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KNSS 220 Athletic Therapy > Foot and Ankle > Flashcards

Foot and Ankle Flashcards

1
Q

Describe the ligaments of the foot.

A

Ligaments​ ​between​ ​all​ ​phalanges,​ ​can​ ​have​ ​sprains​ ​between​ ​all

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2
Q

Describe the ankle ligaments on the medial side.

A
  • Ligament​ ​on​ ​inside​ ​of​ ​ankle​ ​is​ ​deltoid​ ​ligament:​ ​medial​ ​side​ ​(covers​ ​majority​ ​of inside​ ​of​ ​ankle)
  • Medial​ ​side​ ​of​ ​ankle​ ​is​ ​stronger
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3
Q

Describe the ankle ligaments on the lateral side.

A
  • Anterior​ ​talofibular​ ​ligament​ ​(anterior,​ ​connects​ ​talus​ ​and​ ​fibula)
  • Calcaneofibular​ ​ligament​ ​(connect​ ​calcaneus​ ​and​ ​fibula)
  • ​ ​Posterior​ ​talofibular​ ​ligament​ ​(posterior,​ ​connects​ ​talus​ ​and​ ​fibula)
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4
Q

Describe the ankle ligament on the anterior side.

A
  • Anterior​ ​inferior​ ​tibularfibular​ ​ligament
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5
Q

What are the 3 types of muscles in the foot?

A
  • DAB muscles
  • PAD muscles
  • Muscles​ ​at​ ​lower​ ​leg​ ​that​ ​insert​ ​at​ ​foot
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6
Q

What are DAB muscles?

A

dorsal​ ​abductors​ ​(top​ ​of​ ​foot,​ ​move​ ​toes​ ​apart​ ​from​ ​each​ ​other)

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7
Q

What are PAD muscles?

A

plantar​ ​adductors​ ​(bottom​ ​of​ ​foot,​ ​bring​ ​toes​ ​in​ ​together)​ ​(ex.​ ​Toe​ ​cramps)

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8
Q

What is flat feet called?

A

pes planus foot

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9
Q

pes planus foot is the product of ______ _______.

A

excessive​ ​pronation​ ​(bottom​ ​of​ ​feet​ ​are​ ​falling​ ​flat​ ​in​ ​arch)

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10
Q

What are the causes of pes planus?

A
  • Can​ ​be​ ​born​ ​with​ ​it
  • Comes​ ​along​ ​with​ ​several​ ​other​ ​conditions​ ​(ex.​ ​Down syndrome)
  • Can​ ​get​ ​this​ ​from​ ​spraining​ ​your​ ​ankles​ ​a​ ​lot​ ​(weakens ligament​ ​that​ ​holds​ ​arch up)
  • Can​ ​get​ ​it​ ​from​ ​wearing​ ​really​ ​tight​ ​shoes​ ​(tight​ ​shoes​ ​=​ ​ligaments​ ​don’t​ ​have​ ​to work​ ​as​ ​hard,​ ​too​ ​weak​ ​to​ ​hold​ ​it​ ​up)
  • Overweight​ ​(weight​ ​bearing​ ​on​ ​arch)
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11
Q

What are the signs and symptoms of pes planus?

A
  • Pain​ ​in​ ​arch​ ​(ache)
  • Pain​ ​in​ ​medial​ ​side​ ​of​ ​ankle
  • Weak​ ​feet
  • Feet​ ​tire​ ​quickly​ ​on​ ​arch/inside
  • Can​ ​lead​ ​to​ ​bunions​ ​(bulge​ ​bone​ ​out​ ​to​ ​the​ ​side​ ​to​ ​hold​ ​weight)
  • Knees​ ​cave​ ​in,​ ​inside​ ​of​ ​knees​ ​are​ ​weak
  • Hips​ ​cave​ ​in,​ ​hips​ ​aren’t​ ​sitting​ ​right
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12
Q

How do we manage pes planus?

A
  • No​ ​pain​ ​=​ ​do​ ​nothing
  • insoles/orthotics
  • Can​ ​be​ ​taped
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13
Q

What is pes cavus?

A
  • high arch foot
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14
Q

What are the causes of pes cavus?

A
  • generally born with it
  • rare
  • common in runners
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15
Q

How can we tell if someone has pes cavus?

A

Look​ ​at​ ​imprint​ ​of​ ​foot​ ​when​ ​wet​ ​(only​ ​see​ ​heel,​ ​ball,​ ​and​ ​toes,​ ​nothing connecting)

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16
Q

What are the signs and symptoms of pes cavus?

A
  • Can​ ​have​ ​no​ ​symptoms
  • Can​ ​have​ ​pain​ ​and​ ​tightness​ ​in​ ​bottom​ ​of​ ​foot
  • Hammertoes​ ​(toes​ ​bunch​ ​up)
  • Calluses​ ​on​ ​top​ ​of​ ​toes,​ ​heels,​ ​ball​ ​of​ ​foot
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17
Q

How do we manage pes cavus?

A
  • No​ ​pain/discomfort​ ​=​ ​do​ ​nothing
  • Try​ ​to​ ​loosen​ ​structures​ ​at​ ​bottom​ ​of​ ​feet
  • Roll​ ​out​ ​feet​ ​with​ ​golf​ ​ball
  • Stretch​ ​out​ ​bottom​ ​of​ ​feet
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18
Q

What is the plantar fascia?

A
  • runs​ ​bottom​ ​of​ ​feet,​ ​starts​ ​bottom​ ​of​ ​feet,​ ​fans​ ​out​ ​to​ ​all​ ​toes
  • Shock​ ​absorption/support​ ​for​ ​bottom​ ​of​ ​feet
  • Attached​ ​to​ ​achilles​ ​tendon​ ​and​ ​calf​ ​muscles
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19
Q

What is plantar fasciitis?

A

inflammation of the plantar fascia

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20
Q

How does pes cavus relate to plantar fasciitis?

A

plantar​ ​fascia​ ​is​ ​already​ ​tight​ ​(works​ ​harder​ ​because​ ​it​ ​has​ ​to​ ​spread​ ​out farther​ ​and​ ​rebound​ ​farther)

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21
Q

What makes you more likely to have plantar fasciitis?

A
  • Tends​ ​to​ ​be​ ​more​ ​common​ ​in​ ​runners​ ​(more​ ​shock​ ​to​ ​the​ ​bottom​ ​of​ ​the​ ​feet, higher​ ​impact,​ ​more​ ​often)
  • Tend​ ​to​ ​have​ ​it​ ​more​ ​often​ ​if​ ​you​ ​wear​ ​unsupported​ ​footwear​ ​(no​ ​cushion​ ​for​ ​feet)
  • Tight​ ​achilles​ ​tendon​ ​or​ ​calf​ ​muscles​ ​means​ ​tight​ ​plantar​ ​fascia
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22
Q

Describe the progression of signs and symptoms for plantar fasciitis.

A
  • Burning​ ​pain​ ​on​ ​the​ ​bottom​ ​of​ ​their​ ​feet
  • Starts​ ​with​ ​being​ ​sore​ ​only​ ​after​ ​activity
  • Progresses​ ​to​ ​bothering​ ​them​ ​during​ ​activity​ ​(generally​ ​last​ ​part​ ​of​ ​activity)
  • Progresses​ ​to​ ​bothering​ ​them​ ​from​ ​the​ ​beginning​ ​of​ ​activity
  • Progresses​ ​to​ ​hurting​ ​them​ ​all​ ​the​ ​time​ ​(regardless​ ​of​ ​weight​ ​bearing​ ​or​ ​not)
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23
Q

What is the tell tale sign of plantar fasciitis?

A
  • first​ ​two​ ​or​ ​three​ ​steps​ ​in​ ​the​ ​morning​ ​feel​ ​like​ ​their​ ​feet​ ​are​ ​on​ ​fire
  • then​ ​it loosens​ ​up
  • ​then​ ​at​ ​end​ ​of​ ​activity​ ​it​ ​hurts​ ​again​ ​(plantar​ ​fascia​ ​is shortened/tightened​ ​overnight,​ ​then​ ​first​ ​steps​ ​stretch​ ​it​ ​out)
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24
Q

How do we manage plantar fasciitis?

A
  • roll/stretch​ ​bottom​ ​of​ ​feet
  • Roll​ ​with​ ​golf​ ​ball,​ ​frozen​ ​water​ ​bottles
  • Ultrasound
  • Massage
  • Heat​ ​feet/stretch​ ​before​ ​activity
  • Ice​ ​feet/stretch​ ​after​ ​activity
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25
Q

How do we assess plantar fasciitis?

A
  • Palpate​ ​plantar​ ​fascia

- Feels​ ​tight,​ ​painful​ ​when​ ​you​ ​touch​ ​it

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26
Q

What is the most common injury in the bottom?

A

inversion ankle sprains

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27
Q

What happens in inversion ankle sprains?

A
  • bottom of the foot goes in

- sprains ligaments on the outside of the ankle

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28
Q

What ligaments do you hurt in an inversion ankle sprain?

A
  • anterior​ ​talofibular​ ​ligament
  • calcaneofibular​ ​ligament
  • ​posterior​ ​talofibular ligament
  • grades​ ​apply​ ​to​ ​each​ ​individual​ ​ligament​ ​(can​ ​have
    different​ ​grades​ ​on​ ​each​ ​from​ ​same​ ​injury)
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29
Q

Which ligaments are typically injured in a grade 1 inversion ankle sprain? What happens to these ligaments?

A
  • Predominantly​ ​anterior​ ​talofibular​ ​and​ ​calcaneofibular​ ​ligaments
  • stretching of a ligament
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30
Q

What are the signs and symptoms of a grade 1 inversion ankle sprain?

A
  • Mild​ ​pain
  • Mild​ ​inflammation
  • No​ ​bruising
  • No​ ​deformity
  • Tender​ ​over​ ​whichever​ ​ligament​ ​has​ ​been​ ​damaged
  • No​ ​laxity​ ​(movement​ ​between​ ​the​ ​bones),​ ​but​ ​special​ ​test​ ​will​ ​be​ ​painful
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31
Q

How do we manage a grade 1 inversion ankle sprain?

A
  • Control​ ​their​ ​pain,​ ​inflammation
  • Ice
  • Compression
  • Should​ ​not​ ​need​ ​to​ ​limp​ ​(full​ ​function​ ​of​ ​all​ ​structures​ ​in​ ​ankle),​ ​but​ ​may limp​ ​due​ ​to​ ​pain
  • Make​ ​sure​ ​they​ ​are​ ​walking​ ​properly
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32
Q

Which ligaments are typically injured in a grade 2 inversion ankle sprain? What happens to these ligaments?

A
  • More​ ​common​ ​in​ ​anterior​ ​talofibular​ ​and​ ​calcaneofibular
  • some tearing of fibres
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33
Q

What are the signs and symptoms of a grade 2 inversion ankle sprain?

A
  • More​ ​pain
  • More​ ​inflammation
  • Bruising
  • Limping
  • Special​ ​test:​ ​pain​ ​and​ ​laxity​ ​(more​ ​movement​ ​out​ ​of​ ​joint​ ​than​ ​you​ ​should)
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34
Q

How do we manage a grade 2 inversion ankle sprain?

A
  • Need​ ​some​ ​sort​ ​of​ ​protection:​ ​taping,​ ​bracing​ ​etc.
  • RICE
  • Anti​ ​inflammatory
  • Need​ ​strengthening​ ​of​ ​joint​ ​and​ ​of​ ​supporting​ ​muscles​ ​and​ ​structures
  • Tubing​ ​(pulling​ ​inside​ ​or​ ​outside)
  • Calf​ ​raises
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35
Q

Which ligaments are typically injured in a grade 3 inversion ankle sprain? What happens to these ligaments?

A
  • At​ ​least​ ​one​ ​of​ ​the​ ​three​ ​ligaments​ ​is​ ​torn​ ​completely​ ​(usually​ ​either​ ​the​ ​anterior talofibular​ ​or​ ​calcaneofibular​ ​ligament)
  • Can​ ​have​ ​avulsion​ ​fracture
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36
Q

What are the signs and symptoms of a grade 3 inversion ankle sprain?

A
  • Lots​ ​of​ ​pain
  • Lots​ ​of​ ​swelling
  • Lots​ ​of​ ​bruising
  • Lots​ ​of​ ​laxity
  • No​ ​function
  • Limping
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37
Q

How do we manage a grade 3 inversion ankle sprain?

A
  • Need​ ​brace​ ​or​ ​boot
  • May​ ​not​ ​be​ ​weight​ ​bearing
  • Protect​ ​area​ ​more
  • Need​ ​to​ ​deal​ ​with​ ​swelling,​ ​pain,​ ​bruising
  • Strengthen​ ​joint
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38
Q

Why are eversion ankle sprains more rare than inversion ankle sprains?

A

ligaments on the inside are stronger

39
Q

Describe a grade 1 eversion ankle sprain.

A
  • Pain,​ ​some​ ​swelling,​ ​no​ ​bruising
  • Stretched​ ​ligament
  • No​ ​laxity
  • Make​ ​sure​ ​they​ ​are​ ​walking​ ​properly
  • Generally​ ​don’t​ ​need​ ​extra​ ​protection
40
Q

Describe a grade 2 eversion ankle sprain.

A
  • Tear
  • More​ ​swelling,​ ​more​ ​pain
  • Limping
41
Q

Describe a grade 3 eversion ankle sprain.

A
  • Complete​ ​tear​ ​of​ ​some​ ​part​ ​of​ ​the​ ​ligament
  • Lots​ ​of​ ​swelling,​ ​bruising
  • Limping
42
Q

What is sprained in a high ankle sprain?

A
  • anterior​ ​inferior​ ​tibularfibular​ ​ligament
  • holds​ ​together​ ​tibia​ ​and​ ​fibula
  • ​sprain​ ​means​ ​they​ ​spread​ ​apart​ ​with​ ​every​ ​step
43
Q

What is typically the MOI of a high ankle sprain?

A

rotation movement

44
Q

What are the signs and symptoms of a high ankle sprain?

A
  • Very​ ​painful​ ​to​ ​walk,​ ​regardless​ ​of​ ​degree​ ​(nothing​ ​else​ ​holds​ ​them​ ​together)
  • Swelling​ ​sits​ ​higher​ ​up​ ​their​ ​leg,​ ​but​ ​lots​ ​of​ ​swelling​ ​would​ ​spread​ ​into​ ​feet
  • More​ ​pain​ ​(every​ ​step​ ​hurts)
45
Q

How do we manage a high ankle sprain?

A
  • Taped​ ​or​ ​braced,​ ​even​ ​if​ ​it​ ​is​ ​a​ ​first​ ​degree
  • Longer​ ​heal​ ​(8-12​ ​week),​ ​even​ ​if​ ​it​ ​is​ ​a​ ​first​ ​degree
46
Q

What are the 2 ankle stability tests?

A
  • anterior drawer test

- talar tilt test

47
Q

What are the 2 tests for high ankle sprains?

A
  • squeeze test

- external rotation test

48
Q

Describe the anterior drawer test.

A
  • Specific​ ​to​ ​deltoid​ ​ligament​ ​and​ ​3​ ​ligaments​ ​on​ ​outside
  • Regular​ ​inversion​ ​or​ ​eversion​ ​ankle​ ​sprain
  • Pulling​ ​and​ ​pushing​ ​shin​ ​and​ ​heel​ ​in​ ​opposite​ ​directions
49
Q

Describe the talar tilt test.

A
  • Specific​ ​to​ ​calcaneofibular​ ​ligament​ ​and​ ​deltoid​ ​ligament
  • Tilting​ ​the​ ​heel​ ​back​ ​and​ ​forth
50
Q

Describe the squeeze test.

A
  • ​anterior​ ​inferior​ ​tibularfibular​ ​ligament

- squeeze tibia and fibula together

51
Q

Describe the external rotation test.

A
  • ​anterior​ ​inferior​ ​tibularfibular​ ​ligament

- Rotate​ ​ankle​ ​out​ ​to​ ​the​ ​side,​ ​force​ ​tibia​ ​and​ ​fibula​ ​apart

52
Q

=

A

fracture

53
Q

Name 3 ways that ankle fractures and dislocations can occur.

A
  • Compression​ ​load​ ​down
  • Twist
  • Sprain
54
Q

What bones can be fractured/dislocated? Which is most common?

A
  • Talus
  • Lateral​ ​malleolus
  • Medial​ ​malleolus
  • no bone is more common than another
55
Q

What types of fractures are most common in the ankle?

A
  • ​crush​ ​type​ ​fracture
  • avulsion​ ​fracture
  • straight​ ​longitudinal​ ​fracture
56
Q

Why are spiral fractures rare in the ankle?

A

spiral force will cause dislocations

57
Q

In what position is the ankle strongest vs dislocations and in what position is the ankle the weakest?

A
  • Foot​ ​in​ ​dorsi​ ​flexion​ ​means​ ​talus​ ​and​ ​tibia​ ​and​ ​fibula​ ​is​ ​tight​ ​and​ ​stable
  • Pointed​ ​toes​ ​means​ ​talus​ ​and​ ​fibula​ ​is​ ​loose,​ ​this​ ​is​ ​the​ ​easiest​ ​way​ ​to​ ​dislocate​ ​ankle
58
Q

What are the signs and symptoms of ankle fractures/dislocations?

A
  • Redness
  • Heat
  • Bruising
  • Grinding
  • Popping
  • Cracking
  • Usually​ ​see​ ​deformity​ ​(divots​ ​or​ ​bulges)
59
Q

How do we manage ankle fractures/dislocations?

A
  • No distal pulse = EMS
  • Need​ ​to​ ​go​ ​to​ ​the​ ​hospital
  • Don’t​ ​need​ ​special​ ​test​ ​if​ ​it​ ​is​ ​obvious
  • Support​ ​ankle​ ​as​ ​best​ ​as​ ​you​ ​can​ ​in​ ​the​ ​position​ ​it​ ​is​ ​in
  • Generally​ ​immobilize​ ​the​ ​person,​ ​will​ ​almost​ ​never​ ​cast​ ​(boot)
60
Q

How do you check for a distal pulse?

A
  • Pulse​ ​on​ ​bottom​ ​of​ ​foot​ ​closest​ ​to​ ​toes
  • Pulse​ ​on​ ​top​ ​of​ ​foot
  • Squish​ ​toes,​ ​if​ ​it​ ​turns​ ​white,​ ​see​ ​if​ ​it​ ​turns​ ​back​ ​to​ ​red
61
Q

Describe rehab for ankle fractures/dislocations.

A
  • Probably​ ​in​ ​boot​ ​for​ ​2​ ​weeks​ ​non​ ​weight​ ​bearing
  • RICE
  • Electrotherapy
  • Do​ ​not​ ​do​ ​ultrasound​ ​(sound​ ​wave​ ​enters​ ​tissues​ ​and​ ​causes​ ​them​ ​to​ ​vibrate,
    anyone​ ​with​ ​a​ ​fracture​ ​or​ ​dislocation​ ​will​ ​feel​ ​this​ ​as​ ​an​ ​electric​ ​sensation)
  • Then​ ​need​ ​stress​ ​on​ ​it,​ ​still​ ​generally​ ​in​ ​boot​ ​for​ ​4 weeks​ ​or​ ​until​ ​they​ ​are​ ​comfortable walking
62
Q

Why are fractures more severe in the lower leg than in the ankle?

A
  • Only​ ​2​ ​bones
  • Veins​ ​and​ ​arteries​ ​and​ ​nerves​ ​in​ ​lower​ ​leg
  • Generally​ ​jagged​ ​fractures,​ ​blood​ ​vessels​ ​are​ ​close​ ​to​ ​bones
  • Muscles​ ​in​ ​lower​ ​leg​ ​are​ ​in​ ​compartments,​ ​swelling​ ​has​ ​nowhere​ ​to​ ​go​ ​=​ ​further damage
63
Q

Where do fractures generally happen in the lower leg?

A

middle area of the shaft

64
Q

What are the signs and symptoms of lower leg fractures?

A
  • Painful
  • Can​ ​be​ ​open​ ​or​ ​closed
  • Jagged​ ​(increase​ ​likelihood​ ​of​ ​being​ ​open)
  • Swelling
  • Bruising
65
Q

What is the special test for lower leg fractures?

A
  • compression test
  • Don’t​ ​do​ ​this​ ​if​ ​it​ ​is​ ​obvious
  • Squeeze​ ​tibia​ ​and​ ​fibula​ ​together
  • Pain​ ​is​ ​positive​ ​indication
66
Q

How will they immobilize a lower leg fracture?

A
  • If​ ​this​ ​fracture​ ​is​ ​below​ ​halfway,​ ​they​ ​may​ ​be​ ​able​ ​to​ ​be​ ​in​ ​a​ ​long​ ​boot​ ​(immobilize​ ​whole tibia)
  • If​ ​fracture​ ​is​ ​above​ ​halfway,​ ​their​ ​knee​ ​needs​ ​to​ ​be​ ​immobilized.​ ​Will​ ​be​ ​in​ ​a​ ​long​ ​leg cast,​ ​or​ ​in​ ​zimmer​ ​splint
67
Q

How long will the leg be immobilized with a lower leg fracture?

A
  • Long​ ​term​ ​immobilization​ ​(at​ ​least​ ​4-6​ ​weeks)
  • Less​ ​time​ ​if​ ​it​ ​is​ ​fibula​ ​(3-4​ ​weeks)
  • More​ ​time​ ​for​ ​tibia​ ​(4-6​ ​weeks)
68
Q

Describe the rehab for a lower leg fracture.

A
  • Regain​ ​ROM​ ​at​ ​ankle​ ​and​ ​knee
  • Watch for atrophy
  • Lots​ ​of​ ​calf​ ​raises,​ ​foot​ ​exercises
69
Q

How does achilles tendonitis occur?

A
  • overuse injury
  • most common injury in achilles
  • MOI: too much calf raise type movement (running, jumping etc.)
  • MOI: calf raise type movement while pushing on achilles (shoes, strapping etc.)
70
Q

What are the signs and symptoms of achilles tendonitis?

A
  • Swollen​ ​right​ ​at​ ​the​ ​structure
  • warm/hot​ ​right​ ​at​ ​the​ ​tendon
  • Might​ ​have​ ​redness
  • Will​ ​NOT​ ​have​ ​bruising
  • Grinding​ ​sensation,​ ​feels​ ​like​ ​it​ ​catches​ ​​ ​(crepitus)
71
Q

What is the special test for achilles tendonitis? How is it performed?

A
  • thompson test

- physically palpate tendon for grinding sensation

72
Q

What are the 4 stages of signs of achilles tendonitis?

A
  • Stage​ ​1:​ ​only​ ​painful​ ​after​ ​activity
  • Stage​ ​2:​ ​starting​ ​to​ ​get​ ​sore​ ​during​ ​activity,​ ​but​ ​doesn’t​ ​impede performance​ ​much.​ ​Painful​ ​during​ ​and​ ​after,​ ​feels​ ​better​ ​next​ ​day
  • Stage​ ​3:​ ​hurts​ ​during​ ​whole​ ​activity,​ ​starts​ ​to​ ​impede​ ​performance (harder​ ​to​ ​run,​ ​jump,​ ​limping)
  • Stage​ ​4:​ ​physically​ ​impossible​ ​to​ ​do​ ​activity,​ ​just​ ​walking​ ​around hurts
73
Q

People generally don’t seek help for achilles tendonitis until stage ___.

A

3

74
Q

What is achilles tendinosus?

A

achilles tendon is breaking down, no way to reverse it

75
Q

How do we manage achilles tendonitis?

A
  • Rest​ ​(activity​ ​modification)
  • Tape,​ ​strap​ ​to​ ​provide​ ​support​ ​to​ ​the​ ​structure​ ​that​ ​is​ ​damaged
  • Strengthen​ ​tendon​ ​without​ ​further​ ​damage
  • Calf​ ​raises
76
Q

How does an acute achilles strain occur?

A
  • 1 time mechanism injury (not overuse)
  • MOI: too much stretch
  • MOI: trying to push off explosively when already in stretch
  • covers 1st and 2nd degree
77
Q

What are the signs and symptoms of a first degree achilles strain?

A
  • Mild​ ​swelling
  • Mild​ ​pain
  • Mild​ ​heat
  • Mild​ ​redness
  • No​ ​deformity
  • Can​ ​walk,​ ​but​ ​painful
78
Q

What are the signs and symptoms of a second degree achilles strain?

A
  • Some​ ​tearing
  • Moderate​ ​swelling
  • Moderate​ ​heat
  • Moderate​ ​redness
  • Bruising​ ​on​ ​either​ ​side​ ​and​ ​down​ ​in​ ​the​ ​heel
  • No​ ​deformity
  • Very​ ​painful​ ​to​ ​walk,​ ​probably​ ​limping
79
Q

How do we manage a first degree achilles strain?

A
  • Taping
  • Strapping
  • 2​ ​weeks
80
Q

How do we manage a second degree achilles strain?

A
  • May​ ​be​ ​in​ ​a​ ​boot​ ​for​ ​1-2​ ​weeks
  • Stabilize​ ​so​ ​that​ ​they​ ​do​ ​not​ ​further​ ​tear​ ​the​ ​tendon
  • 90​ ​degree​ ​boot​ ​=​ ​no​ ​active​ ​movement
81
Q

What is the MOI of a acute achilles rupture?

A

Explosive​ ​movement​ ​when​ ​already​ ​in​ ​the​ ​stretch​ ​position

82
Q

What are the signs and symptoms of a achilles rupture?

A
  • Lots​ ​of​ ​swelling,​ ​redness,​ ​bruising
  • Will​ ​have​ ​deformity​ ​(divot)
  • Feels​ ​like​ ​they​ ​got​ ​shot​ ​in​ ​ankle,​ ​then​ ​no​ ​pain
  • Lacking​ ​ability​ ​in​ ​foot
83
Q

What is the special test for an achilles rupture?

A
  • thompson test
  • contract​ ​gastrocnemius,​ ​testing​ ​if​ ​foot​ ​moves
  • not able to control foot drop
84
Q

How is an achilles rupture managed with surgery?

A
  • Immediate
  • Stitched​ ​together
  • Immobilized​ ​for​ ​3-4​ ​weeks
  • Tend​ ​to​ ​do​ ​surgery​ ​on​ ​athletes
85
Q

How is an achilles rupture managed without surgery?

A
  • In​ ​a​ ​boot,​ ​with​ ​heel​ ​raised​ ​up

- Gradually​ ​try​ ​to​ ​get​ ​them​ ​back​ ​to​ ​90​ ​degrees​ ​every​ ​2​ ​weeks

86
Q

Describe the timeframe for a achilles rupture.

A
  • Season​ ​ending​ ​injury

- Walking​ ​in​ ​boot​ ​approx​ ​6-8​ ​weeks

87
Q

What is a common misconception around achilles ruptures?

A

you are not more likely to rupture if you have had achilles tendonitis or achilles strains

88
Q

What are shin splints called?

A

medial tibial stress syndrome

89
Q

What are the prime causes of shin splints?

A
  • muscles​ ​in​ ​back​ ​of​ ​leg​ ​is​ ​stronger,​ ​they​ ​are​ ​pulling​ ​away​ ​from​ ​medial​ ​side of​ ​tibia
  • Arches:​ ​Muscles​ ​in​ ​lower​ ​leg​ ​has​ ​to​ ​work​ ​harder​ ​to​ ​support​ ​arch​ ​= increase​ ​load​ ​in​ ​muscle​ ​=​ ​pain​ ​in​ ​muscle​ ​up​ ​the​ ​tibia
90
Q

How can we palpate shin splints?

A

Muscle​ ​feels​ ​thick​ ​on​ ​medial​ ​side​ ​of​ ​tibia​ ​(local​ ​inflammation)

91
Q

What can shin splints lead to?

A

stress fractures

92
Q

What are the signs and symptoms of shin splints?

A
  • Pain​ ​in​ ​medial​ ​side​ ​of​ ​tibia​ ​(very​ ​specific)
  • Palpable​ ​inflammation
  • Can​ ​visibly​ ​see​ ​if​ ​severe
  • Hot​ ​to​ ​touch
  • Red
  • No​ ​bruising
  • 4​ ​stages
93
Q

How do we manage shin splints?

A
  • Rest​ ​(modified​ ​activity:​ ​take​ ​out​ ​as​ ​many​ ​things​ ​as​ ​possible​ ​that​ ​aggravate
    injuries​ ​while​ ​letting​ ​them​ ​do​ ​something)
  • Laser
  • Current
  • Ultrasound
  • Ice​ ​after​ ​activities
94
Q

What do we need to remember when sizing crutches?

A
  • Not​ ​meant​ ​to​ ​be​ ​leaned​ ​on​ ​armpits
  • At​ ​least​ ​3-4​ ​fingers​ ​between​ ​armpit​ ​and​ ​crutch
  • Start​ ​with​ ​height​ ​guideline
  • Need​ ​slight​ ​bend​ ​in​ ​elbow
  • Size​ ​to​ ​line​ ​in​ ​wrist
  • Crutch​ ​base​ ​is​ ​meant​ ​to​ ​land​ ​2​ ​inches​ ​outside​ ​of​ ​toes​ ​and​ ​6​ ​inches​ ​in​ ​front​ ​of​ ​toes

KNSS 220 Athletic Therapy (14 decks)

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