The lower leg Flashcards
what can happen to the peroneus muscle with an inversion ankle sprain
it can cause subluxation (temporary slip out of its groove)
functions of the lower leg flexors & extensors
flexors: plantar flexion of the ankle
extensors: dorsiflexion of the ankle
lower leg flexor muscles
gastrocnemeus & soleus
lower leg extensor muscles
tibialis anterior
which movements does anterior compartment the collectively perform
-dorsiflexion of ankle
-extension of toes/big toe
-inversion of ankle
which movements does lateral compartment the collectively perform
-ankle eversion
which movements does superficial posterior compartment the collectively perform
-plantar flexion of ankle
which movements does deep posterior compartment the collectively perform
-plantar flexion of the ankle
-flexion of toes/big toes
-inversion of ankle
achielles strain- 1st & 2nd degree (age and MOI) 3rd degree (age and MOI)
1st & 2nd:
age- any age
MOI- excessive dorsiflexion, sudden stop & go, forceful plantar flexion w/ knee moving into full extension
3rd:
age- 30/50 years (tendon structure changes as we age)
MOI- history of chronic inflammation
which 2 main muscles make up the achilles tendon
gastrocnemius & soleus
S/S with achilles strain (8)
-point tenderness localized to the site of injury
-include a pop noise
-visible defect
-inability to stand on toes or balance on affected side
-positive thompson test
-amount of pain, swelling & discolouration will follow general classification system for strains
-full ruptures happen 2-6cm proximal to calcaneal insertion
management of achilles strain (4)
-RICE + pressure
-conservative management (achilles issues can become chronic)
-heel lift used to keep from over stretching
-strength & stretching begins as soon as possible
management for achilles ruptures (3)
- surgical repair & return of 75-80% function
OR - non surgical repair: RICE/NSAID’s, non weight bearing cast 6 weeks, then walking cast 2 weeks (return of 75-90% function)
-Rehab 6 months: ROM, PRE & wearing 2cm heel lift in both shoes
do muscle strains have an MOI?
no
S/S 1st degree muscle strain
-little tears to muscle
-mild weakness, swelling pain & loss of function
-pain on stretching
-decreased ROM
-no palpable defect
S/S 2nd degree muscle strain
-moderate tears to muscle
-moderate to severe weakness, swelling, pain (contraction) & loss of function
-pain on stretching
-ROM: decreased from swelling
-no palpable defect
S/S 3rd degree muscle strain
-rupture of muscle
-moderate/severe weakness & swelling
-none to mild pain on contraction/stretching
-ROM: may increase or decrease depending on swelling
-severe loss of function
-palpable defect (early)
Achilles tendonitis: etiology
-tendon overloaded from extensive stress
-gradual & onset, worsens with continued use
-decreased flexibility exacerbates condition
achilles tendonitis: S/S
- generalized pain & stiffness, localized to proximal of calcaneal
- warm and painful with palpation
-limited strength in gastroc/soleus
-may progress to morning stiffness
-crepitus with active plantar flexion and passive dorsiflexion
-chronic inflammation may lead to thickening of tendon
achilles tendonitis: management
-use anti inflammatory modalities/medications
-strengthening must progress slowly to avoid aggravating the tendon
-reduce stress on tendon (orthoditcs/flexibility)
predisposing factors for tendonitis in lower leg (5)
-training errors
-direct trauma
-infection of penetrating wound into tendon
-abnormal foot mechanics
-poor/not properly fitted footwear
Shin contusion: etiology, S/S, management
etiology:
-direct blow
-common in areas not covered my muscle
S/S:
- intense pain, rapidly forming hematoma w/ jelly consistency
Management:
-RICE
-compression
-fit with donut pad & pro wrap for protection
-can develop into osetomyelitis (deterioation of bone)
Muscle contusion: etiology, S/S, management
etiology:
- contusion of leg in gastroc area
S/S:
- bruise, pain, weakness, partial loss of limb function
-palpation will reveal hard, rigid & inflexible area
-internal hemorrhaging & muscle gaurding
management:
- gentle stretch to prevent spasm, ice & compression
-pressure (donut) pad to reduce re-injury and protect
gastroc strain: etiology & MOI
-common in medial head at muscular tendon junction
-related to muscle cramping
MOI:
-forced dorsiflexion with knee extension
-forced knee extension with foot dorsiflexed
Gastroc strain: S/S & management
S/S:
- depending on grade…swelling, pain, muscle disability
-painful tearing sensation (hit with a stick)
- edema, point tenderness & functional loos of strength
management:
- RICE
-grade 1= gentle stretch after cooling
-weiht bearing as tolerated, can use heel wedge
-gradual rehab program
Acute leg fracture: etiology (fibula & tibial fractures)
fibula:
-inversion or eversion ankle sprain
-happens in middle third
-damage to interosseus membrane
Tibial:
- occurs in lower third
-direct blow or trauma
leg fracture: S/S & management
S/S:
-intense pain with and without movement
-immediate swelling
-leg appears hard and swollen
-crack is heard
-deformity may be present
management:
- x-ray, reduction, 6-8week cast
-surgery
-walking boot till healed
Medial tibial stress syndrome: etiology
-inflammation of periosteum (outer part of bone) along distal third of tibia
- caused by repetitive microtrauma
-weak muscles (hamstrings/glutes), improper footwear, training errors, varus foot, hypermobile/pronated feet/fore foot supination
medial tibial stress syndrome: S/S
- pain after activity
-pain before and after activity, not affecting performance
-pain before, during & after affecting performance
-pain so severe, performance is impossible
medial tibial stress syndrome: management
- 5/7 days of rest + ICE (no load bearing or running)
-x-ray/bone scan to determine if fracture is present
-evaluate feet for malalignment - flexibility program for gastroc soleus complex
-evaluate to determine if arch taping or orthodics are neccessary
