LOWER LEG, FOOT & ANKLE

ANATOMY, RECOGNITION, TREATMENT, THERAPY

TIM AMSHOFF LATMOORE TRADITIONAL SCHOOL

ANKLE JOINT

• 3 main bones• Lower leg: tibia & fibula• Foot: Talus

ANKLE MOVEMENTS (ROM)

• Inversion• Eversion• Plantar flexion (gas pedal)• Dorsiflexion (toes up)

ANKLE STABILITY (LIGAMENTS)

• ATF (anterior talo-fibular)• PTF (posterior talo-fibular)• Calcaneofibular• Deltoid ligament (medial aspect)• Tib-fib (anterior and posterior)

LOWER LEG

• Fibula (lateral malleolus) • Tibia (medial malleolus)

• Gastrocnemius• Soleus

ANTERIOR MUSCLES

• Anterior compartment:• Anterior tibialis• Extensor Muscles• Peroneus Muscles

COMPARTMENT SYNDROME SHIN SPLINTS

Do you see

ecchymosis?

OTHER ANATOMY

• Fascia (foot)• Arches

MEASURING ARCHES

HOW DO ARCHES FALL?

• Managing/treating painful arches

• Is it plantar fasciitis?

• orthotics

• Is it a strained (fallen) arch?

• Replace insoles; support arches?

• Taping of the arches

CALF PAIN

Ruptured Achilles/gastrocnemius

• Thompsons test

• Age of patients typically

CAN YOU SEE THE 2 MUSCLES AND THE TENDON?

Gastroc.

soleus

Achilles tendon

CALF PAIN CONTINUED

• How do I stretch out a calf that is cramping?

• During game/practice

• Middle of night

• Is it dehydration really?

• Do bananas really help?

• Can you tape the calf?

• Yes, but support is for achilles

OTHER WAYS TO STRETCH IT…Push against resistance

HOPS

• Always rule out a fracture and set a standard on Active ROM before asking participant to move

ANKLE SPRAINS

• 3 types or degrees

• 1st degree:

• Mild; slight tear in fibers of ligaments & capsule; some minor swelling and ecchymosis

• 3

ANKLE SPRAINS CONTINUED

• 2nd degree

• Swelling is definite, ecchymosis, pain is uncomfortable (but not sharp), pain could be over several areas; will need help to ambulate

3RD DEGREE ANKLE SPRAINS

• Swelling is noticeable, ecchymosis, not able to apply weight, usually when landing on another person’s foot; improper foot wear; severe force applied

• Rehab. Is necessary at extensive level; surgery may occur

• Definite tear or rupture of ligaments in ankle

WHAT CAN IT LOOK LIKE?

High ankle sprain

ANKLE SPRAIN TREATMENT (TX.)

• Varies

• Whirlpool is great use; ice bags

• Follow RICE for 24-48 hours before changing plan

• May need physician referral

• May need crutches or WC

• Dependent upon outcome of FX. Tests

• Do not allow to sleep in ACE bandages

OTHER CONDITIONS

• Stress fractures

• Cast shoe or walking boot

• Stop activity

• Morton’s Neuroma

• Padding at

• Ball of foot

MORE…

• Turf toe

• Sprained toe

• Plantar fasciitis

• Tear occurs

• Muscle/tendon herniates

• Most pain: 1st step in morning

MORE…

• Ingrown toenails

• Tinea Pedis

• Athlete’s Foot (viral; socks color, dry; shower?)

• Blisters

• Hot spots, improper footwear?

• Wet shoes, socks• Do not pop and drain

• Allow to dry out, cover up

•Ankle taping