Foot/Ankle Flashcards
Pronation = what motions?
DF
Eversion
ABduction
*Mnemonic = PEDAB
Supination = what motions?
PF
Inversion
ADduction
*Mnemonic: IPADS
High Ankle Sprain: MOI
DF + ER
High Ankle Sprain: structures commonly involved
AITFL
PITFL
Transverse TFL
Deltoid Ligament
High Ankle Sprain: key sxs & special tests
-Swelling (less than lateral sprain).
-Limited PF ROM.
-Inability to WB/walk.
-P! with passive end-range DF & ER.
(+) Squeeze Test
(+) Point Test
(+) Cotton Test
High Ankle Sprain: indicator of deltoid ligament damage
Talus displaces away from medial malleolus during passive DF & passive ER.
Squeeze Test: procedure, purpose, (+)
High ankle sprain.
Squeeze distal tib & fib together, work up the leg.
(+) = P! at syndesmosis w/ squeezing proximally.
Point Test: procedure, purpose, (+)
High ankle sprain (AITFL).
Apply pressure w/ finger over AITFL.
(+) = P!
Cotton Test: procedure, purpose, (+)
High ankle sprain (instability).
Passively move heel side to side.
(+) = lateral translation.
High Ankle Sprain: treatment
Surgical repair if very displaced and/or fracture also present.
Control pronation (bc DF + ER restricted).
Lateral Ankle Sprain: structures commonly involved
ATFL
CFL
PTFL (rare)
Lateral Ankle Sprain: MOI
Inversion + PF
Lateral Ankle Sprain: special tests
Anterior Drawer: ATFL.
Talar Tilt: CFL
Talar Tilt Test: procedure, purpose, (+)
CFL sprain.
Passive inversion (neutral PF/DF).
(+) = excessive motion.
Tarsal Tunnel Syndrome: definition & pathophysiology
Compression of posterior tibial N
Structures within the tarsal tunnel
Tibialis Posterior tendon.
FDL tendon.
FHL tendon.
Tibial N.
Posterior tibial artery & vein.
Posterior Tibial N supplies what muscles?
Tibialis Posterior.
FDL.
FHL.
Soleus.
Tarsal Tunnel Syndrome: key sxs & special tests
-P! and paresthesia over medial malleolus, medial arch, & plantar surface.
-Agg by excessive pronation.
-P! with passive DF & eversion.
-P! with active PF & inversion.
(+) Tinel’s
Medial Tibial Stress Syndrome: definition & pathophysiology
Posterior shin splints.
Overuse (running, jumping).
Excessive traction of soleus & post tib mm.
Can lead to stress fx.
Medial Tibial Stress Syndrome: key sxs
-P! in posterior/medial calf.
-Agg by active combined PF + inversion.
Medial Tibial Stress Syndrome: treatment & prevention
-Eccentric calf strengthening.
-Core & hip strengthening.
-Proprioception, balance.
-Shoes w/ good shock absorption.
Achilles Tendinitis: risks & MOI
-Overuse (jumping, running).
-Muscle imbalance of gastroc & soleus = overworks Achilles.
-Over pronation.
Achilles Tendinitis: key sxs
-P! with active PF & heel raises.
-P! with passive DF.
-Limited DF ROM.
Plantar Fasciitis: key sxs & special tests
-P! under heel.
-Agg by WB, esp in the morning.
-P! with passive great toe ext.
(+) Windlass Test
Windlass Test: procedure, purpose, (+)
Plantar Fasciitis.
Passive MTP ext (allow IP to relax/flex, avoids false positive from tight EHL).
(+) = heel P!
Navicular Drop Test: procedure, purpose, (+)
Subtalar pronation.
Palpate navicular while pt shifts weight from non-test leg onto test leg.
(+) = significant inferior displacement.
Talar Bulge: what does it look like & indicates what?
Talar head protrudes medially.
Subtalar pronation.
Rearfoot angles: neutral, pronation, supination
Neutral = 4deg valgus to 4deg varus.
Pronation = 5deg valgus.
Supination = 5deg varus.
Talocrural arthrokinematics (open chain)
Talus (convex) rolls & slides on tibia.
-DF = anterior roll, posterior slide.
-PF = posterior roll, anterior slide.
Talocrural arthrokinematics (closed chain)
Tibia (concave) rolls & slides on talus.
-DF = anterior roll & slide.
-PF = posterior roll & slide.
Subtalar Joint: bones & movements
Talus & Calcaneus.
Inversion & Eversion.
Talocrural Joint: bones & movements
Tib + Fib & Talus.
Primarily PF & DF.
PF = slight inversion + add.
DF = slight eversion + abd.
Distal Tib-Fib Posterior Glide: procedure & promotes what motion?
PF.
Slightly IR tibia, stabilize medial malleolus.
Push down on lateral malleolus.
Distal Tib-Fib Anterior Glide: procedure & promotes what motion?
DF.
Slightly IR tibia, stabilize medial malleolus.
Hook hand & push upward on lateral malleolus.
Talocrural Anterior Glide: procedure & promotes what motion?
PF
Stabilize distal tib/fib.
Pull upward on calcaneus.
Talocrural Posterior Glide: procedure & promotes what motion?
DF
Stabilize distal tib/fib.
Push downward just above malleoli.
Subtalar Medial Glide: procedure & promotes what motion?
Eversion (some DF + pronation).
Stabilize talus, push medially on calcaneus.
Subtalar Lateral Glide: procedure & promotes what motion?
Inversion (some PF + supination).
Stabilize talus, push laterally on calcaneus.
Intertarsal & Tarsometatarsal Plantar Glides: procedure & promotes what motion?
Supination.
Stabilize proximal bone.
Push plantarly on distal bone.
Intertarsal & Tarsometatarsal Dorsal Glides: procedure & promotes what motion?
Pronation.
Stabilize proximal bone.
Push dorsally on distal bone.
