THE FOOT

1
THE FOOT

• Chapter 18

2
Introduction

• The traditional sports activities in which
  athletes compete at the high school, college and
  professional level all involve some elements of
  running, jumping and changing directions. The
  function of the foot is critical. One instant
  the foot must be a mobile adapter to absorb
  shock, and the next minute it must become a rigid
  lever to propel the body forward. Injury is
  common.

3
Foot Anatomy

• Bones
• Phalanges, metatarsls, Tarsal Bones (Calcaneus,
  talus, navicular, cuboid, 3 cuneiform)
• Articulations
• Stabilizing Ligaments

4
Foot Anatomy

• Nerve Supply and Blood Supply
• Nerve tibial (back of leg/ plantar surface of
  foot) common peroneal (front of leg dorsal
  foot)
• Blood anterior and posterior tibial arteries
• Arches
• Longitudinal (medial and lateral)
• Anterior metatarsal (runs across distal
  metatarsal heads runs medially to laterally)
• Transverse metatarsal (across tarsal bones
  medially to laterally)
• Plantar Fascia (medial calcaneus to proximal
  metatarsal heads)

5
Muscles and Movements

• Dorsiflexion tibialis anterior, EDL, EHL,
  Peroneus Teritus
• Plantar flexion Gastrocnemius, soleus,
  planatris, peroneus longus and brevis, posterior
  tibialis, etc
• Inversion, Adduction, Supination tibialis
  posteriror, FDL, FHL, EHL, tibialis anteior
• Eversion, Abduction, Pronation peronus longus
  and brevis, peroneus tertius, EDL
• Movement of phalanges FDL, Quadratus plantar,
  lumbrical, interossei, EDL, EHL, EDB, etc

6
Foot Biomechanics

• Normal Gait Patterns
• Pronation and Supination
• Excessive Pronation (internal rotation of the
  leg) hypermobility at the joint
• Excessive Supination (external rotation of the
  leg)
• Other Structural Deformities

7
Prevention of Foot Problems

• Shoes Socks
• Construction
• Last basic form shoe built on
• Upper portion controling foot
• Midsole affects stbaility
• Heel counter control rearfoot motion
• Selection
• For pronated foot less flexible good rearfoot
  control straight-lasted (forefoot does not
  curve)
• Proper Foot Care Hygiene
• Toenails trimmed, shaving calluses, keeping dry,
  wearing proper devices

8
Foot Orthotics and Devices

• Forefoot varus (excessive pronation)
• Rigid type and medial wedge under head of 1dt
  metatarsal
• Forefoot Valgus (excessive supination)
• Semirigid and lateral wedge under 5th metatarsal
• Rearfoot Varus
• Semirigid and have wedge under medial calcaneus
  and small wedge under 1st metatarsal

9
Assessing Foot Conditions

• History
• Observation
• Palpation
• Special Tests

10
Recognition ManagementSpecific Injuries
Conditions

• Injuries to the Tarsal Region
• Talar Fracture
• Calcaneous Fracture / stress fracture
• Severs Disease
• Retrocalcaneal Bursitis
• Heel Contusion
• Cuboid Subluxation
• Tarsal Tunnel Syndrome

11
Recognition ManagementSpecific Injuries
Conditions

• Metatarsal Region
• Flat foot (aka?)
• High Arch (aka?)
• Longitudinal Arch Strain (lateral )
• Plantar Fascitis (braces arch)
• Jones Fracture (base of 5th)
• Metatarsal stress fracture
• Most common 2nd March Fx
• Bunion (hallux valgus 1st met.)

• Sesamoditis
• Metatarsalgia (2nd, 3rd met head)
• Metatarsal arch strain
• Mortons Neuroma (b/t 3rd 4th )

12
Recognition ManagementSpecific Injuries
Conditions

• Toes
• Sprain
• Turf Toe
• Hyperextension injury to great toe
• Fracture / dislocations (usually dorsal)
• Mortons toe (short 1st met, WB on 2nd met)
• Hallux Rigidus (DJD, bony spurs dorsal aspect of
  1st met)
• Hammer/Claw toes
• Overlapping toes

13
Foot Rehabilitation

• General body conditioning
• Weight Bearing (pay attention to kinetic chain)
• Joint Mobilization maintain/normalize joint
  motion)
• Flexibility (especially as impact the phalanges)
• Neuromuscular (strength kinetic chain)
• Foot Orthotics
• Prevention from Reinjury

14
Summary

• The function of the foot is critical to athletic
  performance.
• Evaluation and recognition of injuries and
  conditions can present a challenge to the
  athletic trainer.
• Many chronic conditions of the lower extremity
  can be related to foot mechanics.
• Management, rehabilitation, and prevention of
  foot conditions is essential.