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Foot and Ankle
Anatomy and Pathologies of the foot and ankle
46
Other
Undergraduate 4
11/09/2015

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Cards

Term
What are the 3 bones that make up the ankle?
Definition
tibia, fibula, talis
Term
What is the mortise of the ankle?
Definition
lateral and medial malleolus and the talus
Term
What is the main weightbearing bone of the leg?
Definition
The Tibia, bears 80-90% of the weight
Term
What connects the tibia and fibula?
Definition
Interosseous membrane
Term
What causes high ankle sprains?
Definition
Forced dorsiflexion and eversion, damaging the interosseous membrane
Term
What is the purpose of the fibula?
Definition
distal portion of ankle mortise, attachment site for ligaments and muscle
Term
What type of joint is the ankle joint?
Definition
synovial hinge joint
Term
What are the main motions of the ankle joint?
Definition
Dorsiflexion and plantarflexion. Relies heavily on soft tissues for support
Term
Anterior Talofibular ligament
Definition
Tight during plantarflexion and resists inversion. Main ligament injured during ankle sprains
Term
Calcaneofibular ligament
Definition
Resists inversion, second most commonly injured ligament
Term
Posterior Talofibular ligament
Definition
Deepest of lateral ankle ligaments, rarely injured. Resists posterior translation
Term
Deltoid ligament
Definition
Main ligament of the medial aspect of the ankle. Comprised of 4 ligaments, prevents eversion, rarely injured
Term
Subtalar Joint
Definition
Comprised of talus and calcaneus. Allows for eversion and inversion of the ankle
Term
Tibialis Posterior
Definition
Allows for plantarflexion and adduction of the foot, also inversion of the ankle
Term
Flexor Digitorum Longus/Flexor Digitorum Hallucis
Definition
Act on toes, weak plantarflexion and inversion
Term
Why are the muscles of the ankle/foot prone to injury?
Definition
Due to location relative to medial malleolus/ superficial location
Term
fibularis longus/brevis
Definition
Located on lateral aspect of the ankle, allows eversion/plantar flexion of ankle. Both pass behind lateral malleolus. Commonly injured
Term
Posterior aspect of ankle
Definition
Made up of gastrocnemius/soleus. Makes up achilles tendon. Gastrocnemius crosses ankle/knee joint. Plantar flexors
Term
Anterior aspect of the ankle
Definition
Made up of tibialis anterior and extensor pollicis hallucis
Term
50 degrees of rotation
Definition
Plantarflexion
Term
20 degrees of rotation
Definition
Dorsiflexion
Term
35 degrees of rotation medially
Definition
Inversion
Term
15 degrees of rotation laterally
Definition
Eversion
Term
Lateral ankle sprain or Inversion sprain
Definition
Most common orthopedic injury. Caused by injury of the ATF
Term
Medial ankle sprain or Eversion sprain
Definition
Injury to deltoid ligament. Uncommon
Term
Syndesmotic sprain
Definition
High ankle sprain, caused by splaying of mortise. Heals poorly, 4-6 weeks recovery. Can be surgically repaired
Term
What have been proven to reduce the risk of lateral ankle sprains?
Definition
lace up braces
Term
What are the two types of instability caused by ankle sprains?
Definition
mechanical and functional instability
Term
How should one progress through proprioceptive training to treat an ankle injury?
Definition
Proprioception training starts early during the proliferation phase of healing, done using a wobble board. Advanced proprioceptive training during phase 3, remodeling.
Term
Pronation of the foot
Definition
dorsiflexion, abduction, and eversion saggital, transverse, frontal
Term
Supination of the foot
Definition
plantarflexion, adduction, and inversion
saggital, transverse, frontal
Term
Plantar fascia
Definition
fibrous connective tissue running on the plantar aspect of the foot from the heel to each toe. Provides stability for the foot
Term
Medial longitudinal arch
Definition
Connects to plantar fascia, responsible for pes planus or pes cavus
Term
Pes Planus
Definition
Over-pronation of foot. Flat feet. Causes an increase in the valgus stress and angle at the ankle. Pes planus leads to excessive eversion of the heel. Pes planus can also lead to MTSS, tibial stress fx, bunions at the foot. Can also lead to mechanical injuries and pain at the knee and hip as well.
Term
How can one overcome over pronation of the foot?
Definition
To help overcome excessive pronation of the foot, need to make sure to strengthen the intrinsic foot muscles as well as gluteus medius muscle.
Term
Pes Cavus
Definition
Over-supination. High arch. Causes an increase in varus stress at the ankle. The arch is too rigid which can lead to stress fractures, lateral ankle sprains, and plantar fasciitis. Much less common in the general population
Term
Plantar fasciitis
Definition
inflammation of the PF usually at the medial calcaneal (heel) attachment site. Is an overuse injury usually seen after training on a hard surface, increasing the frequency or intensity of training, in individuals with tight heel cords. Also see this in individuals with low and high arches (low arch due to the eversion at the heel, high arch due to the rigid nature of the arch itself).
Term
What is the treatment for plantar fascitis?
Definition
pain control, stretch calf complex, rollout arch and plantar aspect of the foot, stretch with a night splint, intrinsic foot and hip strengthening and cross train. Custom orthotics needed also.
Term
Achilles Tendonitis
Definition
microtrauma to the Achilles tendon that builds over time causing inflammation in the tendon near the distal attachment site on the calcaneus (heel bone)
Term
How can achilles tendonitis be treated?
Definition
Treat with RICE, calf complex stretching (pain free) and foam rolling.Use heel cups to raise the heel up, decreasing the amount of active plantar and dorsiflexion needed, thus reducing force
Term
How do you treat an Achilles Tendon Rupture
Definition
Always surgery, usually within first 4 weeks. Repair, or stitch together, the ends of the ruptured tissue
Term
How long does healing/rehab for achilles tendon rupture last?
Definition
Return to sport is 6-12 months
Term
What should you make sure of before approving a return in someone who has had an achilles tendon rupture?
Definition
Make sure active and passive dorsiflexion is at least 10 degrees
Term
What are the stages of the 6-12 months of treating an achilles tendon rupture?
Definition
boot or cast for 6 weeks. Gradual return to weightbearing with boot at 12 weeks. Passive/active assisted ROM after 12 weeks. Jogging can start at 10-12 weeks
Term
Shin splints
Definition
Overuse injury usually resulting from excessive pronation at the feet, increased valgus moment/stress at the ankle, and increased valgus moment at the knee
Term
How can shin splints be treated
Definition
. Strengthen Glut med as a stabilizer, ER, and abductor in order to help combat MTSS symptoms. Also, custom orthotics and intrinsic foot stabilizer strength will help with symptoms as well. Make sure heel cords are stretched as well
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