Transcript Foot and Ankle Injuries

FYI
 The foot and ankle support the weight and transfer
force as a person walks and runs.
 The feet and lower legs work to maintain balance and
adapt to various surfaces.
 Ankles are the most common and most frequent
injured joint.
Preventing Foot and Ankle Injuries
 Taking care of the foot and ankle is essential to injury
prevention and continuous athletic participation
 Preventative measures may include:
 Wearing shoes that provide ankle and arch support.
 Using supportive ankle taping
 Strength and conditioning programs
Treating Foot and Ankle Injuries
and Conditions
 Since the feet and legs form the foundation on which
an athlete walks and runs, injuries to ligaments,
tendons, muscles, and bones can be disabling.
Ligament Injuries
 Sprain-stretching or tearing of ligaments and usually
occurs as a result of trauma to a joint that is forced to
the extreme of its range of movement.
 Sprains commonly occur at the great toe, arch, lateral
ankle joint (outside), and the medial ankle joint
(inside)
Great-toe Sprain
• Great-toe helps kick a ball, push off when walking or
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running, and maintain balance.
If excessive force is applied to this area, such as forced
flexion and extension, the ligaments can be sprained.
Some feel turf causes more great-toe sprains than real
grass.
ATC will recommend RICE
When athlete returns to action, the great-toe can be
taped and padded to provide support and decrease
pain.
Arch Sprain
 Can be caused by running on a hard surface,
improper footwear, or repetitive stress
 Athlete will report significant pain over the
involved arch and will experience difficulty
walking or running
 ATC will notice swelling and some discoloration
over the plantar surface
 PRICE (protection, rest, ice, compression,
elevation)
 An arch pad may relieve some of the pain
Lateral and Medial Ankle Sprains
 85% of ankle sprains are caused by excessive inversion
 Deltoid ligament is very strong compared to the lateral
ligaments and the fibula prevents severe eversion
 When the ankle inverts, the lateral ligaments are
injured
 Severity will depend on the amount of force, the amount
of taping, the type of shoe, and the strength of the
muscles
Lateral and Medial Ankle Sprains
 Athlete with an injury must be evaluated to determine
its severity
 Shoe and sock must be removed
 Swelling and discoloration may occur
 ATC will determine the severity based on the athlete’s
ability to move the ankle
 if no decrease in range of motion or strength, athlete may be
allowed to play with the ankle protected by a brace or tape
 Any decrease in range of motion will be treated with PRICE
Ankle Dislocations
 Can occur either anteriorly or posteriorly
 Anterior dislocation occurs when the heel of the foot
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strikes the ground forcefully
Posterior dislocation occurs with a blow to the anterior
aspect of the leg while the ankle is in plantar flexion
Deformity, obvious pain, rapid swelling will occur
ATC will splint the lower leg and ankle, call 911, give
the athlete ice, and remove athlete from the field
*Physician must put the bones back in place because
the ligaments, nerves, and blood vessels can be
damaged
Muscle and Tendon Injuries
 Strains occur as a result of overstretching or putting a
muscle or tendon under excessive tension
 Tendonitis-inflammation of a tendon
 Typically occurs as a result of a repetitive stress (running
or jumping)
 Common tendon injuries and strains in the foot region
involve the Achilles tendon
Achilles Tendinitis
 Achilles tendon is the strong tendon joining the
gastrocnemius muscle in the calf to the heel
 Any sport involving repeated running, jumping,
and landing may cause cells in the tendon to break
down prematurely—causing tendonitis
 ATC will note swelling, tenderness, and expression
of pain.
 Rest and ice will need to be done by the athlete
Achilles Tendon Rupture
 Feels as if someone shot him in the back of the
lower leg
 Occurs when there is forced dorsiflexion of the
foot, a blow over the Achilles tendon, or a sudden
forceful contraction of the gastrocnemius
 Athlete will feel the tearing
 ATC will notice swelling and a depression where
the tendon used to be attached
 The tendon must be repaired surgically
Bone Injuries
 Direct impact to an area and repetitive use can cause
fractures
 Common symptoms include pain, pressure, and
inability to move the body part
 ATC can splint the injured area
 Athlete must go to a doctor to get X rays and a cast
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Metatarsal Avulsion Fracture
 Most common avulsion fracture-aka Jones fracture
 The ankle is forced into inversion, the muscles
contract forcefully to stabilize the later aspect of the
ankle, the peroneus brevis tendon pulls part of the
bone away at its attachment
 ATC uses PRICE and refers athlete to the team
physician
Epipyseal Injury of Distal Tibia and
Fibula
 Epiphyses-growth plates
 Distal tibia and fibula epiphyses become injured
when the ankle is forced into plantar flexion and
inversion
 Athlete will experience pain and swelling
 ATC will splint the injury and refer him to a
physician for X rays
 Possible for the epiphysis to close prematurely,
which will stunt bone growth at that site
Stress Fractures
 Most commonly occur to the tibia, fibula, and
metatarsals
 Repetitive stress due to running is usually the cause
 Pain becomes more intense at night and after the
activity
 A bone scan can be used to verify a stress fracture
 An X ray will not show a stress fracture until 2 weeks
after the initial injury when a callus begins to form at
the site
 Takes 4-6 weeks of rest
Other Common Injuries
 The weight-bearing lower extremities are prone to
other injuries
Shinsplints
 Common term used for pain in the lower leg
 Muscle fibers on the medial side of the tibia
become torn and irritated
 Athlete complains of pain and inability to run or
walk properly
 Treatments-PRICE, changing training activities,
taping is possible.
 Recommended to get new shoes, stretching and
arch supports
Contusions
 Bruising
 Soccer and field hockey players are prone to
contusions of the lower leg
 RICE
 ATC may tape on additional padding to protect area
from further impacts
Toe
Abnormalities
 Hammer Toe-middle joint of the toe is flexed and the
joint (phalange and metatarsal) is hyperextended
 Halux valgus (bunion)-pressure on toe toward the
midline of the body at the great toe
 Ingrown toenail-nail grows into the surrounding soft
tissue