Lecture 3 - Conditions of the Foot Flashcards
We gather a lot of information stress testing»>
Athlete’s ability to move
- Range of motion (ROM)
- Athlete’s pain
- Athlete’s strength
- Instability
- Pt. tenderness/crepitus
- Functional capabilities
Function testing is done in 3 ways:
Active -Passive ROM’s -Resisted ACTIVE always comes first! Then PROM or RROM? Depends on the structure..
Active functional testing:
Active testing is done by the athlete.
- Observe quality and quantity of movement attained.
- Note the most painful ranges and do them last
Passive functional testing
Passive testing is done by the care-giver.
-Passive testing is intended to test the inert (non-contractile)
tissues of the patient.
-This is best done with the athlete relaxed, and supported.
-Note pain-free ROM, guarding, laxity, etc..
Passive functional testing end feels:
-End feel is the sensation examiner gets when joints reaches
its end ROM
Passive functional testing end feels:
Normal: _______
Abnormal: ______
– bone on bone, soft tissue approximation, tissue
stretch
–Muscle spasm, capsular, bone on bone, empty,
springy block.
Resisted functional testing
Resisted testing involves both the examiner and the athlete.
- Involves an isometric muscle contraction w/ joint neutral.
- Strength is then evaluated on a scale of 1-5
Active ROM will gather
basic info about athlete’s abilities
Passive ROM stresses inert
(non contractile) tissues.
Resisted ROM stresses
active (contractile) tissues.
When force is applied to tissues, the amount of deformation will
depend on the tissue’s material properties.
-Greater _____, the less likely deformation will be seen
-Greater_____, the more likely deformation will be seen
(and may return to original shape)
stiffness
elasticity
The load deformation curve shows
stiffness, peak load at
failure, and energy absorbed by tissue
Many factors affect the tissue ability to absorb force
- Direction of Force: _______
- Stress: _____________
Tension, Compression, Shear, Torsion
Force divided by the surface area it is applied through.
Ligament Sprains: 1st Degree
- Microscopic stretching of fibers, few torn,
- Some pain and point tenderness
- No loss of structural stability
- No loss of function
- *Tape and return in 2-3 days**
Ligament Sprains: 2nd Degree
- Significant tearing of fibers.
- Significant pain, especially with stretching.
- Significant structural weakening or instability.
- Moderate swelling with slow onset discolouration.
- Loss of function (PWB, NWB)
- *Support on return, 2-6 weeks**
Ligament Sprains: 3rd Degree
- Complete tearing of fibers.
- May present with severe, or no pain at all.
- Loss of structural stability, empty end feel.
- Severe swelling, discolouration.
- Full loss of function.
Surgical intervention, bracing, 3months-1year
Contusions disrupt muscle tissue, and this causes bleeding within
the muscle called a
hematoma
Hematoma’s must be treated to avoid ______
further complications.
Myositis Ossificans
Ossification of tissues within the muscle belly.
-Can result in a palpable lump.
-Primarily caused by untreated contusions, and repeated injury
before a previous contusion is healed.
-May also be cause by too aggressive treatment inflamm..
Pes Planus/Cavus is - - - -
- Flat footed or high arches.
- Congenital and also affected by muscles and ligaments
- Affected by and affects the knee!
- Treated with appropriate footwear, foot exercises
Plantar Fasciitis
(__% of population affected)
-Intrinsic factors:
-Extrinsic factors:
i: High arch, no arch, rigid foot, decrease strength.
e: Footwear, training habits, training surfaces.
Plantar Fasciitis
-S/S:
Point tender/medial side of calc.
- Localized pain.
- Stiff in the AM or w/ no activity.
- Unable to walk on toes.
- Pain ↑ with toe extension.
Treatment
PIER -Stretch achilles -Adjust training and footwear -Tape, or orthotics. -Address weaknesses. -Soft tissue work in AM (tennis ball or massage
Turf Toe is..
Sprain of the 1st MTP joint capsule/plantar plate.
-Caused by hyper-extension of 1st toe.
Turf Toe
-S/S:
- Swelling in 1st toe
- Pain with running, ext of toe
- May have ↓ function in flexion
turf toe treatment:
PEIR -Out 1-3 weeks (sometimes more) -Full healing can take 3-6 months) -Tape
Bursitis treatment
- Rest, Ice (NO pressure)
- Adjust footwear
- Donut pad may be applicable
Bursitis is caused by ____
retro calcaneal pressure, or excessive inversion/eversion.
what kind of people are prone to bursitis?
High arch people are more prone
What causes hammer toe?
May be congenital or due to wearing shoes that are too small.
Hammer toe
is ____ of the ____ joint , ____ of PIP, and ____/neutral DIP
Extension
MTP
Flexion
Extension
How do you fix hammer toe
Must adjust footwear or sometimes surgical intervention
Claw toe is ____ of the ____ joint. ____ of PIP and ____ of DIP
hyper extension
MTP
flexion
flexion
what is claw toe caused by ?
caused by shoes or tendon contractures
What us Hallux Valgus??
-Pressure on medial aspect of 1st MTP joint can cause thickening of
capsule and bursa (bunion) that forces toe laterally.
What causes a talus fracture ?
Caused by a severe twist or impact with another object
What is the cause of a calcaneus fracture??
caused by a fall of jump from a height
How to treat a foot fracture ?
PIER & Immobilize
-Refer for immediate follow up.
-Cast/immobilize for 6-8 weeks.
-Tape where appropriate when returning to sport.
-Encourage appropriate rehab when possible to minimize disuse
2ndary complications.
What causes a jones fracture??
Plantar flexion w/ forceful inversion.
