The Foot Chapter 17. Foot Anatomy 26 Bones 7 Tarsal 5 Metatarsal 14 Phalanges 38 Joints 4 Arches.
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Transcript of The Foot Chapter 17. Foot Anatomy 26 Bones 7 Tarsal 5 Metatarsal 14 Phalanges 38 Joints 4 Arches.
The FootChapter 17
Foot Anatomy 26 Bones
7 Tarsal 5 Metatarsal 14 Phalanges
38 Joints 4 Arches
Bones of the Foot
Bones of the Foot
Bones of the Foot
Tarsal Bones
Talus Calcaneus Navicular Cuboid Cuniforms
Medial Intermediate Lateral
Metatarsals & Phalanges
Sesamoid Bones 2 (medial and lateral) Under great toe Functionpulley, increase leverage of
tendons that control great toe
Joints of the Foot
Tibiotalar Talocrural Subtalar Talonavicular Calcaneocubiod Metarsocunieform
Joints of the Foot
Metatarsophalangeal Joint
Proximal Interphalangeal Joint
Distal Interphalangeal Joint
Regions of Foot
Forefoot Metatarsals Phalanges
Midfoot Navicular Cuboid 3 Cuniforms
Hindfoot Calcaneus Talus
Regions of the Foot
• Thick white band of fibrous tissue originating from the medial tuberosity of the calcaneus and ending at the proximal heads of the metatarsals
• Work with ligaments to support arches during weigh bearing and downward forces
Plantar Fascia
Foot Arches
Functions1. Support body weigh in an economical fashion2. Absorb the shock of weight bearing3. Provide a space on the plantar aspect of foot for
blood vessels, nerves, and muscles
Medial Longitudinal Arch
• Highest of 3 arches of foot
• Calcaneus, Talus, Navicular, Cuniforms & 1st three metatarsals
• Supports—– Ligaments:
• Spring ligament
• Plantar fascia
– Tendons:• Tibialis posterior
• Tibialis anterior
Lateral Longitudinal Arch
• Lower and flatter• Calcaneus, Talus,
Cuboid, 4th & 5th metatarsals
• Supports—– Ligaments:
• Short plantar ligament• Plantar fascia
– Tendons:• Peroneus longus
Transverse Arch
• Cuniforms, Cuboid, & 5th metatarsal
Shoe Wear Patterns
• Excessive Pronation– Wear out front of shoe
under 2nd metatarsal
• Excessive Supination– Wear out lateral border of
shoe
• Common Misconception– Wearing out the back
lateral corner of the shoe means you pronate
– This is normal wear pattern
Gait
Pulse
• Posterior Tibial Artery• Medial Malleolous• Dorsalis Pedis artery• Extensor Tendon
Great Toe
Foot Movements
Dorsiflexion Plantar Flexion Pronation
Inversion Eversion Supination
Muscles of FootIntrinsic Muscles• Relate to specific body
part or bone
• Flexor hallucis longus• Flexor hallucis brevis• Flexor digitorum longus• Extensor digitorum longus• Abductor hallucis• Abductor digiti minimi• Tibialis posterior
Extrinsic Muscles
• Muscle outside a body part, organ, or bone
• Gastrocnemius
Muscles of the Foot
Muscles of the Foot
Muscles of the Foot
Common Injuries
of the Foot
Fractures & Stress Fractures
• Impair ability to perform competitively
• NWB
• More swelling & pain than ligament sprain
• Point tenderness present
• Obvious deformity often present
• Usually occur acutely; result of traumatic episode
Jones Fracture
• Fracture to the diaphysis at the base of the 5th metatarsal
• Repetitive stress, direct force, or inversion and PF of foot
• Healing slow; high nonunion rate
Retrocalcaneal Bursitis
• Swelling of the bursa at the back of the calcaneus under the Achilles tendon
• S/sxs: – Pain in heel– Painful to touch– Pain worse when
rising on toes– Red, warm skin over
back of heel
Plantar Fascia
• Wide, non-elastic ligamentous tissue that extends from the anterior portion of calcaneus to heads of metatarsals
• Supplies support to longitudinal arch
Plantar Fasciitis
• Strain/irritation of the plantar fascia
• Caused by:– Overuse– Unsupportive footwear– Tight Achilles tendon– Running on hard
surfaces– Chronic irritation
• Pain, tenderness on bottom of foot near heal (especially in am)
• Untreated will lead to:– Bone imbalance– Heel spurs– Muscle strains– Shin splints
• Correct training errors• Ice• Massage• Evaluate shoes &
activity level• Arch support• Heel cup or cushion
Plantar Fasciitis—Treatment
Arches
Pes Planus
• Flat foot• Associated with excessive
pronation• Multiple causes:
– Lack of shoe support– Weak muscles
• Pain & weakness in medial longitudinal arch• Calcaneal eversion• Navicular bulging• Flattening of arch
Pes Cavus
• aka Clawfoot, hollow foot
• Associated with excessive supination
• Shock absorption poor
• General foot pain and metatarsalgia common
• Abnormally short Achilles tendon
• Calluses ball and heel
Arch Sprains
• Ligaments stretch, thus fail to hold bones of foot in position
• When arch weakened, it cannot absorb shock normally
• Causes:– Overuse– Overweight– Fatigue– Training on hard
surfaces– Non-supportive shoes– Shoes in poor
condition
Turf Toe
• Great toe strain
• Hyperextension of the first MTP joint of the big toe
• Treatment:– RICE & Support– Limit movement– Turf toe taping
Heel Spur
• Bony growth on calcaneus
• Causes painful inflammation
• Aggravated by exercise
• As foot flattens, plantar fascia is stretched & pulled where it attaches to calcaneus
calcaneus reacts by
forming spur of bony material
Heel Contusion
• Irritation of the lateral aspect of the heel
• Sudden stop-and-go or sudden change in movement
Heel Contusion—Treatment
• Cold application before activity
• Ice & elevation after activity
• Absorb shock—– Heel cups– Donut pad
Sever’s Disease
• Traction injury at the apophysis of the calcaneus where the Achilles tendon attaches
• Young, physically active athletes– Comparable to Osgood-Shlatter’s disease (at
tibial tubercle of knee)
• Pain occurs during vigorous activity and does not continue during rest
Blisters
• Occur on any part of body where there is friction
• Most common on feet or heels
• Treatment Goals: – Relieve pain– Keep from enlarging– Avoid infection
Blisters—Treatment
• Wash area thoroughly• Use sterile blade to
cut small hole in blister
• Squeeze out clear fluid
• Do not remove skin
• Prevention:– Wear work gloves– Break in new skin– Petroleum jelly/skin
lube– Adhesive bandage
Prevention of Foot Injuries
• Selecting appropriate footwear
• Using shoe orthotic
• Foot hygiene
Rehabilitation of the Foot
• Towel pulls
• TheraBand®
• Marble pick-up