Foot and Ankle Injuries

Plantar Fasciitis Inflammation of the

plantar fascia ( band that connects calcaneus to metatarsal-phalangeal joint)

MOI

1. high arches

2. excessive pronation

3. obesity/weight gain

4. overuse – stand,walk,run

Plantar Fasciitis MOI causes the fascia to

stretch!

Signs/Symptoms:

1. pain upon taking first step in the morning.

2. pain and inflammation on medial attachment of calcaneus

3. can lead to a heel spur

Treatment

1. rest and ice to decrease inflammation

2. stretch calf muscles

3. arch supports – orthotics

4. oral anti-inflammatory medication

Heel Spur Develops when plantar

fasciitis goes untreated

Common problem in distance runners -15+miles per week

Calcium growth at site of attachment

Treatment – rest and ice

** stretch intrinsic muscles of foot and calf muscles

Sever’s Disease

Sever’s Disease MOI

- achilles tendon continually pulls at insertion site thus pulling on the growth plate of the calcaneus.

• Occurs in 10-15 year olds

• Associated with running and repetitive jumping

• Poor or flimsy footwear

Treatment

1. rest

2. stable footwear

Jones FractureBase of the 5th metatarsal

fractureAttachment of peroneal

tendon

Jones Fracture – 5th metatarsal

Fracture of the 5th metatarsal ½”-3/4” from the base

Often mistaken as a sprain or avulsion fracture

Danger – non-union fracture due to poor blood supply

MOI:

1. inversion injury to ankle of foot

2. overuse – repetitive stress – Sprinters!

Signs/Symptoms: severe pain when walking, swelling and bruising

Treatment – 6-8 weeks casted non-weight bearing

Treatment for Jones Fracture

Severe fracture – surgical screw

Depends on severity of fracture

Great Toe Sprain Known as turf toe

Sprain to the metatarso-phalangeal joint(MTP) of the 1st toe

MOI: hyperflexion

Great toe is involved in the final push off the ground and receives the pressure of 8 times the body weight

3 degrees of turf toe 1st – no time loss, ice,

tape, strengthen toe box of footwear

2nd – time lost, crutches, ice, tape, strengthen toe box of footwear

3rd – season ending injury, possible surgery

Treatment – contrast bath

Anatomical image of Achilles tendon

Posterior/Inferior aspect of lower leg

Gastrocnemius and soleus unite into a tough band of fibrous tissue and attaches to the calcaneus

Largest and strongest tendon of the body that allows you to stand on toes when walking, running and jumping

Bursae sac cushions the tendon

Achilles tendonitis Inflammation of the

tendon

MOI:

1. overuse from running/walking, running hills

2. tight calf muscles

3. heels to sneakers

Signs/Symptoms: pain and inflammation

Treatment: rest, ice, stretch

Achilles tendon tear Micro-tears or large tear

MOI: sudden movement or gradual wearing from overuse

Signs/Symptoms:

1. pain and inflammation over site of tear

2. impaired movement

Treatment:

1. rest and ice

2. NSAID

3. heel lift

4. gentle stretching

* NO CORTISONE SHOTS – weakens the tendon

Achilles Tendon Rupture

Achilles Tendon Rupture Thompson’s Test –

squeeze the calf and the foot does not move.

Treatment: SURGERY

-long term immobolize and rehabilitation

Complete tear of the tendon

Signs/Symptoms:

1. hear a “pop” sound

2. feels like you have been shot in the leg

Causes: sudden bursts from jumping, pivoting, and sprinting

Common in the” Weekend Warrior”

Ruptured Achilles tendon

Causes of Fractures ACCIDENTS – car, motorcycle, falls, struck by an

object

Aging – decrease in balance, coordination, eyesight and hearing can result in falls

Bone Fatigue – prolonged repetitive forces (professional football players, marathon runners, Olympic gymnasts)

Avulsion fracture of fibula

Fractures of fibula and/or tibia

Tibia FracturesNeck of tibia Limb lengthening