Foot, Ankle, Lower Leg Injuries Sports Medicine 1 Lexington High School
Mar 27, 2015
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)