Power Point Presentation to Accompany 2011 Delmar Cengage

Power. Point Presentation to Accompany © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning

Chapter 17 The Foot, Ankle, and Lower Leg © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 2

Objectives • Upon completion of this chapter, you should be able to: – Describe the anatomy of the foot and ankle – Cite primary extrinsic and intrinsic muscles of the lower leg – Explain the common injuries and conditions affecting the foot, ankle, and lower leg – Describe medial tibial stress syndrome and its treatment © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 33

The Lower Leg • Exposed to numerous types of trauma during athletic practices and events – Common injuries include: • • • Contusions Strains Tendonitis and tendon ruptures Medial tibial stress syndrome Stress fractures and other fractures Compartment syndrome © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 44

The Foot and Ankle • 15% of sports injuries involve ankle ligaments, bones, and tendons • Basic anatomy: © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 55

Common Injuries of the Foot and Ankle • Ankle sprains – First degree (mild) – Second degree (moderate) – Third degree (severe) • Treatment: protection, rest, ice, compression, and elevation (PRICE), followed by rehabilitation © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 66

Animation – Ankle Sprain Click Here to Play Ankle Sprain Animation © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 7

Common Injuries of the Foot and Ankle (cont’d. ) • Arch sprains – Caused by overuse, overweight, fatigue, training on hard surfaces, and nonsupportive shoes • Treatment: cold, compression, and elevation • Blisters – Occur anywhere there is friction • Treatment: relieve pain, keep from enlarging, and avoid infection © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 88

Common Injuries of the Foot and Ankle (cont’d. ) • Great toe sprain – Big toe hyperextends • Treatment: protection, rest, ice, compression, elevation, and support © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 99

Common Injuries of the Foot and Ankle (cont’d. ) • Plantar fasciitis – Tissue becomes strained from overuse, unsupportive footwear, a tight Achilles tendon, or running on hard surfaces • Treatment: correct training errors, icing, and massage © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 1010

Common Injuries of the Foot and Ankle (cont’d. ) • Heel bruise – Heel receives, absorbs, and transfers impact from sports activities – Ligaments, tendons, and fat pad are subject to stress and injury • Treatment: cold application before activity, cold and elevation afterward, heel cups or pads © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 1111

Common Injuries of the Foot and Ankle (cont’d. ) • Heel spur – Bony growth on calcaneus that causes painful inflammation of soft tissue • Treatment: taping or shoe inserts • Fractures – Immediately impairs ability to perform – Often the site of point tenderness is present, and an obvious deformity may be seen © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 1212

Common Injuries to the Lower Leg • Contusions – Occur most often over the shin • May also involve muscular areas of the leg – Result of a direct blow • Strains – Occur anywhere along the muscles – Normally result from a violent contraction, overstretching, or continued overuse © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 1313

Common Injuries to the Lower Leg (cont’d. ) • Muscle cramps – Sudden, involuntary contraction of a muscle – Contributing factors may include fatigue, fractures, dehydration, lack of nutrients, poor flexibility, improperly fitted equipment • Treatment: passive stretching, fluid replacement, massage, rest, and ice © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 1414

Common Injuries to the Lower Leg (cont’d. ) • Achilles tendonitis – Caused by inflammation of the Achilles tendon – Tearing of tendon tissues caused by excessive stress • Treatment: best is prevention (stretching), ice, antiinflammatory medication, physical therapy, rest • Achilles tendon rupture – Caused by poor conditioning and overexertion • Treatment: must be surgically repaired © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 1515

Common Injuries to the Lower Leg (cont’d. ) • Medial tibial stress syndrome (shin splints) – Normally the result of doing too much too soon • Treatment: ice, reducing activity level, and gentle stretching of posterior leg muscles • Long-term treatment: biomechanical assessment of lower extremities, physical therapy, orthotic devices, anti-inflammatory medications, and a strengthening and flexibility program © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 1616

Common Injuries to the Lower Leg (cont’d. ) • Stress fractures – Incomplete crack in the bone – Signs include a “hot spot” of sharp, intense pain • Compartment syndrome – Develops when there is swelling within one or more lower leg compartments • Treatment: immediate transportation to the nearest medical facility (surgery will usually be needed) © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 1717

Common Injuries to the Lower Leg (cont’d. ) • Fractures – Tibia can be fractured by a direct blow, a twisting force, or occasionally from repetitive overuse – Fibula is normally fractured by a direct blow to the outside of the leg © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 1818

Additional Tests for the Foot, Ankle, and Lower Leg • Standard methods of testing various structures of the lower extremity: – Anterior Drawer Test – Plantar Fascia Test – Talar Tilt Test – Tinel’s Sign © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 1919

Conclusion • Injuries to the lower extremity are common in athletics • Solid understanding of anatomy will help the examiner assess injuries • Proper conditioning, equipment, and training are essential to the overall health of the athlete © 2011 Delmar, Cengage Learning © 2010 Delmar, Cengage Learning 2020