfoot– Talus– Calcaneous
Musculotendinous Anatomy
• Anterior Aspect– Extensors of toes– Extensor digitorum
longus– Extensor digitorum
brevis– Extensor hallucis
longus– Extensor hallucis
brevis
Musculotendinous Anatomy
• Posterior Aspect– Flexors of toes– Flexor digitorum
longus– Flexor digitorum brevis– Flexor hallucis longus– Flexor hallucis brevis
Circulatory Anatomy
• Where to palpate the Distal PulseA. Posterior tibial artery
B. Dorsal pedis artery
A B
Neurological Anatomy• Tibial nerve – located in
-superficial posterior muscles
• Peroneal nerve- located in– Superficial – lateral compartment– Deep – anterior compartment
• Plantar nerve – located in– Medial and lateral – foot
Common Foot Injuries
• STRAINS- muscles and tendons
• SPRAINS- ligaments
• FRACTURES- bones
• DISORDERS- skin, calluses, bunions
Plantar Fasciitis
Plantar fasciitis (say "PLAN-ter fash-ee-EYE-tus") is the most common cause of heel pain. -The plantar fascia is the flat band of tissue (ligament) that connects your heel bone to your toes. -It supports the arch of your foot. If you strain your plantar fascia, it gets weak, swollen, and irritated (inflamed). Then your heel or the bottom of your foot hurts when you stand or walk.
Plantar Fascia Biomechanics
If you strain your plantar fasciait gets:
weak, swollen, and irritated (inflamed).
Then your heel or the bottom of your foot hurts when you stand or
walk.
Treatment(Tx) for Plantar Fasciitis • CAUSES• Your feet roll inward too much when you walk (excessive pronation).• You have high arches or flat feet.• You walk, stand, or run for long periods of time, especially on hard surfaces.(athletes)• You are overweight.• You wear shoes that don't fit well or are worn out.
• You have tight Achilles tendons or calf muscles.• Tx : Rest,Ice,Equipment,NSAID(non-steroidal anti- inflammatory drug)
• Give your feet a rest. Try not to walk or run on hard surfaces.• To reduce pain and swelling, try putting ice on your heel. Take an over-the-counter
pain reliever like ibuprofen, or anti- inflammatory like naproxen (such as Aleve)• NSAID=Non-steroidal Anti-inflammatory Drugs• Do toe stretches , calf stretches several times a day, especially when you first get
up in the morning.• Get a new pair of shoes. Pick shoes with good arch support and a cushioned sole. Or
try heel cups or shoe inserts (orthotics ). Use them in both shoes, even if only one foot hurts.
Fractures of the Foot• Tarsal bones (rear foot)
– Calcaneous M.O.I- (mechanism of injury)• Direct contact (fall/jump)• Can be complete or stress
– Talus M.O.I• Forced dorsiflexion• Susceptible to avascular necrosis (tissue death due to a lack of
blood supply) and osteochondritis dissecans (piece of cartilage, along with a thin layer of the bone beneath it, comes loose from the end of a bone)
– Metatarsals • Transverse or spiral• Avulsion @ base of 5th met is a Jones’ fracture• Stress fracture or Marcher fracture – usually 2nd or 3rd metatarsal• Tx: stabilize, splint, send to E.R. for x-rays and cast• Minimum 6-8 wks in a cast / surgery may be needed.
Foot Strains and Sprains• Arches
– Medial longitudinal arch strain
• Plantar fasciitis– Heel spur
syndrome
• Phalanges– Great toe MP joint
• “Turf Toe”• Sprain ligaments of
big toe
Contusions to the Foot
• Calcaneous– “Heel bruise”– “Stone bruise”
• Metatarsals– Usually at met heads
Treatment:
rest, ice, protectionMetatarsal heads
Structural Conditions• Morton’s Toe
– Second toe is longer than the Great toe
– Can lead to stress fractures and neuroma (nerve tumor)
• Hallux Valgus– Valgus stress on first
ray– Leads to bunions
Structural Conditions• Hammer Toes
– Buckling of an IP joint– Commonly due to muscle
imbalance– Leads to calluses and
bunions
• Pes Planus– Flat feet– Excessive pronation– Shin splints / knee
problems
• Pes Cavus– High arches– Faster runners– Claw feet– Excessive supination
Other Foot Injuries
• Tinea pedis– “athlete’s foot”– Fungal infection of skin
Tx:
topical ointment, antibiotic
• Verrucae plantaris– Plantar warts– Viral infection of the sole of
the foot
Tx: • topical ointments
Other Foot Injuries
• Morton’s Neuroma– Inflammation of the
nerve typically between the 3rd and 4th metatarsals
Tx: Rest, protection,
injections or surgery• Retrocalcaneal bursitis
– “pump bumps”– Caused by inflammation
of Achilles bursaTx:Rest, Ice, Protection,
NSAID