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Foot, Ankle, & Lower Leg. Injuries. Great Toe Sprain. At the 1 st Metatarsal-phalangeal joint Hyper extension or hyper flexion Pain, tenderness, and/or swelling is on dorsal or plantar surface of MTP joint. Ingrown Toe Nail. Ingrown Toe Nail. Nail grows into surrounding tissue
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Foot, Ankle, & Lower Leg Injuries
Great Toe Sprain • At the 1st Metatarsal-phalangeal joint • Hyper extension or hyper flexion • Pain, tenderness, and/or swelling is on dorsal or plantar surface of MTP joint
Ingrown Toe Nail • Nail grows into surrounding tissue • Cause : poor trimming of toe nails; rounded instead of straight; or too short
Inversion Ankle Sprain Lateral ligaments usually injured due to stretching mechanism 85% of ankle sprains are inversion Fibula prevents severe eversion Deltoid ligament is stronger
Inversion Ankle Sprain • Deformities • Swelling, discoloration, pain & point tenderness • ROM decreased • Strength decreased • Orthopedic Test : Anterior Drawer Test – Grade I, II, III
Inversion Ankle Sprain
Ankle Sprains • So What structures are normally injured? • Grade 1: Anterior Talofibular • Grade 2: ATF & Calcaneofibular • Grade 3: ATF, CF, & Posterior Talofibular
Jones’ Fracture • Avulsion fracture of the 5th metatarsal head in inversion sprain • Xrays needed to rule out fracture if suspected
Achilles Tendonitis • Irritation or inflammation of the Achilles Tendon • Swelling, tenderness, heat, crepitus (crunchiness), pain • If worsens, can lead to complete tear
Achilles Tendon Rupture • Athlete usually falls, grabbing leg in pain • Feels as if they were shot in the back of their leg • Extreme pain, swelling, deformity or depression, weakness or complete loss of plantar flexion • Orthopedic Test: Thompson’s Test
GASTROCNEMIUS • STRAIN
Shin Splints • Called Medial Tibial Stress Syndrome • It is inflammation of the periosteum lining of the tibia • Caused from the Soleus muscle insertion • Pronation • Out of shape or overuse • Change in running distance, surface, footwear, or form
Shin Splints (cont.) • Dull achy pain, can be present before, during, and after activity • Point tender on medial border of tibia • Pain with resisted plantar flexion (due to Soleus) involvement
Stress Fractures • Caused by repetitive stress • Usually to tibia, fibula, and metatarsals (but can occur in any bone) • Complain of most intense pain after activity and during night • Pain and swelling on bone at fracture site
Stress Fracture • Bone scan is • needed to • diagnose
Using those X-ray Eyes • Percussion test • Bump test • Squeeze Test • Vibration (tuning fork) • Compression/Distraction