The Foot Flashcards
the foot is comprised of ____ bones and ____ joints
26 bones, 36 joints
heel strike is a ______ (rigid, nonrigid) lever whereas toe-off is a ______ (rigid, nonrigid) lever
heel strike -> rigid lever
toe-off -> non-rigid lever
____% of individuals suffer from foot problems
80
true or false; foot problems can lead to other problems up the kinetic chain (eg., back problems can arise from foot problems)
true
sinus tarsi is loaded with ________
proprioceptors
which of the following is true about the foot?
a) if the rear foot is unlocked, the rest of the foot is unlocked
b) if the rear foot is unlocked, the rest of the foot is locked
c) the position of the rear foot is not indicative of what the rest of the foot would be
d) none of the above
a
what structure is responsible for allowing the mobile and rigid period during walking
plantar fascia
fallen medial longitudinal arch is also known as
a) plantar fasciitis
b) Raynaud’s syndrome
c) fallen arch/flat foot
d) none of the above
C
transverse metatarsal ligament function
stops toes from splaying out
how would you best prevent foot injuries?
a) paying attention to hygiene
b) correcting biomechanical structural deficiencies through orthotics
c) appropriate footwear
d) both B and C
e) all of the above
E
achilles tendon insertion
calcaneal tuberosity
plantar fascia
Lisfranc injury etiology
dorsum of foot rolls further forward (snowboarding, football, equestrian sports)
S&S Lisfranc injury
- inability to weight bear
- localized swelling & tenderness
Pes Planus etiology
- poor biomechanics
- wearing tight shoes
- trauma
- overweight
- excess exercise pressure on arch
S&S Pes Planus
- pain
- weakness or fatigue in medial arch
- flattened appearance of arch
Management - Pes planus
- leave it alone is not causing an issue
- orthotics, arch taping if problems develop
Pes Cavus - etiology
- higher arch than normal
- associated with excessive supination
- accentuated high medial longitudinal arch
S&S pes cavus
- poor shock absorption, resulting in metatarsalgia
- foot pain
- clawed or hammer toes
- associated with tight achilles and plantar fascia
- heavy callus development on ball and heel of foot
pes cavus - management
- leave it alone if not causing an issue
- orthotics (?)
- stretch achilles and plantar fascia
plantar fasciitis - etiology
- tight heel cord
- cavus foot or hyperpronation
- changes in footwear or training surfaces
- excessive training
S&S plantar fasciitis
- point tenderness medial heel/ medial arch
- pain with forceable dorsiflexion
- first step pain
management of plantar fasciitis
- orthoses/heel cup
- arch taping/night splint
- massage and vigorous stretching
metatarsal stress fractures - etiology
- common in running and jumping sports
- most frequent in 2nd MT “March fracture”
- associated w/ increase in training, change in training surfaces
- inappropriate footwear
- flat feet & bunions
S&S MT stress fractures
- over 2-3 weeks of dull ache during exercise
- progressing from diffuse to localized pain at rest
MT stress fracture - management
- limit WB activity & cross train with NWB activities
- determine source of injury
- gradual RTA
bunion (hallux valgus deformity) - etiology
- lateral deviation of hallux and exostosis of 1st MT head
- great toe shifts towards 2nd toe
- associated with increase pronation, footwear, genetics
- bunionette (Tailor’s bunion) impacts 5th metatarsophalangeal joint - causes angulation towards 4th tow
bunion S&S
- tenderness, swelling, and enlargement of joint initially, resulting in angulation
- walking becomes painful
bunion management
- wear correct fitting shoes
- appropriate orthotics
- pad over 1st MT head
- tape splint between 1st and 2nd toe
- engage in foot ex for flexor and extensor mm
- bunionectomy may be necessary q
sesamoiditis - etiology
- caused by repetitive hyperextension of the great toe or landing on 1st MTP
- common in dancing and b ball
S&S sesamoiditis
- pain and tenderness under great toe
especially during push off
management of sesamoiditis
- treat with orthotics devices (MT pads, arch supports)
- decrease activity to allow inflammation to subside
Metatarsalgia - etiology
- pain in ball of foot
- tight gastroc-soleus complex or fallen arches; increase callus formation
S&S metatarsalgia
- transverse arch flattened
- pain w/ WB activities
- cavus foot may also cause problems
metatarsalgia - management
- MT pad
- stretching heel cord and strengthening intrinsic foot mm
Morton’s neuroma - etiology
- interdigital nerve irritation d/t tumor or nerve entrapment
- caused by excessive pronation; weak feet
S&S - morton’s neuroma
- burning parasthesia and severe intermittent pain in forefoot
- notably between 3rd and 4th MT heads
- pain relieved with non-wbing
- toe hyperextension increases symptoms
management - morton’s neuroma
- must rule out stress fracture
- MT padding
- shoes with wider toe box
- surgical excision may be required
sprained toe - etiology
- generally caused by kicking non-yielding object
- hyperrextension of 1st MTP = turf toe
S&S Sprained toe
- pain & immediate swelling
- discoloration occuring within 1-2 days
- stubbed toe stiffness and residual pain will last several weeks
management - sprained toe
- POLICE
- buddy taping
- turf toe taping
- begin wbing as tolerable
etiology - subungual hematoma
- direct pressure, dropping an object on toe
- kicking another object
- repetitive shear force on toenail
- improperly fit shoes, running downhill
S&S subungual hematoma
- accumulation of blood underneath toenail, extreme pain, loss of nail
subungual hematoma - management
- RICE immediately to reduce pain and swelling
- relieve pressure within 12-24 hours (lance or drill nail) - must be sterile to prevent infection
etiology - ingrown toenail
- generally occurs in great toe
- results in lateral pressure from shoes
- poor nail trimming and repeated trauma
S&S ingrown toenail
- pain
- swelling & redness around irritated section
management of ingrown toenail
- conservative management includes soaking inflamed toe in warm water (20 min)
- place cotton under edge of nail to clear from skin
- if chronic, remove wedge of nail and apply antiseptic compress until inflammation resides
- physician may take more aggressive approach
ingrown toenail prevention
- properly fitting shoes and socks are essential
- weekly toenail trimming (cut straight across)
- leave nail long enough to clear skin
tinea pedis - etiology
- most common form of superficial fungal infection
- highly contagious
S&S tinea pedis
- extreme itching or soles of feet, between and on top of toes
- appears as dry scaling patch or inflammatory scaling red papules forming larger plaques
- may develop secondary infection from itching and bacteria
tinea pedis - management
- topic antifungal agents and good foot hygiene
blister - etiology
- result of a shearing force that produces a raised area that accumulates with fluid
blister S&S
- hot spot, sharp burning sensation, painful
- superficial area of skin raised with clear fluid
blister prevention
- use of dust or powder or lubricant to reduce friction
- 2 pairs of socks if feet are sensitive or perspire excessively
- appropriate shoes that are broken in
- pad hot spots
- lubricants
- management - see wound care lab
