Lower leg rehabilitation Flashcards
What are some common lower leg injuries?
- Shin splints
- Gastrocnemius strain
- Medial tibial stress syndrome
- Superior tib/fib sprain
- Peroneal strain
- Peroneal tendon subluxation
- Compartment syndrome
What are some common methods of injury?
- Impact (ground reaction forces)
- Overstretch
- Eccentric loading
- Traumatic
What are the symptomatic phases of gait?
- Toe off
- Midstance
- Heel strike
What are some ways to protect the calcaneus from heel impact?
- Adjust the surfaces
- Cushion footwear
- Shock absorbing insoles
- Heel pads
When are the dorsiflexors under eccentric load the most?
Downhill running
When are the plantar flexors under eccentric load the most?
- Uphill running
- Forefoot running
What are some causes of shin splints?
- Interosseous membrane inflammation
- Pereosteal pain (tibia/fibula)
- Stress fractures
- Acute myositis (dorsiflexors)
- Tendinitis (dorsiflexors)
- Anterior/posterior compartment syndrome
What are some common contributing factors to lower leg injuries?
- Muscle imbalances
- Inflexibility: gastrocs/solues
- Biomechanics: foot pronation/supination, trendelenberg
What are some examples of strengthening exercises?
- Heel raises
- Straight knee: gastrocs
- Bent knee: soleus
- Heel walks: dorsiflexors
- Toe walks: gastrocs/soleus
- Downhill walks: dorsiflexors (eccentric)
What are some different joint mobilizations that can be done?
- Superior tib/fib joint: anterior/posterior, superior
- Talocrural joint: anterior/posterior, traction
- Sub talar joint: medial/lateral, traction
What is pes planus?
Pronation of the foot
What is pes cavus?
Supination of the foot
What is pes equinus?
Achilles tightness
What are some important characteristics that footwear should have?
- Rocker action
- Foot support
- Shock absorption
- Stability
What are some ways to treat achilles tendonitis?
- Control inflammation
- Control stress: heel lift
- Manage chronic fibrosis: friction massage
- Increase flexibility: wedge board
- Increase strength
- Increase tensile strength: eccentric training
- Sport specific
- Biomechanics
What is the Alfredson’s protocol of achilles tendinopathy?
- 2X/day, 7 days/week, 12 weeks
- Knee extended and flexed
- 3 sets X 15 reps of each
- Muscle soreness during the first 1-2 weeks should be expected
What are the steps of the Alfredson’s protocol?
- Body weight in injured side (in plantar flexion)
- Lower heel beneath forefoot
- Only load eccentrically
- Use non-injured leg to get back to the starting position
- Continue even if there is pain (to a certain point)
What are the parameters for the achilles drop stop program?
- 3 set X 20 resp
- Both legs, slow drops, 7 days
- Both legs, quick drops, 7 days
- Single legs, slow drops, 7 days
- Single legs, quick drops, 7 days
What are some ways to treat anterior compartment syndrome?
- Control swelling and pain: rest
- Increase dorsiflexion flexibility: kneeling plantar flexion
- Increase plantar flexion flexibility: wedge board
- Address biomechanics: pronation
- Surgery may be required: fasciotomy
What is medial tibial stress syndrome?
Periosteal pain along the medial tibia
What are some causes of medial tibial stress syndrome?
- Biomechanical: pronation
- Overuse
- Footwear
- Running surface
What are some ways to treat medial tibial stress syndrome?
- Control pain
- Control inflammation
- Decrease the stress
- Increase flexibility
- Strength
- Proprioception
- Progressive return to activity
