THE FOOT, ANKLE & LOWER LEG

INJURIES

SECTA

Sports Medicine

Common Injuries of the Foot & Ankle

Ankle sprains:The most common injuryMostly due to excessive inversion and

plantar flexionMost commonly injured ligament is the

anterior talofibular ligamentLess common is the eversion sprain due to

the deltoid ligament

Common Injuries of the Foot & Ankle

Ankle Sprains1st degree:

○ 1 or more of the supporting ligaments are stretched

○ S/S: minor discomfort, point tenderness, little or no swelling, no abnormal joint movement

○ TX: RICE, splinting, taping, bracing, eliminate all activities that cause pain

○ Rehab: ROM exercises, stretching exercises, strengthening exercises

Common Injuries of the Foot & Ankle

Ankle Sprains2nd degree:

○ Portion of 1 or more ligaments is torn○ S/S: pain, point tenderness, swelling, disability

loss of function, slight abnormal movement○ TX: RICE, splinting, taping, bracing, eliminate

all activities that cause pain○ Rehab: ROM exercises, stretching exercises,

strengthening exercises

Common Injuries of the Foot & Ankle

Ankle Sprains3rd degree:

○ 1 or more of the ligaments have been completely torn

○ S/S: extreme pain (unless nerve damage has occurred), loss of function, point tenderness, rapid swelling, chance of fracture

○ TX: RICE, splinting, taping, bracing, eliminate all activities that cause pain, consult a physician

○ Rehab: ROM exercises, stretching exercises, strengthening exercises, possible surgery

Common Injuries of the Foot & Ankle

Inversion ankle sprain Inversion ankle sprain

Common Injuries of the Foot & Ankle

Arch SprainMost involve the metatarsal or inner

longitudinal archReduces the ability of the arches to absorb

shockCaused by overuse, overweight, fatigue,

training on hard surfaces, wearing nonsupportive or worn shoes

TX: RICE

Common Injuries of the Foot & Ankle

Great Toe Sprain (Turf Toe)Big toe hyperextends (first

metatarsophalangeal joint) often due to slippery surfaces

Minor injury but does limit athletes’ performance

TX: RICE, support, often x-rays to rule out more severe injury

Common Injuries of the Foot & Ankle

Plantar FasciitisPlantar fascia

becomes strained due to overuse, toe running, unsupportive footwear, running on hard surfaces

S/S: Pain near heel (similar signs as heel bruise)

TX: RICE, stretching, heel cushion

Common Injuries of the Foot & Ankle

Retrocalcaneal BursitisCaused by constant

rubbing from the heel of the shoe leading to chronic inflammation of the bursa

S/S: tenderness, swelling, warmth and redness

TX: Doughnut pad place around the area

Common Injuries of the Foot & Ankle

BunionThe head of the 1st

metatarsal enlarges due to wearing improperly fitting shoes

S/S: Obvious deformity, tenderness, and swelling

TX: Proper shoe selection, protection devices, possible surgery

Common Injuries of the Foot & Ankle

Bunion

Common Injuries of the Foot & Ankle

Pes PlanusOver pronation of the

foot caused by the lack of support in shoes, genetics, or age

S/S: foot pain, lack of longitudinal arch, lateral heel tilt

TX: arch stretches, toes curls, ice massage, orthotics

Common Injuries of the Foot & Ankle

Pes Planus

Common Injuries of the Foot & Ankle

Ingrown ToenailCaused by improper

shoe size and nail cutting

S/S: increased pain, swelling, redness around the nail bed

TX: hot, soapy water, antibiotics, raise nail up

Common Injuries of the Foot, Ankle & Lower Leg

Muscle Cramp:A sudden, involuntary contraction of the muscleContributing factors:

○ Fatigue○ Fractures (due to atrophy)○ Dehydration○ Lack of nutrients in diet (sodium, magnesium,

calcium, potassium)○ Poor flexibility○ Improperly fitted equipment

TX: passive stretching, fluid replacement, massage, rest, ice

Common Injuries of the Foot, Ankle & Lower Leg

ContusionsMost commonly occur

over the shin due to a blunt force trauma

Complication of a severe contusion may lead to Compartment Syndrome or peroneal nerve damage

TX: ice

Common Injuries of the Foot, Ankle & Lower Leg

Achilles TendonitisCaused by repetitive weight bearing

activities that increase quicker than the body can adapt

S/S: pain and stiffness around the Achilles tendon- gradual onset

TX: limit/restrict the activity that caused the irritation, aggressive stretching

Common Injuries of the Foot, Ankle & Lower Leg

Achilles Tendon RuptureCaused by a sudden eccentric force is

applied to a dorsiflexed foot with a chronically tight tendon

S/S: feel/hear a pop, feels as if kicked in the leg, inability to plantar flex foot

TX: Surgery vs. cast

Common Injuries of the Foot, Ankle & Lower Leg

Achilles Tendon Rupture

Common Injuries of the Foot, Ankle & Lower Leg

Medial Tibial Stress Syndrome Shin SplintsCaused by changes of any kind in training,

abnormal strength in antagonist muscleS/S: anterior medial shin painTX: eliminate bad changes, modified rest,

cryotherapy, arch tape job

Common Injuries of the Foot, Ankle & Lower Leg

Stress FractureCaused by repeated stress place on a bone

that is greater than the body’s ability to adapt or heal

S/S: point tender at fracture site, pain relief in the morning

TX: rest

Common Injuries of the Foot, Ankle & Lower Leg

Stress Fractures

Common Injuries of the Foot, Ankle & Lower Leg

FracturesCaused by direct blow, twisting force,

repetitive use (stress fractures)10-15% of lower-leg fractures are open

fracturesTibial fractures are more easily recognized

than fibula fractures

Common Injuries of the Foot, Ankle & Lower Leg

Fractures

Closed Fracture Tibial x-ray

Common Injuries of the Foot, Ankle & Lower Leg

Fractures

Common Injuries of the Foot, Ankle & Lower Leg

Fractures

Common Injuries of the Foot, Ankle & Lower Leg

DislocationCaused byS/S:TX:

Common Injuries of the Foot, Ankle & Lower Leg

Dislocation