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7/21/2019 Injuries to the Lower Leg, Ankle, & Foot (Ch. 16)
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Posterior tibial/fexorPosterior tibial/fexor
retinaculumretinaculum
Deltoid ligamentDeltoid ligament
Achilles tendonAchilles tendon
Posterior tibialis m. and plantariPosterior tibialis m. and plantari
m.m.
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Peroneus longus and brevisPeroneus longus and brevis
m.m.
Extensors o the toesExtensors o the toes
Posterior tibialisPosterior tibialis
m.m.
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Pes cavushigh, rigidarch
Pes planuslow,hper!mobile arch
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" #ulge at $stmetatarso!phalangeal
%oint
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UsuallyUsually INVERSIONINVERSIONsprainssprains
Damage to the anterior talo-fibular ligament occurs firstDamage to the anterior talo-fibular ligament occurs first
Second, the calcaneo-fibular ligament is sprainedSecond, the calcaneo-fibular ligament is sprained
any times strains of the peroneus longus and bre!is m"any times strains of the peroneus longus and bre!is m"occuroccur
S#ells $generally% according to se!erity $grades &,',(%S#ells $generally% according to se!erity $grades &,',(%
Often happens because the athlete steps on someone else)sOften happens because the athlete steps on someone else)s
footfoot
Or, the athlete lands from a *ump or a step #ith his+her footOr, the athlete lands from a *ump or a step #ith his+her foot
in!erted and plantar-fleedin!erted and plantar-fleed
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&upports the&upports the
oot inoot in
plantarfexedplantarfexed
positionposition
&upports the an'le in the () degree *fat&upports the an'le in the () degree *fat
oot+ position.oot+ position.
&upports the an'le in&upports the an'le indorsifexiondorsifexion
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Anterior talobularAnterior talobular
ligamentligament
-alcaneobular-alcaneobular
ligamentligament
Anterior tibiobularAnterior tibiobular
ligamentligament
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Posterior tibialisPosterior tibialis
tendontendon
&pring&pring
ligamentligament
Peroneus m.Peroneus m.
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ExtensorExtensor
0etinaculum0etinaculum
ExtensorExtensortendonstendons
Extensor 0etinaculumExtensor 0etinaculum
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1he proximal end is a snovial %oint,
acting as part o the 'nee
1he distal end is a sndesmosis %oint,which is a side!b!side arrangement
held together b transverse ligaments
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Avulsion fracture at base of the 5thmet
Peroneus brevis tendon causes it
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The posterior tibialis m. gets strained and irritated,especially when the athletes foot over-pronates
Another form of shin splints is periostitisof thetibia.
Periostitis is in!ammation of the outer bone lining"periosteum# of the tibia, and possiblyof theinterosseus membrane between the tibia and $bula
%ce massage and deep manual massage often bringrelief. Anti-in!ammatory medications are also helpful
Additional arch support, shin splint taping, plusanterior tibialis m. and posterior tibialis m.strengthening, and calf stretching, are alsoimportant parts of treatment for this condition
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&uscles on the anterior aspect of lower leg areenclosed in connective tissue
'ecause of overuse or severe impact, the musclesin the compartment will swell and e(pand, but the
connective tissue will not, causing the pressure inthe leg to increase
)auses severe pain that increases with activity
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*ou will notice hot, red s+in, loss of foot motion,and hardness of the area
)an be confused with shin splints, shin splinttaping can aggravate the problem
Athlete may also notice parasthesia or wea+nessin lower part of shin andor foot
This condition can cause permanent nerve andcirculation problems
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efer to doctor immediately
)an be resolved with surgery
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Soreness *ust anterior to the heel"
Initially caused by tightness of the
heel cord $chilles tendon% " One ofthe classic signs of this condition is
sharp pain *ust anterior and medial
of the heel upon stepping out of bedin the morning"
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.reatment
Stretching
plantar fascia
calf
Ice massage
US
rch supports
n/le strengthening
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eels li+e youve been +ic+ed in the bac+ of theleg
/ccurs with over pronation, or sudden forcefulcontraction of the calf
*oull notice a lac+ of plantar!e(ion whens0uee1ing the calf
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Turf toe
2prain of &TP 3oint
4sually due to e(cessive e(tension
2ubungual hematoma
etting stepped on causes it
emedied through drilling into nail to relievepressure
%ngrown toe nails
4sually cut out by doc
6i7cult to come bac+ from bc athletes tend torush it
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