Module 3: Ankle and Foot Flashcards
dorsiflexion of talus spreads
malleloi
more plantarflexion causes
more instability
what supports the tibia
superior aspect of the talus
3 ligaments of the foot that creates lateral collateral ligament
- ) Anterior Talofibular Ligament
- ) Calcaneofibular
- ) Posterior Talofibular
most injured tendon due to plantar flexion and inverson sprain
anterior talofibular
second most commonly injured ligament
calcaneofibular
talus typically subluxates
anterior with ankle sprain
why is there limited dorsfilexion
jamming of condyle against anterior tibial ridge
80% of ankle sprains are
inversion
what muscles are attached to the talus
none
DDX of subluxated talus
short achilles/tight calf
congenital anomaly
anterior tibial bone spur
patency of dorsal pedal artery
signs indicating an adjustment of the talus
limited dorsiflexion
shallow anterior talar fossa to palpation
what does a plantarflexion inversion sprain/strain create
antero-medial talus
what side is the doctor on for anterior medial talus
opposite side of involvement
anterolateral talus doctor position
on same side of involvement
aka’s for ankle joint
talocrural
ankle
tibiotalar
mortise
what adjustment works well with shin splints
talocrural AP
tarsal tunnel syndrome presentation
burning, sharp pain, or paresthesia in sole of foot
intermittent complaints with standing, walking, running
positive tinel sign
what can cause tarsal tunnel syndrome
repetitive hyperflexion/hyperextension
post traumatic fibrosis from sprain
ganglion
abnormal biomechanics and/or tightening of the flexor retinaculum or arch of abductor hallucis
how many bones in teh foot
26
what is the talus responsible for
medial foot motion during pronation and supination
talus is keystone of
medial longitudinal arch
what is the keystone fo transverse arch
2nd cuneiform
keystone to lateral longitudinal arch
cuboid
what makes up the rear foot
talus and calcaneous
what makes up the midfoot
metatarsals and phalanges
when is the interosseous talocrural ligament tight
during inversion
subtalar axis is
45 degrees to the floor in neutral position
closed chain motion of subtalar joint on pronation
calcaneous everts, talus adducts and plantarflexes, leg internall rotates and shortens
closed chain of subtalar motion on supination
calcaneous inverts, talus dorsiflex and abducts, leg externally rotates, knee extends
when the ankle is neutral, what is the position of calcaneous and sustenaculum tali?
vertical calcaneous
horizontal sustenaculum tali
signs that indicate the adjustment of talocalcaneal joint
fixation upon motion
hypermobility
pain @ calcaneotibial/spring ligament
pain @ calcaneofibular/calcaneocuboid ligament
if problem with inversion/eversion
adjust calceneous
if problem with ab/adduction
adjust cuboid
MOI for medial calcaneous
weak heel counters
chronic repetitive trauma of running/jumping
severe ankle sprains
MOI for lateral calcaneous adjustments
hyperpronation
eversion ankle sprains
inversion/eversion is what kind of stroke to the heel?
J strokeq
what kind of stroke is for abduction/adduction?
shallow U stroke
what would an xray indicate for anterior navicular, cuneiforms, or met bases
raise of 2mm+ from the anterior talus head
most common mechanism of anterior navicular, cuneiforms, or met bases
stepping on something, kicking a hard object, or poor supporting shoes
most common midfoot subluxation
posterior tarsals
what can you NOT do when adjusting posterior tarsals?
plantarflex
anterior (superior) cuboid needs what kind of thrust
z axis
thickest and shortest metatarsal
first metatarsal
what metatarsal bears weights readily
2nd metatarsal due to length
function of metatarsals
locking tarsals in full pronation, assist supination as fulcrum for plantar fascia
normal range of motion for dorsiflexion for FHL
70-90
normal ROM for FHL under load
35 degrees or 1/3
less than 35 degrees of FHL dorsiflexion causes
block of normal windlass effect and supination
4 stages of hallux limitus/rigidus
- ) functional
- ) early joint adaptation
- ) established arthrosis
- ) ankylosis
causes of hallux limitus/rigidus
biomechanical, post-traumatic, structural, iatrogenic, other
when can we work with hallux limitus
stage 1 and 2
surgical procedure performed to remove bone spurs from base of big toe
cheilectomy
normal glide with metatarsals and phallanges
5mm superior and inferior
when are orthotics prescribed
when foot is not within range of motion, even with correction of foot subluxations
dorsiflexor tendons go to
anterior to malleoli
plantarflexion tendons go
behind malleoli
what muscle controls plantarflexion and inversion
L5, posterior tibialis
peroneous brevis and longus affects
S1, plantarflexion and eversion
dorsiflexion and eversion controlled by
peroneus tertius/extensor digitorum longus
2 main reasons for casting and ordering orthotics after adjusting the feet
- ) Angles of varus/valgus often change
2. ) better assessment, the better chance of acceptance and excellent results for patient
