Lower Leg Flashcards
What are the muscles responsible for dorsiflexion?
anterior tibialis, extensor digitorum longus, extensor hallucis longus, peroneus tertius
What are the muscles used for plantar flexion?
gastrocnemius, soleus, peroneus longus/brevis, flexor digitorum longus, flexor hallucis longus, plantaris
What muscles are used for inversion?
tibialis anterior/posterior, extensor hallucis longus, extensor digitorum longus, flexor hallucis longus
what muscles are used for eversion?
peroneus longus, peroneus brevis, peroneus tertius, extensor digitorum longus.
What muscles make up the anterior compartment of the lower leg?
tibialis anterior, peroneus tertius, extensor digitorum longus, extensor hallicus
What muscles makes up the lateral compartment of the lower leg?
peroneus longus and brevis.
What muscles make up the superficial posterior compartment of the lower leg?
gastrocnemius, soleus, plantaris
What muscles make up the deep posterior lower leg compartment?
flexor digitorum longus, flexor hallucis longus, tibialis posterior.
What is the largest and strongest tendon in the body?
achilles
how much force can the achilles withstand?
~1000lbs
what is the etiology of an acute achilles strain?
common in sports, occurs alongside sprains or excessive dorsiflexion.
pain may be mild to severe.
severe injury is caused by partial/complete avulsion or rupture.
Management of Achilles strain?
RICE
after hemorrhaging subsides elastic wrap should be applied
conservative treatment, achilles issues may become chronic
heel lift, stretching/strengthening asap.
What is achilles tendinitis?
inflammatory condition involving tendon, sheath or paratenon.
- referred to as tenosynovitis
- causes fibrosis/scar tissue that restricts motion in sheath
- can lead to tendinosis
What is achilles tendinosis?
does not present inflammation, area loses normal appearance, cell disorganization, scarring and degeneration present.
Signs and symptoms of achilles tendinitis?
generalized pain, stiffness, localized proximal to calcaneal insertion.
warm and painful with palpation, thickening of tendon
limited strength
crepitus with plantar flexion/dorsiflexion.
Management for achilles tendinitis/tendinosis:
slow healing
reduce stress on tendon, address structural faults
use anti-inflammatory modalities/medications
cross friction massage
slow progressive strengthening.
Etiology of an achilles tendon rupture:
sudden stop and go; forceful plantar flexion w knee moving into full extension.
generally history of chronic inflammation
signs and symptoms of achilles rupture:
sudden snap with immediate pain that subsides
point tenderness, swelling, discoloration, decreased ROM
obvious indentation
occurs 2-6cm proximal to calcaneal insertion.
What is the special test for achilles rupture?
thompson test
What is management for achilles rupture?
surgical repair for serious injuries; return to 75-80% function
non-operative consists of RICE, NSAIDs, analgesics, non weight bearing cast for 6 weeks, walking cast 2 weeks (75-90% normal function)
rehab -6 months ROM, Progressive Resistive Exercise (PRE), wearing 2cm heel lift in both shoes.
What is the etiology, signs and symptoms and management of the gastrocnemius strain?
strain occurs near musculotendinous attachment caused by quick start/stop, jumping.
depending on grade: variable swelling, pain, muscle disability
may feel like being “hit with a stick”
edema, point tenderness and functional loss of strength
RICE, NSAIDs, analgesics. grade 1- gentle stretching, weight bearing as tolerated.
where are acute leg fractures common?
fibula in primarily middle third
tibia primarily lower third.
What is Medial tibial stress syndrome?
MTSS- also known as shin splints
What is the etiology of MTSS?
pain in anterior shin
catch all for stress fracture, muscle strain, chronic anterior compartment syndrome.
10-15% all running injuries, 60% all leg pain in athletes.
Repetitive microtrauma
can be from weak muscles, improper footwear, training errors, varus foot, tight heel cord, hypermobile/pronated feet, forefoot supination.
What are 4 grades of pain for MTSS?
- pain after activity
- pain before activity/after not affecting performance
- pain before, during, after, affecting performance
- pain so severe performance is impossible.
Management for MTSS?
x-ray/ bone scan activity modification correction of abnormal biomechanics ice massage flexibility program for gastroc-soleus complex arch taping/orthotics.
What bony landmarks do you palpate during a lower leg assessment?
tibia, fibula, medial and lateral malleolus
What muscles and tendons do you palpate during lower leg assessment?
gastrocnemius, achilles tendon, peroneals, tibialis anterior.
