ankle/foot specific conditions Flashcards
Cuboid subluxations often mimic s/s of ___.
plantar fasciitis
Displacement of the cuboid results in pain where?
4th and 5th met heads
over the cuboid
referral to the heel
Cuboid displacement results in pain due to the stress placed on the ______ when the foot is in PRON.
peroneal muscles
In PRON, the cuboid moves ___ and ___.
inferior and medial
What is the MOI of cuboid subluxation?
PRON and trauma
definition: Head of the 1st met, toe assumes a valgus position
hallux valgus deformity (bunions)
Bunions are commonly associated with forefoot ____ or a flexible _____.
varus, 1st ray, OR a flattened Transverse arch
What is the most common nerve problem of the LE?
Morton Neuroma
definition: a mass occurring about the nerve sheath of the common plantar nerve while it divides into 2 digital branches
neuroma
Morton neuromas are often located where?
Located between 3rd and 4th met heads where nerve is thickest
What are the s/s of morton’s neuroma?
- severe intermittent pain radiating into the tips of the toes from the distal met heads
- Relief with NWB
- Irritation with collapse of the transverse arch which puts the transverse metatarsal ligaments under stretch thus compressing the common digital nerve and vessels
- Excessive foot pronation = predisposing factor
- Patient c/o burning parasthesia in the forefoot, localized in 3rd web space, radiating into toes
Turf toe is a ___ injury common in the athletic population.
hyperEXT
What does turf toe result in?
sprain of the 1st MTP joint
Turf toe is linked to artificial turf due to flexible foot wear allowing greater _____ of the Great toe.
DF
___-___ weeks rest in severe cases of turf toe may be required to reduce pain to point where patient can push off
3-4 weeks
What are the MOIs of tarsal tunnel syndrome?
- Overuse
- over pronation
- trauma
What are s/s of tarsal tunnel syndrome?
- pain
- numbness
- parasthesia
- TTP over tibial nerve behind the medial malleolus
What are the aggs of morton neuroma?
Symptoms worsened by squatting, stair climbing, running, wearing shoes with narrow toe box, & high heels
Where are stress fractures in the foot commonly found?
navicular
second MT
diaphysis of the 5th MT
Where are stress fractures in the foot commonly found?
navicular
second MT
diaphysis of the 5th MT
What is the MOI for navicular and/or 2nd MET Fx?
excessive PRON
What is the MOI for 5th MET Fx?
rigid pes cavus foot
Those with navicular and 5th MET Fx should be NWB in a short leg cast for __-__ weeks if it is a nondisplaced Fx
6-8 weeks
Those with 2nd Met Fx should have modified rest and NWB exercise/pool running/UBE/Bike/Nu-step for ___-__ weeks
2-4 weeks
What is immediately indicated for active patients if they have a navicular and/or 5th met FX?
immediate internal fixation
What is the common presentation of plantar fasciitis/fasciosis?
- Pain in the proximal arch and heel
- Patient c/o pain in the anteromedial aspect of the heel
- Most painful in the morning
- Pain with toes and forefoot DF during terminal stance
Those with plantar fasciitis/fasciosis are in a Short leg walking cast for ___-___ weeks
4-6 weeks
Symptoms of plantar fasciitis/fasciosis can persist up to ____ weeks which requires patient compliance with POC
12 weeks
What is the most common ankle sprain?
Inversion sprains
What is the weakest ligament of the three lateral ligaments?
ATFL
(true/false) Deltoid ligament may also be involved with an inversion sprain due to impingement between the fibular malleolus and the calcaneus.
true
Why are eversion sprains less common than inversion sprains?
- bony and ligamentous anatomy
- strength/thickness of deltoid ligaments
- fibular malleoli extends further inferiorly
(true/false) Eversion sprains may take longer to heal than inversion due to severity of injury
true
What is the initial priority for rehabilitation of ankle sprains?
DF and PF
What is minimized early in rehabilitation when treating an ankle sprain?
Inversion and eversion
Dislocation of the peroneal tendons occur in response to what?
due to rupture or laxity of the retinaculum
What can possibly occur with subluxation/dislocation of the peroneal tendons?
Avulsion fx of the distal fibula may co-occur with sublux or dislocation
What are the MOIs for subluxation/dislocation of the peroneal tendons?
- Sudden forceful contraction of the peroneal muscles with DF and Eversion
- Pt feels or hears a “pop” and complain of ”giving way”
A person with peroneal tendon dislocation/subluxation is in a short leg cast in slight ____ and NWB for 5-6 weeks
PF
When treating subluxation/dislocation of the peroneal tendons, after the short cast is removed, (gentle/aggressive) ankle rehab is started.
aggressive
Where is tendinopathy most commonly found in the ankle?
Posterior tibialis tendon behind the medial malleolus
What is the typical presentation of tendinopathy in the ankle?
- Pain both with active movement and passive stretch
- Swelling around tendon area
- Crepitus with movement
- Stiffness and pain following periods of inactivity, particularly in the morning
How long does it take for tendinopathy to resolve if the correct course of treatment is taken immediately?
10-14 days
What is a dome Fx?
Non-displaced compression Fx of the talus
With an ankle Fx, a patient should be full WB with a walking brace by ___ weeks.
6 weeks
