assessment and conditions of the lower leg.

Question 1

what are the 4 compartments of the lower leg? MT

Answer 1

• superior posterior compartment.
• deep posterior compartment.
• lateral compartment.
• anterior compartment.

Question 2

what structures are associated with the superior posterior compartment? MT

Answer 2

• gastrocnemius
• soelus
• plantarus

Question 3

what structures are associated with the deep posterior compartment? MT

Answer 3

• fibula posterior
• tibial artery.
• flexor digitorum longus
• tibia posterior artery and nerve.

Question 4

what structures are associated in the lateral compartment? MT

Answer 4

• protus longus
• brevis

Question 5

what structures are associated with the anterior compartment? MT

Answer 5

• extensor digitorums
• tibia artery
• pronus tarsis.

Question 6

what areas of the lower leg on bones do you palpate?

Answer 6

• fibular head and shaft
• medial and lateral malleolus
• tibial shaft
• tibial plateau (can’t really palp.)

Question 7

what are soft issue structures to palpate?
(3 pern. + 2 flex +1)

Answer 7

• peroneus longus, brevis, tertius.
  flexor hallicis, digitorum longus
• posterior tibialis.

Question 8

what are soft issue structures to palpate?
(exten +others)

Answer 8

• anterior tibialis
• extensor hallucis longus, digitorum
• gastrocnemius
• soleus
• Achilles tendon

Question 9

what is peroneal tendon subluxation/ dislocation? MT

Answer 9

• dynamic force being applied to the ankle.
• dramatic blow to posterior lateral malleolus or moderate/ severe inversion ankle sprain resulting in tearing of perineal retinaculum.
• some cases tendon may rupture.

Question 10

what are s/s of perineal sublet/dislocation? MT

Answer 10

• complain of snapping in and out of groove with activity.
• eversion against manual resistance replicates sublimation
• recurrent pain, snapping, instability.
• present w/ ecchymosis, edema, tenderness, crepitus over tendon.

Question 11

what is management for peroneal sublex/dislocation? MT

Answer 11

• compression with felt horseshoe
• RICE, meds from MD
• conservative treatment time 5-6 weeks.

Question 12

what is anterior tibialis tendinitis? MT

Answer 12

• occurs after extensive down hill running
• no MOI
• dorsiflexion + inversion actively will be painful.

Question 13

s/s of anterior tibialis tendinitis? MT

Answer 13

• point tenderness over anterior tibialis tendon, and of the muscle.

Question 14

how do you manage anterior tibialis tendinitis? MT

Answer 14

• rest/ decrease running time & distance, avoid hills.
• serious case, ice & before and after stretching.
• Dailey strengthen.

Question 15

what is posterior tibialis tendinitis? MT

Answer 15

• common overuse condition in runner with foot hyper mobility or over pronation. (flat feet)
• repetitive microtrauma.
• active + resisted issues
• plantar flexion + inversion issues.
• on medial side.

Question 16

s/s of posterior tibialis tendinitis? MT

Answer 16

pain & swelling in area of medial malleolus.
- edema, point tenderness, increase pain pain during resistive inversion and plantar flexion.

Question 17

management of posterior tibialis tendinitis? MT

Answer 17

• RICE
• NWB cast w/ foot in inversion may be used.
• taping or orthotics

Question 18

what is peroneal tendinitis? MT

Answer 18

• found in patients that have pes cavus (high Arch) due to excessive supination, placing stress on peroneal tendon
• issues with passive dorsiflexion.
• pain pushing off.

Question 19

s/s of peroneal tendinitis? MT

Answer 19

• pain behind medial malleolus during push off.
• pain along distolateral aspect of calcaneus and beneath the cuboid.

Question 20

management for peroneal tendinitis? MT

Answer 20

• Rice, elastic tape, warm-up and flexibility exercises.
• orthotics.

Question 21

where is anterior, posterior tibialis tendinitis , peroneal and achilles tendinitis located?

Answer 21

• on top of the foot.
• behind medial mall.
• behind lateral mall.
• along Achilles tendon

Question 22

what causes leg cramps and spasms?

Answer 22

• fatigue, loss of fluids, electrolyte imbalance.

Question 23

what are 3 syndromes that make up compartment syndrome? MT

Answer 23

• acute compartment syndrome
• occurs secondary to direct trauma.
• medical emergency.
• acute exertion compartment syndrome
• evolves with minimal to moderate activity.
• chronic compartment syndrome.
• symptoms increase at a certain point during activity.
• pain, pale skin, numb and tingling, faint pulse.

Question 24

s/s of compartment syndrome? MT

Answer 24

• deep aching pain and tightness due to pressure and swelling.
  -reduced circulation and sensation.

Question 25

what is management for compartment syndrome? MT

Answer 25

• severe acute or chronic may require a medical emergency that is surgery to reduce pressure or release fascia.
• rice
  if surgery is required no activity for 2-4 months

Question 26

what are stress fractures of tibia and fibula?

Answer 26

• muscles that are constantly pulling on the bone.
• tibia stress fractures are more common than fibula stress fractures.
• overuse conditions of people with structural and biomechanics insufficiencies.
• training errors
• shin splints can lead to stress fractures, constant dull ache should be x-rayed.

Question 27

s/s of stress fractures?

Answer 27

• pain mire intense after exercise than before.
• point tenderness

Question 28

management of stress fracture?

Answer 28

• reduce activity for 14 days.
• after 2 weeks of no pain, can gradually return to play.
• 6-8 wk recovery.
• cycle before running.