Transcript THE FOOT
Chapter 14 - THE FOOT ANATOMY ANATOMY – 26 BONES • TARSAL BONES – 7 – Calcaneus – heel bone – Talus – forms the ankle – Navicular – medial in respect to the talus – Cuboid - lateral – Cuneiforms (3) ANATOMY - BONES • METATARSALS – 5 – 1ST one is medial and 5th one is lateral ANATOMY - BONES • PHALANGES (Toes) – 14 – Big toe has two phalanges, the rest of the toes have three – Proximal, middle, and distal ANATOMY - BONES • SESAMOIDS – Sesamoid bones sit in tendons – These are on ball on foot below big toe – Helps distribute weight ANATOMY - ARCHES • Support body weight and absorb shock • There are four arches: – – – – MEDIAL LONGITUDINAL ARCH LATERAL LONGITUDINAL ARCH METATARSAL ARCH TRANSVERSE ARCH ANATOMY • PLANTAR FASCIA – Broad, flat tendonous structure that runs on the undersurface of the foot – Starts on the calcaneus and inserts onto the heads of the metatarsals – Supports the arch of the foot FOOT - MOTIONS • Toes – Flexion and Extension • Foot – Pronation – like fallen arch – Supination – high arch INJURIES INJURIES • PLANTAR FASCITIS – Common with athletes who are on toes and/or have high arches – Causes: Not enough arch support in shoes, tight calf muscle – Signs/Symptoms: Pain occurs in the heel to midfoot, especially with dorsiflexion • Hurts in the morning, feels better as they warm up – Treatment: Gentle stretches, roll on tennis ball or frozen can, arch taping or orthodics. INJURIES • RETROCALCANEAL BURSITIS – ‘Pump bump’ – Cause: Pressure from back of shoe – Signs/Symptoms: Swelling where the Achilles attaches to the calcaneus – Treatment: RICE, stretching, shoes with wider heel cups, donut pad. INJURIES • FRACTURES – Toes – Metatarsals • DISLOCATIONS – Interphalangeal Joints • SPRAINS • STRAINS INJURIES • JONES FRACTURE – Fracture of the base of the 5th metatarsal – Causes: overuse; inversion; rotational forces – S/S: Feels and hears a ‘pop’; pain in the lateral foot – Tx: immobilization (cast) 6-8 weeks or longer, often requires surgery INJURIES • BUNIONS (HALLUX VALGUS) – Deformity of the head of the 1st metatarsal – Cause: extra bone is laid down on head of 1st metatarsal • Great toe becomes malaligned – S/S: Pain, swelling and deformity of big toe joint – Treatment: Proper shoes; doughnut pad over the bunion; surgery? INJURIES • MORTON’S NEUROMA – Neuroma is a mass about the nerve sheath – S/S: burning, cramping, numb feeling in space between third and fourth toes. – Cause: Hyperextension of toes and wearing shoes with narrow toe boxes can increase symptoms – Tx: teardrop pad under the metatarsal heads, good shoe selection, possible surgery INJURIES • TURF TOE – page 307 – Great Toe sprain – Cause: Hyperextension of the big toe at the metatarsal phalangeal joint; kicking something • Common on artificial turf b/c turf shoes allow more motion – S/S: swelling and pain in the joint – Tx: RICE, rigid insoles or toe boxes, taping to prevent hyperextension of toe INJURIES • INGROWN TOENAILS – Cause: leading side of toenail grows into skin, usually results in infection and pain • May trim nails too short or ill-fitting shoes – S/S: Inflammed nail bed, may have drainage/pus – Tx: May need to refer to doctor; soak in betadine bath; pack cotton under toenail BIOMECHANICAL PROBLEMS • PRONATION – Cause of many, many leg, knee, back problems – What does it look like • Fallen arch with toes pointed outward • Looking at feet from behind, the Achilles will angle outward QUESTIONS?