ankle pathologies Flashcards
what is a primary consequency of hallux valgus?
hypermobility of the 1st MT
what is the main cause of hallux valgus?
hyperpronation during propulsive phases of gait
shoes too narrow which compress the feet
what can hallux valgus be identified clinically?
1st MT is adducted on medial cuneiform relative to midline
1st phalynx is abducted on MT relative to midline
how can hallux valgus be treated
correct for the hyperpronation w/ strenghtening of the intrinsic muscles and posture or orthosis
taping for temporary pain relief
what is plantar fasciopathy?
histological degeneration and deterioration of collagen fibers, increased secretion of ground substance proteins and fibroblast in areas of proliferation
what clientele is affected by plantar fasciopathy?
- very active people
- people w/ a shigh standing workload
what causes plantar fasciopathy?
degenerative causes due to excessive and repeated loading
low arches: increase the stress in order to stabilize the arch
high arches: inability to pronate foot and thus decreased shock absorption and thus increase stress on foot
-poor MTP extension = poor windlass mechanism = increased stress on plantar fascia
-tightness of myofascial structure = increased pronation or increased tension on fascia
what is the most common MOI(s) for plantar fasciopathy?
overuse injury (insidious)
WB activivity s/a running
activities w/ excessive mvmt, foot pronation or stressing/stretching of plantar fascia (MTP in full extension, foot hyperpronated or foot hypersupinated)
what is the pain site for plantar fasciopathy?
medial tuiberosity of calcaneus and extends along the medial border of the plantar fascia
what is the pain pattern for plantar fasciopathy?
pain worse in am or post activity in WB
if more severe: pain w/ NWB
pain increases w/ mvmt stretching/stressing of the plantar fascia
hwta can be noticed in gait in a foot w/ plantar fasciopathy?
hypersupination or hyperpronation
what is the effect of having a foot hypersupinated
poor motion of tbhe bones thus excessive load on the fascia
what is the effec of foot hyperpronated?
hypermobility
how is the ROM in a foot w/ plantar fasciopathy?
MTPs full extension might be painful and stiff
how is palpation for plantar fasciopathy?
pain on medial tubercle of calcaneuse
might have a heel sput; which is generally painless
what results from flexibility testing for plantar fasciopathy
stiffness
what test can be used to test flexibility in plantar fasciopathy? explain the test?
windlass test
pt in WB is asked to bring hallux into full extension, the arch should rise
might be painful
if nothing happens or is delayed –> weakness
if needs lots of force before being initiated –> stiffness of the fascia
can imaging be used for plantar fasciopathy?
only is conservative Rx is uneffective it is used to detect changes in the facia or heel spurs
how can we decrease pain in plantar fasciopathy
- avoid aggravationlload reduction
- ice and NSAIDs to reduce inflmmation
- taping to elevated fascia
when is stretching used as a tx option for plantar fascipathy? what stretches cn be done
when the plantar fascia is stiff w/ windlass test
-PROM MTP exrtension, full ankle DF
STT, self massage
what grading techniques ares used for mobilization of 1st MTP in extension?
grade 3 and 4
what strenghtning is suggested for plantar fasciopathy?
- hyperpronated foot: STR of intrinsic muscles of the foot
- might want to STR tibialis post and hip ABD/ER
exercise prescribed for plantar fasciopathy?
- pt raises the medial arch of the foot and asked to keep edge in contact w. groun and 1st MTP w/ toe resting normally on floor.
goa: 10 reps of 10s hold 4-5x per day
how can the biomechanics be corrected in the case of plantar fasciopathy?
- taping: only temorary while strengthening intrinsic muscles
- orthodics or new footwear
- othoses