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AN 3203- Mod 10 > 25_26- Foot/tibia disordera > Flashcards

25_26- Foot/tibia disordera Flashcards

1
Q

what is metatarsalgia

A
  • sharp/aching/burning pain in forfoot
  • worse when standing/walking/running
  • a sharp/shooting pain that pt describes having a pebble in shoe
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1
Q

what is metatarsalgia

A
  • sharp/aching/burning pain in forfoot
  • worse when standing/walking/running
  • a sharp/shooting pain that pt describes having a pebble in shoe
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2
Q

risk factors for metatarsalgia

A
  • intense training (run)
  • high arched feet/low arched
  • tight pot compartment mm
  • mortons/hammer toes
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3
Q

3 types of metatarsalgia

A

A. Impact pain
B. Stress fx
C. Mortons neuroma

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4
Q

mechanopathlogy of mortons neuroma

A

occurs as a result of compression of interdigital nerve against the distal end of the superficial transverse metatarsal lig during dorsiflex

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5
Q

mc loc of mortons neuroma

A

Mc occurs between 3rd and 4th metatarsals

2/3, 5/5 after

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6
Q

causes of mortons neuroma biomechanically

A
  • overpronation results in loss of transverse arch which produces mechanical irritation to digital branches
  • mc in women believed to be caused by high heal shoes
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7
Q

histopathological causes to mortons neuroma

A
  • deg changes (mucoid degenerative) are notes
  • mucoid deposition in confined space results in increased pressure
  • leading to ischemic compression/demylenation.axonal damage
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8
Q

conservative tx to general metatarsalgia

A
  • rest from aggravating activity
  • stretch post compartment mm
  • control over pro
  • Stay away from positive heal
  • orthotics (metatarsal pad)
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9
Q

risk factors of plantar facciitis

A
  • obesity/reduced ankle dorsiflexion
  • associated w tight achilles
  • associated with pes plants and pet caves
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10
Q

characteristics of plantar fasciitis syndrome

A
  • Am pain and stiffness
  • medial heel pain w weight bearing
  • w walking pain decreases but can reoccur later in day
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11
Q

Why shoudnt it be called plantar facciitis

A

its aponeurosis and histologically no inflammation

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12
Q

what does low arched foot cause in windlass effect

A

tension in plantar fascia has to be higher to get equal rot

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13
Q

plantar fasciitis pathology

A
  • deteriorated collageen fibres, increased secretion of ground substance pros, fibroblast proliferation and neovascularization
  • believed if you can prevent the neovascularization you will stop the infiltration of nerves that accompany the blood vessels and hence stop pain
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14
Q

foot orthosis an corticosteroid for plantar faccits

A

both can lead to decreased pain associated w plantar fasciitis

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15
Q

what actually is achilles tendinosis

A

no inflammation

-biopsy revealed disorganized and degenerate collagen fibres

16
Q

mechanism of achilles tendinitis injury theories (4)

A
  1. soleus portion which wraps around gastro portion strangles the tendon and injuries it
  2. Poor blood supply prevents healing (then neovascularization occurs)
  3. Whipping action causes by overpronation/oversupination
  4. rapid eccentric action followed by rapid contraction action (toe off)
17
Q

clinical causes of achileies tendinosis

A
  • racing in heel less spikes/ low heeled shoes
  • worn out runners
  • excessive pronation
  • take off supination
18
Q

conservative approach to achileases tendinosis

A
  • stop running (for at least 7-21 days)
  • do other execises
  • stretch
  • strengthen
19
Q

how should strengthen + stretch in achilles tendonopathy be done

A
  • stretch should be done for 10-20mins per day
  • very painful to begin with
  • eccentric heel lowering to strengthen (concentrate on the eccentric portion, not on the heel raise)
20
Q

grade 1 achilles tendonpathy

A
  • rest one week before resuming normal schedule
  • stretch calf 20 min/day
  • add 7-15mm heel raise
  • cross friction to tendon
21
Q

grade 2 achilles rehab (running pain not affecting performance)

A
  • approach as per grade 1
  • reduce speed work, hill running, long runs and weekly distance
  • orthotics
  • cross-frriction
22
Q

grade 3 achilles tendonopathy rehab (running pain affecting performance)

A
  • approach as grade 1/2
  • rest for 3 w
  • after 3 w (resume jogging, cycle, or swim)
  • resume serious running after injury reverts to grade 1
23
Q

running shoe tx for achilles tendonopathy (4)

A

7-15mm heel raise on outside or inside

  • ridgid heel counter
  • vertical achilles pad
  • rigid midsole material
24
Q

primary postulated effect of foot orthoses on achilles tendinopathy

A

effect of foot orthoses on achilles tendinopathy relates to kinematic change and not distribution of plantar pressures, so we doubt this would have an sig effect

25
Q

definition of medial tibial stress syndrome

A

pain along posteromedial border of tibia that occurs during exercise, excluding pain from ischemic origin or signs of stress fracture

26
Q

role of tibia post (2)

A
  1. decelerate subtler jt pronation during stance phase (eccentric action)
  2. To return the subtler jt to neural after pronation (concentric action)
27
Q

traction theory of medial tibial stress syndrome

A

tib post actively tractions the periosteum which leads to inflammation and eventual bone

28
Q

tibial bowing theory of MTSS

A

ability of calf mm to cause repeated bending or bowing of the tibia, thereby causing a stress rxn and periosteal rxn

(military recruits w MTSS has a lower cross sectional cortical area compared w similar subjects)

29
Q

risk factors of MTSS

A
  • pronation
  • navicular drop >6.8mm
  • more rear/forfoot varus
  • running < 8.5 y

AN 3203- Mod 10 (13 decks)

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