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PS200 > Ankle + lower leg injuries > Flashcards

Ankle + lower leg injuries Flashcards

1
Q

Lateral ankle sprain onset/MOI

A
  • sudden
  • rapid change of direction or awkward landing
    -> ATFL = PF + inv.
    -> CFL = DF + neutral
    -> PTFL = DF + inv.
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2
Q

Lateral ankle sprain subjective

A
  • painful + swollen
  • pain on WB
  • instability
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3
Q

Lateral ankle sprain physical

A
  • swollen + bruised
  • decreased AROM/PROM
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4
Q

Lateral ankle sprain specific tests

A

+ve anterior draw

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5
Q

Lateral ankle sprain management

A
  • tape/brace
  • early mobilisation
  • decrease WB
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6
Q

Chronic ankle injury onset/MOI

A
  • gradual
  • functional ankle instability from:
  • repeated LCL sprains
  • poor control of surrounding muscles
  • < proprioception
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7
Q

Chronic ankle injury Mx

A
  • strength training
  • proprioception training
  • taping/bracing
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8
Q

Deltoid ligament sprain onset/MOI

A
  • sudden
  • ev, abduction w/ high force (often w/ fibula fracture)
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9
Q

Deltoid ligament sprain subjective

A

pain on lateral ankle

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10
Q

Deltoid ligament sprain physical

A
  • swelling/bruising
  • pain on eversion, DF + PF
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11
Q

Deltoid ligament sprain specific tests

A

+ve eversion talar tilt test

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12
Q

Deltoid ligament sprain Mx

A

same as LCL sprain, recovery twice as long

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13
Q

Achilles tendinopathy onset/MOI

A

overuse
footwear

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14
Q

Achilles tendinopathy subjective/agg/easing

A

agg - activity but goes away w/ warm up/comes back after cool down
ease - rest

worse in morning

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15
Q

Achilles tendinopathy physical

A
  • pronation on WB, IR
  • PF or heel raise reproduce pain in RSC
  • calf stretch may reproduce pain in MLT
  • local swelling, thickening of tendon
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16
Q

Achilles tendinopathy Mx

A
  • stretching 15-30 secs/week (avoid DF for insertional AT)
  • heavy loading eccentric training
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17
Q

Tibialis posterior subjective - agg/ease

A
  • medial ankle pain
  • agg = activities causing prolonged stretching into EV ie. running
  • ease = rest
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18
Q

Tibialis posterior physical

A
  • excessive pronation
  • RSC Inv/PF painful
  • stretch = EOR passive eversion/DF painful
  • tender + swollen along tendon
  • difficulty going up on toes
19
Q

Tibialis posterior Mx

A
  • unloading
  • taping/bracing
  • EPA’s
  • stretching
  • strengthening
20
Q

FHL tendinopathy subjective/agg/ease

A
  • medial heel pain
  • agg = toe-off or forefoot WB
  • ease = rest
21
Q

FHL tendinopathy physical

A
  • RSC of toe F painful
  • stretch of toe painful
  • TOP +/- crepitus over tendon
22
Q

Plantar fasciopathy onset/MOI

A

gradual over a few months

can be due to high training load, prolonged standing or poor footwear

23
Q

Plantar fasciopathy subjective/agg/ease

A
  • pain along prox. PF + attachment to calcaneal tuberosity
  • agg = heel pain in first few steps of morning/after sitting / prolonged activity/bad shoes
  • ease = as activity continues (to point), NWB + supportive shoes
24
Q

Plantar fasciopathy 24hr pattern

A
  • AM = worst
  • DD = activity dependent
  • PM = sore by EOD
25
Q

Plantar fasciopathy physical

A
  • antalgic gait, excessive pronation
  • limited ROM of hallux
  • TOP of plantar heel
  • passive accessory movements may be stiff
26
Q

Plantar fasciopathy Mx

A
  • load reduction + taping
  • strengthening + stretching
  • corticosteroid injections
  • surgery
27
Q

MTSS/shin splints onset/MOI

A

gradual

increased training volume/frequency/intensity

28
Q

MTSS/shin splints subjective/agg/ease

A
  • deep dull ache 5cm in bottom 1/3rd of shin
  • pain initially decreases w/ w/u but returns later + after walking or stairs
  • worse morning after exercise
29
Q

MTSS/shin splints physical

A
  • excessive foot pronation
  • TOP section of medial tibial border
  • tender thickened soleus, deep fascia + FDL at insertion on tibial border
  • MLT calf tight
30
Q

MTSS/shin splints Mx

A
  • manage pain = ice, NSAIDs
  • myofascial release
  • taping to support tib. post
  • evaluate training + shoes
31
Q

Tibial stress fracture onset/MOI

A

gradual

32
Q

Tibial stress fracture subjective/agg/ease

A
  • local pain w/ walking, at rest
  • agg = exercise, esp. impact activities
33
Q

Tibial stress fracture 24hr pattern

A

worse at night

34
Q

Tibial stress fracture physical

A
  • rigid foot or excessive pronation
  • increase muscle fatigue + decreased absorption
  • TOP locally ++
  • percussion/tuning fork +ve
35
Q

Tibial stress fracture Mx

A
  • avoid strain/repetitive loading
  • crutches initially if severe
  • exercise again when no pain on WB
  • modify training
36
Q

Sever’s disease onset/MOI

A

gradual/caused by growth spurt

growth plate is injured by excessive forces

37
Q

Sever’s disease subjective/agg/ease

A
  • paina around insertion of achilles on calcaneus
  • agg = worse w/ activity, impact movements
  • ease = loose shoes, rest
38
Q

Sever’s disease physical

A
  • RSC PF/heel raise may reproduce pain
  • MLT tight calf, stretch may reproduce pain
  • TOP locally at insertion
39
Q

Sever’s disease Mx/prevention

A
  • strecthing
  • self massage
  • modifying sport/training by gradually increasing load
  • train on sprung boards/grass rather than hard ground
  • appropriate footwear
40
Q

Posterior impingement syndrome onset/MOI

A

gradual

injury or repeated plantar flexion

41
Q

Posterior impingement syndrome subjective/agg/ease

A
  • ballet dancer/soccer player
  • deep ache in posterior ankle
  • agg = pushing off, PF activities
  • ease = rest
42
Q

Posterior impingement syndrome physical

A
  • swelling in back of ankle
  • pain in single leg heel raise
  • local TOP
  • local pain w/ PF
43
Q

Posterior impingement syndrome Mx

A
  • rest
  • manual mobilisation
  • NSAIDs
  • corticosteroids

surgical removal of OS trigonium/posterior process

PS200 (6 decks)

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