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The FOot

The FOot. The foot. 26 bones 7 tarsals calcaneus, talus, navicular, cuboid, cuneiforms (lateral, intermediate, medial) 5 metatarsals 14 phalanges. The arches. Support body weight and shock Transverse arch Metatarsal arch Medial longitudinal arch Lateral longitudinal arch.

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The FOot

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  1. The FOot

  2. The foot • 26 bones • 7 tarsals • calcaneus, talus, navicular, cuboid, cuneiforms (lateral, intermediate, medial) • 5 metatarsals • 14 phalanges

  3. The arches • Support body weight and shock • Transverse arch • Metatarsal arch • Medial longitudinal arch • Lateral longitudinal arch

  4. Plantar fascia • Thick white band of fibrous tissue • Originates from medial calcaneus • Inserts on the distal metatarsal heads • Supports the foot against downward forces

  5. Medial movements of the foot • Adduction • Supination (inversion and adduction) • Muscles that cause action pass behind and in front of medial malleolus • Behind- Tibials posterior, flexor digitorum longus, flexor hallicus longus • In front- Tibialis anterior, extensor hallicus longus

  6. Lateral movements • Abduction • Pronation (eversion and abduction) • Muscles that cause action pass behind and in front of lateral malleolus • Behind- peroneus longus, peroneus brevis • In front- peroneus tertius, extensor digitorum longus

  7. Prevention of injuries • Strengthening, stretching and mobility exercises • Orthotics- worn to correct a variety of biomechanical abnormalities than can lead to injury • Custom or generic • Type of footwear • Surface • Irregular and variable can strengthen foot

  8. Assessment of injury • Hops • History- (how it occurred, mechanism, type of pain) • Observation- (favoring foot, walking with a limp, deformities, swollen, discolored) • Palpation- (point tenderness, feel for deformities, check dorsal pedal pulse (anterior surface of the ankle and foot) • Special tests

  9. Retrocalcaneal bursitis • “Pump Bump” • Chronically irritated bursa from constant rubbing and pressure from the heel of the shoe bony callus forms • SS- tenderness, swelling, redness, palpable and tender bony bump • Care- doughnut pad, heel lift (changed site of pressure)

  10. Sever’s disease • Chronic inflammation of Achilles tendon attachments in young athletes

  11. Plantar fasciitis • Pain on the length of the sole of the foot • Leg length difference, stiff medial longitudinal arch, tightness of the calf, shoes without support, running on soft surface • SS- complains of pain on anterior medial heel (site of attachment), pain in the morning while getting out of bed • Care- calf stretching, exercises to stretch fascia, arch taping, orthotics

  12. Heel bruise • Bruise on the bottom of the calcaneus • Sudden stop and go movements, jumping • Ss- severe pain in the heel, cannot bare weight • Care- ice, do not bare weight for 24hours, heel cup, doughnut pad

  13. Metatarsal fractures • Caused by a direct force, being stepped on, being kicked or kicking, twisting forces • sS- point tender and may feel a deformity • Care- control swelling, walking cast for 3-6 weeks

  14. Jones fracture • Most common metatarsal fracture • Fracture of the Neck of the 5th metatarsal • Occurs from overuse or rotational forces • usually already had a stress fracture • SS- sharp pain, hear a pop • Care- non weight bearing for 6-8 weeks (non displaced). Displaced requires surgery and non weight bearing

  15. Second metatarsal fracture • March fracture • Running and jumping in sports • Morton’s toe= higher chances for fracture • SS- pain and point tenderness, pain during running and walking, ongoing pain and aching during non weight bearing movements • Care- non weight bearing, pool running, stationary bike, Ube

  16. Fracture and dislocations of the toes • Kicking an object, stubbing toe, dropping heavy objects on the toes (phalanges) • SS- swelling and discoloration • Care- buddy taping. If more than one toe is involved casts may be applied for a few days. 3-4 weeks on inactivity • Dislocations are less common than fractures

  17. bunions • Deformity of the head of the 1st met. • Hallux valgus- great toe becomes malaligned and moves laterally • SS- when developing: tenderness, swelling, and enlargement with calcification of the head of the first met. Poor fitting shoes increase tenderness and pain • Care- wear shoes with proper width, donut pad over the bunion, surgery

  18. Morton’s Neuroma • Mass occurring in the common plantar nerve- usually between 3rd and 4th met heads • SS- radiating pain from the distal met heads to the end of the toes. Pain is relieved when not weight bearing, burning and numbness in the forefoot, pain with hyperextension in weight bearing (squatting, stair climbing and running). “feels like there is a rock in my shoe” • Care- met bar, teardrop shaped pad is placed between the heads of the 3rd and 4th met. Shoe with a wide toe box

  19. Turf toe • Hyperextension injury- sprain of the great toe • Either repetitive overuse or trauma, or from kicking a non-yielding object • Care- flat insoles with thin sheets of steel under the forefoot

  20. Calluses • Caused by shoes that are too narrow or too short • Care- use an emery file after each shower, doughnut pad, wedges, and arch supports (help distribute the weight on the feet more evenly and thus reduce skin stress

  21. Blisters • Result of shearing forces acting on the skin, fluid accumulates below the outer skin layer • Care- cover irritated skin with a friction proof material, cover blister with an adhesive bandage, apply a doughnut pad that surrounds the blister • Do not cut or puncture= reduce the risk of infection

  22. Corns • Cause by the pressure of improperly fitting shoes • Hard corns- form on top of toes • Soft corn- combination of wearing narrow shoes and excessive foot perspiration • Care- • Soft corns- wear properly fitting shoe, keep skin between the toes dry and keep toes separated. • Hard corn- soak feet daily in warm soapy water to soften corn. Should protect with a small felt or sponge rubber doughnut

  23. Ingrown Toenails • Side edge of the toenail grows into the soft tissue nearby, usually resulting in severe inflammation and infection • SS- swelling, heat, aching, redness and accumulation of puss • care- proper fitting shoes, trim nails correctly, leave nail long enough to clear the underlying tissue, cut a “v” into the nail

  24. Subungual hematoma • Blood under the toenail • Caused from being stepped on, dropping an object on the toe, kicking another object • Can cause severe pain and can ultimately cause loss of the nail • SS- may be immediate or slow, pain, bluish-purple color, light pressure exacerbates pain • Care- apply ice immediately, elevate foot, drill a small hole through nail to release the blood

  25. Questions?

  26. https://o.quizlet.com/DR9vr7Jc.X1PVs80ULteXQ_m.jpg • http://learnaboutyourfeet.weebly.com/uploads/3/0/6/0/30601763/453981.png?1401865352 • http://www.happyfeetz.com/wp-content/uploads/2011/11/haglunds-deformity-02-300x212.jpg • http://www.iwalk-free.com/wp-content/uploads/2017/02/Jones-fracture-2.jpg • https://static1.squarespace.com/static/588017c803596e2e07185797/t/58dc9463be65945ca29e8ead/1490850969370/Hallux+valgus+bunion • https://www.gentlefootdoctor.com/wp-content/uploads/2015/03/turf-toe-treatment-brandon-podiatry.jpg

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