Intro to Foot Types

Question 1

forefoot pathology

Answer 1

hallux valgus
hallux limitis
hallux rigidus
plantarflexed 1st ray
dorsiflexed 1st ray
Tailor's Bunion
Hyperkeratoses
Hammer Digit Syndrome

Question 2

what is another name for hallux abductovalgus

Answer 2

hallux valgus

Question 3

what is hallux valgus

Answer 3

hallux is laterally deviated relative to the 1st MT, the 1st ray may be medially deviated relative to the 2nd ray

Question 4

HAV may be associated with what other deformity

Answer 4

bunion deformity

Question 5

what are biomechanical etiologies of HAV

Answer 5

• any deformity leading to 1st ray hypermobility
• any deformity lead to STJ pronation
• flexible PFFR
• flexible forefoot valgus (supinaiton at the LMJA)

Question 6

why can STJ pronation result in a hypermobile 1st ray

Answer 6

pronation leads to a loss of pull of PL

Question 7

what are non-biomechanical etiologies of HAV

Answer 7

heredity
neuromuscular disease
trauma
arthritides
metabolic disorders
shoegear

Question 8

what is hallux limitus

Answer 8

limited motion at the 1st metatarsophalngeal joint

Question 9

what causes of hallux limitus

Answer 9

• structural (bony limitation - exostosis)
• dorsiflexed 1st ray limiting the ability of the base of the proximal phalanx to dorsiflex up and over the 1st MT head
• functional loss of PL

Question 10

what happens if you lose the function of PL

Answer 10

destabilizes the 1st ray preventing normal dorsiflexion of the 1st MTPJ during gait

Question 11

hallux limitus is associated with what biomechanical deformities associated with what

Answer 11

a hypermobile 1st ray

Question 12

what are the signs and symptoms of hallux limitus

Answer 12

• pain at the 1st MPJ (either bump pain or arthritic pain)
• hyperketatosis sub IPJ of hallux, sub 2nd MPJ and sub 4/5th
• hyperexension at the hallux interphalangeal joint
• dystrophic halux nail changes

Question 13

what is hallux rigidus

Answer 13

no motion available at the 1st MPJ

Question 14

what are the etiologies of hallux rigidus

Answer 14

same as hallux limitus

Question 15

describe a plantarflexed 1st ray deformity

Answer 15

the 1st MT head is plantar to the plane of the lesser MTs

Question 16

what are symptoms of a plantarflexed 1st ray

Answer 16

hyperkeratosis directly under the 1st MT head if rigid

Question 17

a flexible plantarflexed 1st ray deformity, where will jamming occur

Answer 17

proximal to the dorsal aspect of the 1st metatrso-cueiform joint

Question 18

what is metatarsus primus elevatus

Answer 18

dorsiflexed 1st ray

lack of adequate plantarflexion leads to inadequate 1st MPJ dorsiflexion

Question 19

signs, symptoms and treatment of MPE is similar to —

Answer 19

hallux limitus

Question 20

what is a tailor’s bunion

Answer 20

laterally deviated 5th MT, medially deviated 5th digit and laterally prominent 5th MT head

Question 21

Tailor’s bunion is associated with what deformities

Answer 21

splay foot
rearfoot varus
forefoot varus

Question 22

name 3 hammer digit syndromes

Answer 22

1. hammertoe
2. claw toe
3. mallet toe

Question 23

what is a hammertoe

Answer 23

flexion contracture at the proximal IPJ and extension at the distal IPJ

Question 24

hammertoe is associated with

Answer 24

overpronation

Question 25

what is claw toe

Answer 25

flexion contractures at both the proximal and distal IPJ

Question 26

what is claw toe associated with

Answer 26

- loss of intrinstic stability | - pes cavus foot type

Question 27

what is mallet toe

Answer 27

contracture at the distal IPJ | long flexors are overpowering

Question 28

name 3 rearfoot pathologies

Answer 28

1. Haglund's Deformity 2. Plantar fasciitis 3. Sinus Tarsi Syndrome

Question 29

what is Haglund's Deformity

Answer 29

a bony prominence at the posterior lateral superior aspect of the calcaneus

Question 30

what is Haglund's Deformity known as

Answer 30

pump bump

Question 31

what deformities is Haglund's Deformity associated

Answer 31

``` rearfoot varus forefoot valgus (an inverted foot) ```

Question 32

what is one of the most common of all foot conditions

Answer 32

plantar fasciitis

Question 33

what is plantar fasciitis

Answer 33

pulling/tearing/inflammation along the course or at the proximal attachment of the plantar fascia

Question 34

pain of plantar fasciitis is commonly located

Answer 34

at the medial attachment of the medial band due to increased pronation lengthening the medial column

Question 35

plantar fasciitis is assocaited with

Answer 35

any cause of STJ pronation/LMJA supination

Question 36

symptoms or plantar fasciitis include

Answer 36

***pain is often greatest when first arising in the am | usually relate some change in activity, weight, or shoegear

Question 37

what type of shoegear should someone with plantar fasciitis wear

Answer 37

firm heel counter good arch support sole that bends only at the MTPJ *make sure the pt wears shoes at home

Question 38

where is the pain located with sinus tarsi syndrome

Answer 38

located in the area of the sinus tarsi

Question 39

what is sinus tarsi syndrome associated with

Answer 39

- a history or lateral sprain | - excessive pronation causing jamming as the talus slides forward and down on the calcaneus

Question 40

how do you treat sinus tarsi syndrome

Answer 40

control of pronation

Question 41

how can a stress fracture occur

Answer 41

- the body responds to stress applied to a bone by remodeling it to make it stronger - remodeling requires both bone creation and bone destruction - when the osteoclastic (destruction) activity out paces the osteoblastic activity (creation), a weak point develops, and a stress fracture may occur

Question 42

what are common sites for stress fractures?

Answer 42

- MT (2nd and 5th most commonly at the distal 1/3) - calcaneus - sesamoids - tibia

Question 43

what are stress fractures associated with

Answer 43

osteoporosis

Question 44

what is tendonitis

Answer 44

inflammation of a tendon

Question 45

where is tendonitis common

Answer 45

posterior tibial tendonitis | achilles tendonitis

Question 46

where is the pain in posterior tibial tendonitis

Answer 46

along the course of the PT tendon | commonly as it passes posterior and inferior to the medial malleolus or at its insertion at the navicular tuberosity

Question 47

posterior tibial tendonitis is also called

Answer 47

posterior tibial dysfunction (PTTD)

Question 48

who does PTTD occur in

Answer 48

ppl who excessively pronate (particularly feet that function with the calcaneus everted) overweight middle aged females

Question 49

PTTD may be associated with

Answer 49

equinus | eversion sports injury

Question 50

where is the pain located in achilles tendonitis

Answer 50

pain along the course or at the insertion of the achiiles tendon

Question 51

achilles tendonitis is associated with

Answer 51

equinus

Question 52

treatment of achilles tendonitis

Answer 52

heel lifts

Question 53

name 2 forefoot pathologies

Answer 53

toenail problems | sesamoditis

Question 54

what are toenail problems assocaited with

Answer 54

poorly fitted shoes

Question 55

black toenail syndrome is common in who

Answer 55

- runners who wear their shoes too short - as the run, the feet slide forward in the shoe, banging up against the front of the shoe - recurrent trauma causes microbleeds under the nail plates, causing the toenail to appear black, pull away from the nail bed, thicken or fall off

Question 56

etiologies, symptoms and treatment of sesamoiditis is similar to

Answer 56

sesamoid stress fracture

Question 57

recurrent ankle sprains occur on the medial or lateral side

Answer 57

almost always lateral