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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 mid-
foot, 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?