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Care Prevention Athletic Injury
foot and lower leg
32
Anatomy
Undergraduate 3
09/29/2014

Additional Anatomy Flashcards

 


 

Cards

Term
Arches of the foot
Definition

1. metatarsal arch

2. transverse arch

3. medial longitudinal arch

4. lateral longiudinal arch

Term
Phases of Normal Gait
Definition

1. Stance Phase: support phase which starts at initial heel strike and ends at toe-off. Accounts for 60% of gait cycle. Involves weight bearing in closed kinetic chain. 

2. swing or recovery phase which represents time from toe-off to heel strike. Period of non weight bearing

(intial swing, mid swing, terminal swing)

Term
Excessive Pronation
Definition

-major cause of stress injuries due to overload 

-results in loose foot

-causes more pressure on metatarsals and tibial rotation at knee

-will not allow foot to resupinate=less powerful and less effecient force produced 

Term
Excessive Supination
Definition

-weight absorption on 1 and 5th metatarsals and inefficient ground reaction force absorption

-limits internal rotation and can lead to inversion sprains

-tibial stress syndrome 

Term
Preventing Foot Injuries
Definition

1. select appropriate footwear


2. correcting biomechanical structurla deficiencies through orthotics

 

3. practice good hygiene 

 

Term
Foot Assessment
Definition

1. History: questions specific to the foot-more pain when wearing footwear, location of pain, training surfaces

 

2. Observations: walking paterns, color, weight bearing

 

3. pulses: insure proper circulation

4. morton's test

Term
Pulses
Definition

Assessed at...

1. posterior tibial: inside of ankle 

2. dorsalis pedis arteries: top of foot

 

Term
Morton's Test
Definition

-Transverse pressure applied to heads of metatarsals causing pain in forefot

-positive sign may indicate neuroma or metatarsalgia

Term
Fracture of the Calcaneus
Definition
  • occurs from jump or fall, may present as posterior tibialis tendinitis
  • immediate swelling, pain and inability to bear weight
  • RICE, refer for X-Ray
  • Non-displaced fracture immobilization and early ROM exercises when pain and swelling subside 
Term
Calcaneal Stress Fracture
Definition
  • Occurs due to repetitive trauma and is characterized by sudden onset in plantar-calcaneal area
  • weight bearing at heel strike causes pain, pain continues following exercise.
  • may require bone scan for diagnosis
  • rest, non-weight bearing cardio training, gradual return to activity 
Term

Apophysitis of the Calcaneus 

(Sever's Disease)

Definition
  • Traction injury at apophysis of calcaneus, where Achilles attaches
  • pain occurs at posterior heel below Achilles attachment in adolescent athletes
  • pain occurs during and after activity
  • best treated with ice, rest, streatching and NSAID's possibly a heel lift
Term

Retrocalcaneal Bursitis

(pump Bump)

Definition
  • inflammation of bursa beneath Achilles tendon
  • result of pressure and rubbing of shoe heel 
  • chronic condition that develops over time
  • pain with palpation, swelling on both sides of heel cord
  • RICE and NSAID's used, ultrasound to reduce inflammation, stretching Achilles, heel lifts, donut pad
Term
Heel Contusion
Definition
  • caused by sudden starts and stops or direction changes--irritation of fat pad
  • severe pain in heel and is unable to withstand stress or weight
  • warmth and redness over tender area
  • reduce weight bearing, RICE, NSAID's, heel cup or doughnut pad
Term
Tarsal Tunnel Syndrome
Definition
  • area behind medial malleolus 
  • any condition that compromses tibialis posteior, flexor hallucis longus, flexor digitorium, tibial nerve, artery or vein
  • may result from previous fracture, tenosynovitis, acute trauma or excessive pronation 
  • pain and paresthesia along medial and plantar aspect of foot, motor weakness and atrophy may result
  • NSAID's and orthotics--possibly surgery
Term

Tarsometatarsal Fracture Dislocation

(Lisfranc Injury) 

Definition
  • Occurs when foot hyperplantarflexed without foot already plantaflexed and rear foot locked resulting in dorsal displacement of metatarsal bases
  • pain and inability to bear weight, swelling
  • possible metatarsal fractures, sprains of 4th and 5th tarsometatarsal joints
  • key to treatment is recognition, realignment and maintaining stability
  • generally requires open reduction with fixation
Term

Pes Planus Foot

(flat foot)

Definition
  • associated with excessive pronation, being overweight, excessive exercise
  • pain, calcaneal eversion, bulging navicular, flattening of medial longitudinal arch or possibly NONE. 
Term

Pes Cavus 

(High Arch foot)

Definition
  • high arch, excessive supination
  • poor shock absorption, heavy callus development on ball and heel of foot, ankle rolls are common
  • stretch Achilles and plantar fascia
Term
Morton's Toe
Definition
  • short 1st metatarsal
  • more weight bearing on 2nd toe as result 
  • can impact gait
  • callus development under 2nd metatarsal head
  • no symptoms=no treatment
  • symptoms=orthotics
Term
Longitudinal Arch Strain
Definition
  • caused by increased stress on arch, flattening of foot during midsupport phase
  • pain with running and jumping, sprained calcaneonavicular ligament
  • immidate care, RICE, crutches 24-48 hours, no weight bearing
Term
Plantar Fascitis
Definition
  • common in athletes and nonathletes
  • pain in proximal arch and heel
  • increased tension and stress on fascia
  • change from rigid supportive footwear to flexible footwear
  • poor running technique, excessive pronation, running on soft surfaces, shoes with poor support
  • pain in anterior medial heel along medial longitudinal arch, increased pain in morning, increased pain with dorsiflexion
Term
Jones Fracture
Definition
  • fracture of metatarsal caused by inversion and plantar flexion, direct force, or repetitive trauma
  • base of 5th tarsal
  • immediate swelling pain over 5th metatarsal
  • surgery, internal fixation
  • doesnt heal well on its own
Term
Metatarsal Stress Fracture
Definition
  • 2nd metatarsal fracture = MARCH fracture
  • usually in 2nd 3rd and 4th 
  • repeated loading on bone
  • dull ache during exercise, pain at rest, progresses from diffusion to localized pain
  • rest and reduced weight bearing
  • gradual return to running 
  • orthotics used to correct excessive pronation
Term

Bunion

(Hallux Valgus Deformity)

Definition
  • exostosis of 1st metatarsal head
  • narrow shoes usually=bursa inflammation and thickness
  • tender, swollen, enlarged, ambulation
  • wear correct fitting shoes, orthotics, pad over 1st metatarsal, tape splint between 1st and 2nd toe, 
  • bunionectomy
Term
Sesamoiditis
Definition
  • repetitive hyperextension of great toe resulting in inflammation
  • treat with orthotic devices--metatarsal pads, arch supports and metatrsal bars
Term
Metatarsalgia
Definition
  • pain in ball of foot
  • transverse arch flattened
  • elevate depressed metatarsal heads, remove excessive callus build-up, stretch 
Term

Morton's Neuroma

 

Definition
  • Thickening of nerve sheath
  • burning paresthesia and severe intermittent pain in forefoot
  • teardrop pad--brings arch up and controls inflammation
Term
Sprained Toes
Definition
  • Kicking non-yielding object
  • pushes joint beyond normal ROM
  • immediate pain-intense and short 
  • sswelling and discoloration 
  • RICE, buddy taping to immobilize, 
Term

Great Toe Hyperextension

(Turf Toe)

Definition
  • hyperextension injury--sprain of 1st metatarsophalangeal joint
  • may be result of single or repetitive trauma
  • increase rigidity of forefoot region in shoe
Term
Fractures and Dislocation of the Phalanges
Definition
  • kicking, stubbing toe, stepped on
  • dislocations less common than fractures
  • dislocations reduced by physician, casting or buddy taping
Term
Hallux Rigidus
Definition
  • bone spurs on dorsal aspect of 1st meta. joint =loss of dorsiflexion
  • lateral foot rolling
  • forced dorsiflexion causes pain, walking is awkward due to weight on lateral aspect of foot
  • stiffer shoe with large toe box, orthotics
  • nsaids
Term
Hammer Toe, Mallet Toe or Claw Toe
Definition
  • hammer: flexible deformity that becomes fixed to to contraction in joint PIP joint
  • mallet: flexion contracture of DIP 
  • claw: flexion of DIP joint hyperextension at MP joint
  • wearing short shoes over and exended period of time
  • MP DIP and PIP can be fixed
  • wearing shoes with more room shave callus, use padding or tape, surgery
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