Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Therapeutic Exercise > Ankle/Foot > Flashcards

Ankle/Foot Flashcards

1
Q

Describe the arthrokinematics of the ankle in dorsiflexion.

A

proximal fibula glides anterolateral and superior on tibia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How would you mobilize the fibula with movement for a patient with limited DF?

A
  • have the pt supine and knees bent to 40 degrees

- pull the fibula anteriorly and superiorly, and then bring the patient down into DF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How does the proximal fibula move on the tibia during plantarflexion?

A

prox fibula glides posteromedial and inferior on tibia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the arthrokinematics of the talus for dorsiflexion and plantarflexion?

A

dorsi: talus rolls anteriorly and slides posteriorly
plantar: talus rolls posteriorly and slides anteriorly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do you MWM for lateral ankle sprains that are lacking DF?

A

stabilize medial malleolus, and give A-P force to lateral malleolus while pushing into DF with your hip
- sustain this hold for 15 sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you MWM the tibia for increased plantarflexion?

A

give AP glide to tibia as pt moves into more plantarflexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you MWM the tibia for increased dorsiflexion?

A
  • have pt stand on table
  • put belt around their distal tibia and around your butt
  • stabilize talus with web of your hand
  • have pt lunge forward and you lean back into the belt

this brings tibia forward for increased DF motion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 3 ways we can MWM to get more DF ROM?

A

1) move fibula anterior and superior
2) give AP to lateral malleolus while having hip on foot to bring into more DF
3) belt around distal tibia and you, pt lunges and you pull tibia forward

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do we MWM to get increased PF ROM?

A

give AP force to distal tibia while pushing foot into PF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If pain with running starts in the beginning and then tapers off, what issue do you suspect?

A

medial tibial stress syndrome (shin splints, periositis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If pain with running is constant throughout and after the activity, what issue do you suspect?

A

stress fracture (yikes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If pain with running is mild at first but then increases the longer you run and doesn’t go away until you stop exercising, what do you maybe suspect?

A

medial compartment syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What muscles are likely to experience tendonosis/opathy due to overuse? (they also get chronic inflammation)

A
  • tib posterior
  • tib anterior
  • flexor hallicus longus
  • achilles
  • fibularis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If a runner tells you that they’re having anterior leg pain that hurts about a mile in but then gets better, what do you think is happening?

A

classic shin splints

- likely due to tib anterior weakness/overuse, and maybe a tight gastroc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What could be causing posterior shin splints?

A

inflammed tib posterior, tight soleus, tight gastroc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where is the pain in shin splints often occuring?

A

distal 2/3rds posteromedial (tib posterior) or anterolateral (tib anterior)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What can repetitive eccentric contractions of the soleus cause? (irritation-wise)

A

medial tibial stress syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What factors can cause medial tibial stress syndrome?

A
  • over-pronating when running
  • imbalance of inversion/eversion strength
  • repetitive eccentric contraction of soleus
  • high BMI, less running experience, poor training, bad shoes
  • previous history of MTSS

all the pounding of running irritates the periosteum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What therapeutic exercise can we give for shin splints?

A
  • stretching (gastroc/soleus) and strengthening (tib post/ant)
  • cross train (take some load off of that soleus)
  • control inflammation
  • assess static and dynamic gait
  • assess shoe type and terrain they’re running on
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Where does the achilles tendonopathy pain usually occur?

A

2-6cm proximal to attachment on calcaneus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why is achilles tendonopathy so difficult to treat?

A

poor blood supply and it’s a huge tendon

22
Q

T/F: Those with achilles tendonopathy see morning stiffness

A

true

23
Q

How can we treat achilles tendonopathy?

A

ECCENTRIC EXERCISE (once they can tolerate)

  • begin by stretching soleus/gastroc
  • strengthen surrounding muscles (tib post/ant)
  • can tape, use orthotics, wear boot
24
Q

How many reps of eccentric exercise should be done?

A

3 sets of 15

25
Q

How long should you avoid physical activity that stresses the tendon?

A

4-6 wks

26
Q

T/F: Need to slow down during the eccentric part of the contraction to reap benefits.

A

false, eccentric has a speed component so just go normal speed

27
Q

How could you progress eccentric exercise for achilles tendonopathy?

A

3 sets of 15, 2x/day, 7 days/wk; 12 wks

1) begin on floor bilaterally doing heel raises and drops
* then do unilaterally
2) progress to stair lowering and do bilateral then unilateral
3) add weight to shoulders now, continue on stair lowering

28
Q

What two muscles create a sling effect around the 1st met in the foot?

A

tib posterior and fibularis longus

29
Q

What muscle supports the medial longitudinal arch of the foot?

A

tib posterior

30
Q

What muscle supports the talonavicular joint during heel strike?

A

tib posterior

31
Q

With posterior tibial tendon dysfunction, where is the trauma located?

A

at the navicular tuberosity

32
Q

What are two ways we can assess for PTTD?

A

1) two many toes sign: toes extend out laterally

2) heel rise: look to see if 1st MET can DF and if there’s pain

33
Q

How can we treat PTTD?

A
  • taping

- exercise: lunges with foot, eccentric DF/eversion (to strengthen tib post), forefoot add/abd with plantarflexion

34
Q

What is the position of the foot with a forefoot valgus?

A

big toe down, little toe up

- compensates by supinating at subtalar, making foot rigid and less shock absorbant

35
Q

How does the subtalar joint compensate for a forefoot varus?

A

pronation

- does same for rearfoot varus

36
Q

What is the windlass effect?

A

MTP joint extension and stretch of plantar aponeurosis with PF

  • gives arch support and push off during gait
37
Q

Which of these issues is the most common and can cause posterior tibial tendon dysfunction?

a) rearfoot valgus
b) rearfoot varus
c) forefoot valgus
d) forefoot varus

A

B) rearfoot varus

38
Q

Excessive pronation during loading response and midstance can be due to what?

A

rearfoot varus

39
Q

Forefoot valgus can cause what compensation?

A

excessive/early supination in midstance

40
Q

Execessive pronation during midstance can be due to what?

A

forefoot varus

41
Q

How do we diagnose pes planus?

A

navicular drop test

42
Q

What can cause plantar aponeurosis?

A
  • too high of arch, fascia can be pulled too tight and cause pain
  • flattened foot stretches fascia and can be painful
  • overuse/inflammation
  • poor training/poor shoe
43
Q

What muscles are mostly involved with inversion ankle sprains?

A

peroneals

44
Q

What are the deficits common with inversion sprains?

A
  • lack of feedforward
  • peroneal endurance
  • inverter strength
  • neuromuscular/postural control
45
Q

Neuromuscular control and support for the ankle is dependent on what 4 things?

A

1) postural control
2) muscle strength (fib long/brev)
3) proprioception
4) muscle reaction time (wears out after awhile)

46
Q

How do we rehab an ankle sprain?

A

work on:

  • postural control with core stability (to reduce reliance on hip/ankle strategies)
  • ROM (limit inv/ev due to pain)
  • strength, power, and endurance of muscles (OKC, CKC, plyos)
  • neuromuscular control (balance, proprioception, unstable surfaces)
47
Q

What’s a good intro exercise for someone with inv/ev weakness?

A

have them move a towel on the floor to the right and left with their ankle while sitting

48
Q

What’s the dosage of postural training you should do?

A

3-5 times per wk, 4-6 wks

- do for athletes (may improve LBP) and elderly (to reduce fall risk)

49
Q

How long until we determine if someone is ready to return to sport?

A

once they have complete ROM and are at 80-90% of pre-strength
- can compare to other limb to figure this out

Or they can return once full practice is tolerated without injury

50
Q

T/F: Ankle bracing/taping may resolve edema.

A

true

51
Q

What is prophylactic ankle bracing? Does it work?

A

wearing brace before injury is proven to help prevent injury by 60-85%

  • wear during practice and games, but not all time
  • helps give proprioceptive feedback for muscles to work
  • BUT still work on strengthening, postural control/balance, and proprioception outside of brace as well

Therapeutic Exercise (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions