Intro to Foot Types Flashcards
forefoot pathology
hallux valgus hallux limitis hallux rigidus plantarflexed 1st ray dorsiflexed 1st ray Tailor's Bunion Hyperkeratoses Hammer Digit Syndrome
what is another name for hallux abductovalgus
hallux valgus
what is hallux valgus
hallux is laterally deviated relative to the 1st MT, the 1st ray may be medially deviated relative to the 2nd ray
HAV may be associated with what other deformity
bunion deformity
what are biomechanical etiologies of HAV
- any deformity leading to 1st ray hypermobility
- any deformity lead to STJ pronation
- flexible PFFR
- flexible forefoot valgus (supinaiton at the LMJA)
why can STJ pronation result in a hypermobile 1st ray
pronation leads to a loss of pull of PL
what are non-biomechanical etiologies of HAV
heredity neuromuscular disease trauma arthritides metabolic disorders shoegear
what is hallux limitus
limited motion at the 1st metatarsophalngeal joint
what causes of hallux limitus
- 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
what happens if you lose the function of PL
destabilizes the 1st ray preventing normal dorsiflexion of the 1st MTPJ during gait
hallux limitus is associated with what biomechanical deformities associated with what
a hypermobile 1st ray
what are the signs and symptoms of hallux limitus
- 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
what is hallux rigidus
no motion available at the 1st MPJ
what are the etiologies of hallux rigidus
same as hallux limitus
describe a plantarflexed 1st ray deformity
the 1st MT head is plantar to the plane of the lesser MTs
what are symptoms of a plantarflexed 1st ray
hyperkeratosis directly under the 1st MT head if rigid
a flexible plantarflexed 1st ray deformity, where will jamming occur
proximal to the dorsal aspect of the 1st metatrso-cueiform joint
what is metatarsus primus elevatus
dorsiflexed 1st ray
lack of adequate plantarflexion leads to inadequate 1st MPJ dorsiflexion
signs, symptoms and treatment of MPE is similar to —
hallux limitus
what is a tailor’s bunion
laterally deviated 5th MT, medially deviated 5th digit and laterally prominent 5th MT head
Tailor’s bunion is associated with what deformities
splay foot
rearfoot varus
forefoot varus
name 3 hammer digit syndromes
- hammertoe
- claw toe
- mallet toe
what is a hammertoe
flexion contracture at the proximal IPJ and extension at the distal IPJ
hammertoe is associated with
overpronation
what is claw toe
flexion contractures at both the proximal and distal IPJ
what is claw toe associated with
- loss of intrinstic stability
- pes cavus foot type
what is mallet toe
contracture at the distal IPJ
long flexors are overpowering
name 3 rearfoot pathologies
- Haglund’s Deformity
- Plantar fasciitis
- Sinus Tarsi Syndrome
what is Haglund’s Deformity
a bony prominence at the posterior lateral superior aspect of the calcaneus
what is Haglund’s Deformity known as
pump bump
what deformities is Haglund’s Deformity associated
rearfoot varus forefoot valgus (an inverted foot)
what is one of the most common of all foot conditions
plantar fasciitis
what is plantar fasciitis
pulling/tearing/inflammation along the course or at the proximal attachment of the plantar fascia
pain of plantar fasciitis is commonly located
at the medial attachment of the medial band due to increased pronation lengthening the medial column
plantar fasciitis is assocaited with
any cause of STJ pronation/LMJA supination
symptoms or plantar fasciitis include
***pain is often greatest when first arising in the am
usually relate some change in activity, weight, or shoegear
what type of shoegear should someone with plantar fasciitis wear
firm heel counter
good arch support
sole that bends only at the MTPJ
*make sure the pt wears shoes at home
where is the pain located with sinus tarsi syndrome
located in the area of the sinus tarsi
what is sinus tarsi syndrome associated with
- a history or lateral sprain
- excessive pronation causing jamming as the talus slides forward and down on the calcaneus
how do you treat sinus tarsi syndrome
control of pronation
how can a stress fracture occur
- 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
what are common sites for stress fractures?
- MT (2nd and 5th most commonly at the distal 1/3)
- calcaneus
- sesamoids
- tibia
what are stress fractures associated with
osteoporosis
what is tendonitis
inflammation of a tendon
where is tendonitis common
posterior tibial tendonitis
achilles tendonitis
where is the pain in posterior tibial tendonitis
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
posterior tibial tendonitis is also called
posterior tibial dysfunction (PTTD)
who does PTTD occur in
ppl who excessively pronate (particularly feet that function with the calcaneus everted)
overweight
middle aged females
PTTD may be associated with
equinus
eversion sports injury
where is the pain located in achilles tendonitis
pain along the course or at the insertion of the achiiles tendon
achilles tendonitis is associated with
equinus
treatment of achilles tendonitis
heel lifts
name 2 forefoot pathologies
toenail problems
sesamoditis
what are toenail problems assocaited with
poorly fitted shoes
black toenail syndrome is common in who
- 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
etiologies, symptoms and treatment of sesamoiditis is similar to
sesamoid stress fracture
recurrent ankle sprains occur on the medial or lateral side
almost always lateral
