Foot, Ankle, Lower Leg Injuries

Sports Medicine 1

Lexington High School

Anatomy

Bony components Tibia, fibula 26 Foot bones

Arches

Medial longitudinal, Lateral longitudinal, anterior metatarsal, and transverseShock absorbersSupport body weightProvide rigid lever for propulsionAccommodation to uneven surfaces

Ligaments

Plantar aponeurosis Medial (Deltoid) Lateral

~ anterior talofibular

~ calcaneofibular

~ posterior talofibular

Muscles

Foot (4 layers) Leg (4 compartments)

AnteriorLateralSuperficial posteriorDeep posterior

Motions

Foot

~ flexion/extension

~ abduction/adduction

~ inversion/eversion Ankle

~ plantarflexion/dorsiflexion

Foot Injuries

Cause Signs and Symptoms Treatment Prevention

Retrocalcaneal Bursitis

Cause: Chronic inflammation of bursa from constant rubbing from heel of shoe.

S/S: Tenderness, swelling, warmth, and redness

TX: Doughnut pad placed around area Prevention: Properly fitting shoes

Bunion

Cause: Bony enlargement of the head of the 1st metatarsal caused from wearing improperly fitting shoes.

S/S: Obvious deformity, tenderness, and swelling.

TX: Proper shoe selection, protection devices, surgery may be necessary

Prevention: Properly fitting shoes.

Metatarsal Fracture

Cause: Direct force or twisting or torsion stresses

S/S: Swelling and pain. More pt tender and sometimes palpable.

TX: RICE, casting Prevention: Avoid getting kicked,

falling/rolling ankle

Pes Planus

Over pronation of foot Cause: Lack of support in shoes,

genetics, age S/S: Foot pain, lack of longitudinal

arch, lateral heel tilt Tx: arch stretches, toe curls, ice

massage, orthotics Prevention: toe curls, proper shoes

Ingrown Toenail

Cause: Improper shoe fitting and nail cutting

S/S: Increased pain, swelling, redness around the nail bed

TX: Hot, soapy water, antibiotics, raise nail up.

Prevention: proper shoes, proper nail trimming

Plantar Fasciitis

Cause: Running, toe running, wrong shoes (acute and chronic)

S/S: Pain near heel. Similar signs as heel bruise

Treatment: RICE, stretching, IM, NSAIDs, pad heel.

Prevention: Stretching

Ankle Sprain

Cause: Inversion of the ankle S/S: Point tenderness, swelling, laxity TX: RICE, rehabilitation immediately Prevention: Strengthening exercises,

proper shoes

Tibia/Fibula Fractures

Cause: Direct Force, rotary force S/S: Immediate pain, swelling,

possible deformity TX: Immediate referral to MD Prevention: Wear proper shin

protection

Shin Splints

Causes: Changes in any kind of training. Abnormal strength in Antagonist muscle

S/S: Anterior medial shin pain TX: Eliminate bad changes, modified

rest, cryotherapy, arch tape job

Achilles Tendonitis

Cause: Repetitive weight bearing activities that increase quicker than body can adapt to.

S/S: Generalized pain and stiffness around the Achilles tendon. Usually gradual onset.

TX: Limiting or restricting the activity that caused the irritation. Aggressive stretching of heel cord.

Prevention: Heel cord stretching, proper acclimization to activity.

Achilles Tendon Rupture

Cause: Sudden, forceful plantar flexion of the ankle with a chronically tight tendon.

S/S: Feel or hear a pop. Feel as if they’ve been kicked in the leg. Inability to plantar flex foot.

TX: Surgery vs. Cast Prevention: Stretching and proper

care of any tendonitis

Compartment Syndrome

Cause: Increased pressure within one of four compartments of lower leg causes compression of the structures in the leg.

S/S: Deep aching pain, tightness, and swelling. Pain with stretching.

TX: Acute~ immediate surgery

Chronic~ activity modification & ice and sometimes surgery

Prevention: Stretching (Hard to prevent)