LE Diagnostic Manual - MPD of Foot/Ankle Flashcards
what are the MPD at the foot/ankle
achilles tendinopathy/rupture
posterior tibialis tendinopathy
CPG recommended outcome measures
LEFS
FAAM
Victorian Institiute of sports assessment-achilles (VISA-A)
subjective reports for achilles tendinopathy/rupture
pain with activities requiring eccentric control
- dynamic activities
explain common locations for pain in the achilles
2-6 cm proximal to insertion
pain with palpation in the midportion
explain predisposition to posterior tibialis tendinopath
over pronation
running/running sports
describe early stage posterior tibialis tendinopathy
aching discomfort in the medial aspect of the ankle
exacerbated by activity / relieved by rest
explain stage 2 posterior tibialis tendinopathy
persistent discomfort and medial swelling
– pain shifts laterally due to calcaneofibular / lateral subtalar impingement
ROM findings associated with MPD at the foot and ankle
most likely limited due to pain/weakness
PF limited in weight bearing
– terminal stance of gait
DF is primary motion limited
muscle performance findings associated with MPD at the foot and ankle
significantly reduced - tendinopathy
what is recommended to track during treatment for those with achilles tendinopathy/post-op rupture
PF strength
Endurance
what tests can be done to observe swelling in the achilles
arc sign
royal london test
special tests for MPD at ankle/foot
achilles tendon rupture
- thomas test
describe interventions for those with mid-portion achilles tendinopathy
tendon loading exercises
– load high as tolerated
(assuming there is not tendon structure frailty)
explain pain education / pt education for those with achilles tendinopathy
pain science or apothoanatomic focus
education on tendon loading strategies
what is not indicated for those with midportion achilles tendinopathy
complete rest
explain evidence supporting manual therapy and dry needling for MPD at ankle/foot
F level
explain heel lifts for MPD at foot/ankle
C level
decrease dorsiflexion during activity
what is recommended for MPD at foot/ankle
all C level (best we got, I guess)
LASER / US
multimodal interventions
Heel Lifts
explain pt education related to posterior tibialis tendinopathy
avoidance of poor or excessive footwear support – find the perfect pair of shoes
interventions related to posterior tibialis tendinopathy
pt education/activity mod
taping
therapeutic exercise
manual
therapeutic exercise would be focused on ____ for posterior tibial tendinopathy
eccentric strengthening of tibialis posterior muscle
strength training of proximal muscles
what is a mobilization that may be done for posterior tibial tendinopathy
mobility restrictions contributing to excessive pronation
– will lead to a lack of dorsiflexion
when is surgery indicated for MPD at foot/ankle
achilles tendon rupture
stage 4 posterior tibialis tendinopathy
