CH. 17 FOOT, ANKLE, AND LOWER LEG INJURIES

Ankle Sprain

MOI: 85% inversion, 15% eversion Deltoid stronger than lateral ligaments Fibula longer than tibia

S/S: pain, swelling, discoloration, decreased ROM 1st degree: ligament stretched 2nd degree: ligament partially torn 3rd degree: ligament completely torn,

surgery

Ankle Sprain

Treatment: RICE, use horseshoe, crutches if needed Taped, braced

before return to participation

Rehab Increase ROM Increase strength Increase

proprioception

Arch Sprain

MOI: overuse, fatigue, training on hard surfaces, wearing improper shoes

S/S: pain over arch, swelling Treatment: RICE, Arch pad Rehab

Increase strength of intrinsic muscles Stretching Achilles

Turf Toe

MOI: Hyperextension or hyper flexion of first metatarsophalangeal joint

S/S: swelling, pain with flexion or extension

Treatment: RICE, tape, walking boot

Rehab: strengthen toe muscles

Plantar Fasciitis

Plantar fascia attaches at calcaneus to the heads of the metatarsals; support for longitudinal arch of foot

MOI: overuse, improper footwear, tight Achilles, running on hard surfaces

S/S: pain in arch of foot, swelling Treatment: RICE, massage, correct

mechanics

Achilles Tendon Rupture

MOI: forced dorsiflexion, blunt force, or sudden forceful contraction of gastroc

S/S: extreme pain, difficulty walking, no plantar flexion, swelling, obvious deformity

Achilles Tendon Rupture

Treatment Surgery Immobilized 6

weeks Rehab

Slow progression of ROM

Isometric strength

Jones Fracture

Fracture of fifth metatarsal

MOI depends on type of fx

S/S: pain over 5th metatarsal

Treatment: RICE, refer to physician

Shin Splints

Medial tibial stress syndrome S/S: pain over anterior portion of

lower leg Treatment: RICE, switch to cross

training Rehab: stretch gastroc and soleus Figure out what is causing shin

splints and fix Shoes Training Surface Running mechanics

Anterior Compartment Syndrome MOI: contusion, fracture, infection,

excessive exercise S/S: pain, increased with movement,

touch, pressure, or stretching, numbness and weakness may develop

Treatment: Acute needs medical attention immediately; surgery required to relieve pressure

Rehab Exercises

For intrinsic foot muscles-towel curl

Theraband-four ways Dorsiflexion Plantar flexion Inversion Eversion

Balance Stretching

Special Tests

Anterior Drawer: tests anterior talofibular ligament

Tinel’s Sign: tests entrapment of tibial nerve

Thompson Test: tests integrity of Achilles tendon