Ankle, Foot, Toes (Exam 2) Flashcards
25% of all sports related injuries are ____ ankle sprain.
Inversion
95% of all ankle sprains are of the ____ ligament complex, due to inversion sprains.
Lateral
Single ligament injured. (Usually anterior talofibular ligament)
1st Degree Sprain
Two ligament injured. (anterior talofibular and fibulocalcaneal)
2nd Degree Sprain
All three lateral ligaments injured. (anterior talofibular, posterior talofibular, fibulocalcaneal)
3rd Degree Sprain
Generally 1st and 2nd degree sprains can be effectively managed _______.
Non-operatively.
RICE WBAT Joint Protection (Braces, Orthoses, Tape, Cast) AROM DF and Eversion Isometric Exercises
Phase I - Maximum Protection
Weight Bearing without crutches ROM and Isometrics without pain Controlled Swelling FWB Concentric/Eccentric Exercises (Theraband/Ankle Weights) Joint Protection Proprioception Exercises Avoidance of unwanted stresses
Phase II - Moderate Protection Phase
All resistive exercises Ambulate without pain/limping Approximately 4 weeks after injury Joint protection during activities Running (Straight-line Jogging 1st) Jumping Plyometrics Proprioception Exercises
Phase III - Minimum Protection Phase
Complete deltoid ligament ruptures occur in combination with _____.
Ankle fractures
Two types of instabilities with chronic ankle sprains.
Mechanical Instabilities and Functional Instabilities
Laxity of the ankle ligaments. (Mechanical Instability)
Peroneus brevis is rerouted through a surgically constructed tunnel in distal fibula. Stabilizes the lateral ankle.
Rehab following surgical repair for mechanical instability.
Strict, rigid cast immobilization for 2 weeks. Followed by hinged rigid orthosis that allows limited ROM for 5-6 weeks. PROM DF and PF later immobilization phase.
Feeling of giving away. (Functional Instability)
Problems with strength, proprioception, and/or ligament stability.
Rehab for functional instability.
Close Chain Resistance Exercises (Cone Tapping)
Proprioception
Concentric/Eccentric Loading
Bracing for support
Sprain of the syndesmotic ligaments of the distal tib-fib joint. Example: Leg/Foot twist into ER (Football, Hockey, Soccer).
High Ankle Sprain
Instability of the peroneal tendons with resulting pain and disability. Example: DF with slight everted.
Subluxing Peroneal Tendons
Some patients have a loose ___ that supports tendons in the peroneal groove.
Retinaculum
Acute Injury Subluxing Peroneal Tendons
Rigid-cast immobilization and NWB for 6 weeks.
Chronic or Recurring Subluxing Peroneal Tendons
Surgical repair. (Bone block, rerouting, periosteal flaps, groove deepening, tendon slings).
Overuse injury resulting from repetitive micro trauma and accumulative overloading of the tendon.
Achilles Tendonitis
Localized pain at mid portion or distal third of the tendon, or where it inserts into the calcaneus.
Primary Feature (Achilles Tendonitis)
Decreased vascularity, aging, degeneration, increased pronation, poor gastroc/soleus flexibility, changing in training, poor footwear.
Causes of Achilles Tendonitis
One of the most common injuries in many sports, but is very prevalent in runners.
Achilles Tendonitis
Greater injury in Men > Women. Ages 35-45 usually.
Achilles Tendonitis
Chronic degeneration of tissue without inflammation.
Tendinosis
In most cases, _______ is the result of tendinosis not tendinitis.
Achilles Tendon Pain
Helps to control pronation.
Achilles Tendon
Excessive pronation, decreased DF ROM, decreased subtalar eversion.
Risk Factors of Achilles Tendonitis
Two Types of Achilles Tendinitis
Mid-portion, Insertional
Medial portion of tendon. Usually 2-6 cm above insertion.
Mid-portion Tendinopathy
Less common, deep surface of tendon. More resistant to treatment.
Insertional Tendinopathy
Bony enlargement at the back of the heel.
Haglund’s Deformity
Between achilles and calcaneus.
Bursitis