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Foot and Ankle Anatomy and Injuries

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Foot and Ankle Anatomy and Injuries

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  1. Unit 5:Understanding Athletic-Related Injuries to the Lower Extremity Foot and Ankle, Anatomy and Injuries Sports Medicine

  2. The Foot and Ankle

  3. Bones = 26 14 phalanges 5 metatarsals 7 tarsals The Foot (Bones)

  4. Toes (Phalanges) • Designed to give wider base for balance and propelling the body forward. • 1st toe (Hallux) • Two sesamoid bones located under the 1st MP joint.

  5. Metatarsals • 5 Bones • 1st metatarsal is the largest and strongest and functions as the main body support during walking and running. • Palpable at the ball of the foot. • 5th metatarsal most common fractured.

  6. Tarsals • 7 bones • Aids in the support of the body. • Calcaneous = largest tarsal bone, supports talus and shapes heel, and provides attachment for achilles tendon.

  7. Joints of the Foot • Interphalangeal joint (IP) • Flexion / Extension • Metarsalphalangeal joint (MP) • Flexion / Extension • Abduction / Adduction

  8. Bones of the Ankle • Tibia • Main weight bearing bone of LOWER LEG • Forms medial malleolus • Fibula • Non-weight bearing • Mainly muscle and ligament attachment • Forms lateral malleolus • Talus • Main weight bearing bone of the ANKLE

  9. Lateral Ligaments of the Ankle • Resist ankle inversion • Anterior talofibular (ATF) • Most commonly sprained • Calcaneofibular (CF) • Posterior talofibular (PTF)

  10. Medial Ankle Ligaments • Deltoid • Resists ankle eversion • Low rate of injury

  11. Quiz • Which bone in the lower leg is the most weight bearing? • What does ATF stand for? • Which ligaments resist inversion? • Which ligaments resist eversion? • What does MP stand for? • How many tarsal bones are there? • How many bones are in the foot?

  12. Answers: • Tibia • Anterior Talofibular • Anterior Talofibular, tibiofibular, calcaneofibular (lateral) • Deltoid ligaments (medial) • Metatarsalphalangeal • 7 • 26

  13. Muscles of the Foot and Ankle • Anterior Muscles (3) • Extensor Hallucis Longus/Brevis • extension of great toe • Extensor Digitorum Longus/Brevis • extension of 2 – 5 phalanges

  14. Muscles of the Foot and Ankle • Anterior Muscles cont. (3) • Tibialis anterior • inversion and dorsiflexion of foot / ankle

  15. Anterior Muscles

  16. Muscles of the Foot and Ankle • Medial Muscles (3) • Tibialis Posterior • Inversion and plantarflexion • Flexor Hallucis Longus • Flexor of great toe and plantarflexion of ankle • Flexor Digitorum Longus • Flexors of 2 – 5 toes and plantarflexion of ankle

  17. Muscles of the Foot and Ankle

  18. Muscles of the Foot and Ankle • Posterior Muscles (2) • Gastrocnemius • plantarflexion of ankle • Soleus • plantarflexion of ankle

  19. Muscles of the Foot and Ankle

  20. Muscles of the Foot and Ankle • Lateral Muscles (2) • Peroneus Longus / Brevis • eversion, plantar flexion of ankle

  21. Quiz • What is the primary function of the Extensor Hallucus Longus and Brevis? • What is the primary function of the tibialis anterior? • What two motions does the peroneus longus and brevis perform? • What motion does the Gastrocnemius/ Soleus perform? • What are the two main motions of the tibialis posterior muscle?

  22. Answers • Extension of great toe • Inversion and dorsiflexion of foot • Eversion and plantar flexion of the ankle • Plantarflexion of ankle • Inversion and plantarflexion

  23. Arches of the Foot

  24. Supinated Arches (High Arches)

  25. Supinated Arches

  26. Pronated Arches (Flat Feet)

  27. Pronated Arches

  28. Pronated Arches

  29. Pronated Arches

  30. Orthotics

  31. Orthotics

  32. Orthotics

  33. Foot and Ankle Injuries

  34. Ankle Sprain • Cause: Excessive inversion or eversion of the ankle • S/S: Point tenderness, swelling, discoloration, laxity, inability to walk or run properly (extent based on degree). • TX: RICE, rehabilitation immediately (Grade III requires immobilization) • Prevention: Strengthening exercises, proper shoes/ equipment

  35. Lateral Ankle Sprain • 1st Degree Ankle Sprain • Mechanism (MX) • Inversion and/or plantarflexion • ATF most common sprained • Occurs during contact or non – contact.

  36. Lateral Ankle Sprain • S/S • 1st degree • Mild pain • Pt – ATF • Possible swelling • Fast recovery to FWB and ROM • No joint laxity

  37. Lateral Ankle Sprain • 2nd Degree Ankle Sprain • MX • Same as 1st degree, more severe. • Involves the ATF, CF • Possible growth plate involvement • Most cases x-ray needed

  38. Lateral Ankle Sprain • S/S • 2nd degree • Felt a pop • Localized severe pain • Pt – more then one ligament • Rapid swelling • Decrease ROM • Laxity in joint • Unable to FWB

  39. Lateral Ankle Sprain • 3rd Degree Ankle Sprain • Rupture of ligaments (ATF, CF, PTF) • Consider a FX • X-ray is mandatory

  40. Lateral Ankle Sprain • S/S • 3rd Degree • Felt or heard pop • Extreme pain • Extreme/rapid swelling • No ROM • Unable to FWB

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