The Ankle and Foot

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The Ankle and Foot

• Everything you need to know.and so much more!!!!
• Mr. DuPrau
• Sports Medicine 2008

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Bones

• Anterior View

• Side View

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Bones
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Muscles

• Plantar and Dorsal Views

• Posterior View of Ankle

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Muscles
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Connective Tissue

• Ligaments

• Tendons

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Connective Tissue
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Injuries to the Ankle and Foot
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Fractures

• Usually result from a combination of plantar
  flexion and inversion.
• Basketball, Soccer, Volleyball and Football carry
  increased risk of these fractures.
• S S Swelling, Point Tenderness and Decreased
  ROM. Athlete will feel moderate to severe pain
  when weight is placed on leg.
• Treatment Splint, Elevate and Ice (Avoid
  movement of injured area if injured joint),
  Monitor vitals until physician can evaluate,
  X-ray and Cast.

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Dislocations and Subluxations

• Usually a result of a twisting motion.
• Basketball, Soccer, Volleyball, Baseball and
  Football carry increased risk of these injuries.
• S S Complete loss of function in injured
  joint, severe pain, swelling and deformity.
• Treatment Check below the injury for pulse,
  splint in comfortable position (Never attempt to
  relocate or reduce the dislocated joint!!), Ice.
• Follow up Rehab should start with Isometric and
  move to isotonic exercises.
• Prevention Ankle braces.strengthening
  exercises.

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Heel Contusions

• Result of direct blow or improperly fitted shoes.
• Basketball players and Long jumpers are prone to
  these injuries due to the jumping activities in
  their sports.
• S S Point tenderness around the heel,
  possible discoloration.
• Treatment Ice, compression and elevation (20
  minutes on, 1 hour off).follow the icing period
  with some ROM exercises (ex. stationary bike)
• Prevention A donut or heel pad will disperse
  the pressure on the foot away from the point
  tenderness

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Ankle Sprain

• One of the most common injuries to the body.
• 85 of sprains are inversion (twist in).
• Stepping on a rock or someone elses foot,
  stepping in a hole, or landing off balance or
  anything causing the ankle to turn awkwardly can
  cause a sprain.
• S S Possible decreased ROM, deformity,
  crepitation, point tenderness, loss of function,
  possible instability, possible abnormal motion
  and immediate swelling.
• Treatment PRICE.
• Follow-up Treatment Isometric exercises and
  flexibility exercises.
• Prevention Checking event area for potential
  dangers, Strengthening exercises, bracing and
  taping for support.

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Turf Toe

• Sprain of the big toe commonly caused by kicking
  or pushing off motion.
• Usually occur in sports where athletes wear
  light, flexible shoes and participate on
  inorganic surfaces, such as artificial grass.
• S S Pain with motion (running, jumping and
  pushing off), possible swelling.
• Treatment PRICE, Taping the big toe to add
  proper support and by adding sole supports to
  make the shoe firmer.

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Achilles Tendon Ruptures

• The Achilles Tendon can be ruptured by activities
  that require abrupt stops and starts (Quick push
  offs or sudden back-peddling).
• Tend to occur in athletes over the age of 30 with
  past history of tendonitis in that area.
• S S May feel a sudden snap that feels like a
  hit to the calf muscle, immediate pain, swelling,
  deformity and loss of motion if completely
  ruptured.
• Treatment PRICE, Splint foot and calf, refer to
  physician for evaluation and treatment.
• Prevention Proper warm-up and stretching

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Achilles Tendonitis

• The over stretching or overuse of the Achilles
  Tendon.
• Basketball, Running, High Jump and Long Jump have
  increased likelihood of injury.
• Without proper conditioning this type of injury
  can occur at the beginning of participation in
  running sports (Frequently suffered by freshman).
• S S Chronic soreness, pain with
  dorsi-flexion, pain with plantar flexion against
  resistance, possible mild swelling and
  crepitation.
• Treatment PRICE, gradual slow stretching of
  the gastrocnemius and soleus muscles, heel lifts
  to relieve stress to the Achilles Tendon.
• Prevention Proper Conditioning and Warm-up.

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Achilles Bursitis

• Caused by repeated stress to the bursa behind the
  Achilles tendon.
• S S Slight swelling and a persistent ache
  that is aggravated by activity.
• Immediate Treatment If no swelling is present,
  apply moist heat packs to the affected area. If
  swelling is present, use PRICE.
• Follow-up Treatment After swelling subsides,
  use moist heat treatments. Pain free stretching
  will maintain mobility in the joint.
• Prevention Proper training techniques.

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Ingrown Toenail

• Condition in which the skin extends over the edge
  of the nail while the nail grows into the nail
  bed, causing pain and possible infection.
• Causes tend to be shoes that fit too tightly or
  poorly trimmed nails.
• Immediate Treatment Soak the toe in a warm
  saltwater solution a few times a day. Cut the
  nail into a V shape. If the problem does not
  improve in 3-5 days, they should be referred to a
  physician.
• Follow-up Treatment Monitor the toe for signs
  of infection and blood poisoning.
• Prevention Wear well fitted shoes and properly
  trim nails.

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Athletes Foot

• Extremely contagious fungal condition of the foot
  caused by a buildup of moisture and heat in
  darkness.
• S S Extreme itching with possible rash,
  pimples, or blisters.
• Immediate Treatment After showering make sure
  feet are dry and powdered before putting on shoes
  and socks. There are also a variety of OTC
  antifungal creams available.
• Follow-up Treatment If symptoms do not improve
  after 2 weeks, see physician.
• Prevention Socks always clean and dry. Use
  medicated, antifungal powder. Wear shower shoes
  in public showers.

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Plantar Fasciitis

• An inflammation of the fibrous membranes
  supporting, covering, and separating the muscles
  of the sole of the foot.
• Caused by repeatedly standing on the toes,
  resulting in stress to the supporting tissues and
  tightness in the gastrocnemius-soleus complex.
• S S Point tenderness which increases with
  pressure, on the bottom of the foot, in front of
  the heel, and along the longitudinal arch. Pain
  is particularly severe in the morning, subsides
  as the day goes on and the tissue warms up w/
  activity.
• Immediate Treatment PRICE.
• Follow-up Treatment Ice massage, stretching,
  taping, or orthotics to give support to the arch.
• Prevention Proper warm-up and conditioning
  geared to that area of the foot and wearing shoes
  that have proper arch support.

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Assessing Ankle and Foot Injuries

• Range of Motion Evaluations, Manual Muscle Tests,
  and Special Tests

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Talar Tilt Test

• Inversion of the foot to determine the stability
  of the ankle joint.

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Anterior Drawer Test for the Ankle

• Application of anterior force to the heel to
  assess the stability of the ankle joint.

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Preventing Injuries to the Ankle and Foot

• Taping, Wrapping and Bracing

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Basic Ankle Taping
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Shin Splint Taping
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Turf Toe Taping
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Arch Taping
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Strength Exercises For the Ankle and Foot