Foot, Ankle and Lower Leg

AT 243-Acute Care LabKrzyzanowicz-Spring ‘10

3 major lateral ligaments◦ Anterior Talofibular ligament (ATF)

Most commonly sprained ligament◦ Calcaneofibular Ligament (CF)◦ Posterior Talofibular ligament (PTF)

1 major medial ligament◦ Deltoid ligament

High ankle sprain (syndesmosis)◦ Distal Tibiofibular ligament

Anatomy

Lateral Ankle Ligaments

Medial Ankle Ligament

Foot Anatomy

Closed basketweave taping◦ Start with shaving their legs (do we really do

this?)◦ Pre-wrap

Start at the mid-calf and work your way down Overlapping by half

◦ Anchor strips Apply 3 anchor strips

Mid-calf Overlapping by half

Apply 1 anchor strip at the mid-foot

Ankle Sprains

Closed basketweave taping◦ Apply 3 stirrups

With an anchor strip after each stirrup Medial to lateral (know the mechanism of injury)

◦ Apply 2 heel-locks (on each side)◦ Apply 1 figure eight (on each side)◦ Close tape job

Ankle Taping

More cost effective way to prevent ankle sprains◦ Cost of an ankle brace vs. taping supplies

$15-20 for a brace (one time cost) vs. $45 for a box of tape

Hundreds of different braces◦ All have same principle

Prevent excessive movement of the ankle

Ankle Braces

Ankle Braces

Same as closed basketweave, but its open in the middle◦ Helps with “pushing” swelling◦ Not used very often◦ Close off with an ace wrap

Open basketweave

Spray/Heel-lace pad◦ Pre-wrap from calf to mid-foot◦ Places two anchor strips over the calf; one over

mid-foot◦ Measures two strips of elastic tape from calf to

mid-foot Splits both pieces down the middle (only about 1’) Places strip on mid-foot-places an anchor strip

Pulls up to calf and places anchor strip Repeats again Closes tape job

Achilles’ Tendon Taping

Achilles’ Tendon Taping

Places anchor at the head of the metatarsals

Beginning at the 1st metatarsal◦ Place strip of tape (1’ tape) and pull around

outside of foot; once at the medial aspect of the calcaneous pull diagonally ending at the metatarsal head

◦ Repeat for toes 2-5◦ Place tape strips (1.5’ tape) on the mid-foot,

starting at the metatarsal heads, pulling lateral to medial- repeat about 3-4 times

◦ Close tape job

Arch Taping

Arch Taping

Arch Taping

Many different supports◦ Dr. Scholls supports-over the counter

Custom orthotics◦ Mold of your foot◦ Custom supports◦ Helps in shin splints, stress fractures

Arch Support

Places a 1’ anchor around the great toe; and a 1.5’ anchor around the mid-foot

Creates two fans of 3-6 pieces of tape◦ Places one fan on the great toe, anchors it down

and then pulls to the mid-foot-anchors it down◦ Places second fan on the great toe, anchors it

down and then pulls to the mid-foot and anchors it down

◦ Makes a figure eight around the great toe (1-2x) Closes tape job

Turf Toe Taping

Turf Toe Taping

These are meant to help change the angle of pull of the patellar tendon

More biomechanically efficient

Helps in persons with “jumpers knee” aka patellar tendonitis

Patellar Tendon Straps

Patellar Tendon Straps

Have athlete stand and flex their knee about 20 degrees◦ Apply two anchor strips inferior to patellar tendon◦ Apply two anchor strips superior to ankle◦ Apply tape in an oblique direction, pulling medial

to lateral the entire way up the leg Overlapping by half

◦ Repeat, pulling lateral to medial◦ Apply a closing strip inferior to patellar tendon

and superior to ankle◦ Close tape job

Shin Splint Taping

Shin Splint Taping

Many different sizes◦ 3 inch◦ 4 inch◦ 6 inch◦ 6 inch double

Used to help push out swelling

Must always check pulse and capillary bed refill!

For the ankle◦ Use a 6’ single wrap◦ Starts distal to

proximal (at the toes)

◦ Medial to lateral◦ Pulls enough force to

push out the swelling

◦ Overlaps in a weaving manner

◦ Check pulse

Ace wraps

Ace Wraps

These are used to help push out swelling as well◦ Used in conjunction

with an ace wrap Very easy to make

◦ Make a horseshoe design out of felt

Horseshoes