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Ch. 17 Foot, Ankle, and Lower Leg Injuries. Ankle Sprain. MOI: 85 % inversion, 15% eversion Deltoid stronger than lateral ligaments Fibula longer than tibia S/S: pain, swelling, discoloration, decreased ROM 1 st degree: ligament stretched 2 nd degree: ligament partially torn
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Ankle Sprain • MOI: 85% inversion, 15% eversion • Deltoid stronger than lateral ligaments • Fibula longer than tibia • S/S: pain, swelling, discoloration, decreased ROM • 1st degree: ligament stretched • 2nd degree: ligament partially torn • 3rd degree: ligament completely torn, surgery
Ankle Sprain • Treatment: RICE, use horseshoe, crutches if needed • Taped, braced before return to participation • Rehab • Increase ROM • Increase strength • Increase proprioception
Arch Sprain • MOI: overuse, fatigue, training on hard surfaces, wearing improper shoes • S/S: pain over arch, swelling • Treatment: RICE, Arch pad • Rehab • Increase strength of intrinsic muscles • Stretching Achilles
Turf Toe • MOI: Hyperextension or hyper flexion of first metatarsophalangeal joint • S/S: swelling, pain with flexion or extension • Treatment: RICE, tape, walking boot • Rehab: strengthen toe muscles
Plantar Fasciitis • Plantar fascia attaches at calcaneus to the heads of the metatarsals; support for longitudinal arch of foot • MOI: overuse, improper footwear, tight Achilles, running on hard surfaces • S/S: pain in arch of foot, swelling • Treatment: RICE, massage, correct mechanics
Achilles Tendon Rupture • MOI: forced dorsiflexion, blunt force, or sudden forceful contraction of gastroc • S/S: extreme pain, difficulty walking, no plantar flexion, swelling, obvious deformity
Achilles Tendon Rupture • Treatment • Surgery • Immobilized 6 weeks • Rehab • Slow progression of ROM • Isometric strength
Jones Fracture • Fracture of fifth metatarsal • MOI depends on type of fx • S/S: pain over 5th metatarsal • Treatment: RICE, refer to physician
Shin Splints • Medial tibial stress syndrome • S/S: pain over anterior portion of lower leg • Treatment: RICE, switch to cross training • Rehab: stretch gastroc and soleus • Figure out what is causing shin splints and fix • Shoes • Training Surface • Running mechanics
Anterior Compartment Syndrome • MOI: contusion, fracture, infection, excessive exercise • S/S: pain, increased with movement, touch, pressure, or stretching, numbness and weakness may develop • Treatment: Acute needs medical attention immediately; surgery required to relieve pressure
Rehab Exercises • For intrinsic foot muscles-towel curl • Theraband-four ways • Dorsiflexion • Plantar flexion • Inversion • Eversion • Balance • Stretching
Special Tests • Anterior Drawer: tests anterior talofibular ligament • Tinel’s Sign: tests entrapment of tibial nerve • Thompson Test: tests integrity of Achilles tendon