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THE FOOT, ANKLE, AND LOWER LEG
CHAPTER 17
Yay Feet!!!
Awwww…
Old Feet
Injured feet
Hobbit Feet???
Unfortunately Looking Feet
A Few Facts…
 Foot and Ankle injuries account for about 15%
of overall sports related injuries.
 There are more than 20,000 ankle sprains in
the U.S. each day! (That’s a lot of icing! )
 The foot and ankle act as shock absorbers
during all running and jumping that we do.
They can absorb around a million pounds of
pressure during a single hour of strenuous
exercise.
Cont…
 When a 150 pound runner, runs 3 miles, they
are putting more than 150 tons of pressure on
each foot!
Yao Ming
Basic Anatomy
 3 arches of the foot
 Medial Longitudinal – The highest of the three
arches
 Transverse – Across the midfoot
 Lateral Longitudinal – Along the fifth ray
Anatomy Break-down…
 Each foot has 26 bones. (7 tarsals, 5
metatarsals, and 14 phalanges)
 Each foot has 38 joints.
 Movement occurs at a joint. Think about how
much movement that is, and how many different
sites there are for potential injury!
Bones of the Foot/Ankle
Joints
 Talocrural Joint – Where the tibia, fibula, and
talus join together
 Subtalar Joint – Where the Calcaneous and
Talus join together. This is the joint that we
are trying to immobilize when taping the
ankle in order to stabilize or prevent a sprain
 Page 241
Muscles
 Intrinsic Muscles: Muscle that relates to a
specific body part or bone
 Plantar flexors, dorsiflexors, abductors, and
adductors of the toes
 Extrinsic Muscles – Located outside a body
part, organ, or bone.
 Gastrocnemius – Calf muscle
Ankle/Foot Injuries
 Strains, Sprains, Dislocations, and Fractures,
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Contusions, and Tendonitis.
Sprain is the most common!!!
Mechanism of Injury – What motion caused
the injury?
Usually a combination of excessive inversion
and plantar flexion at the same time.
This is an inversion ankle sprain which
accounts for about 90% of all ankle sprains
Cont…
 Less common is the Eversion ankle sprain
which involves the ligaments on the inside of
the ankle. Eversion ankle sprains account for
less than 10% of ankle sprains.
Sprains
 Injuries to one or more ligaments in the ankle
 Most commonly injured: Anterior Talofibular
 Sprains are diagnosed by grades which
correlate to varying degrees
Grade I
 First Degree – Mild. One or more ligaments
are stretched. There is minor discomfort,
point tenderness, and little or no swelling. No
loss of stability, or movement of the joint.
Grade II
 Second Degree – moderate. One or more
ligaments are partially torn. There is some
limit of motion, significant swelling, pain,
point tenderness, and loss of function
Grade III
 Third Degree – severe. On or mor eligaments
have been completely ruptured resulting in
joint instability. Extreme pain, loss of
function, point tenderness, and RAPID
swelling.
Treatment
 Protection
 Rest
 Ice
 Compression
 Elevation
 Mri
Why Ice vs. Heat?
 Ice is a vasoconstrictor – It restricts blood
vessels thus reducing and preventing swelling
 Swelling = Pain
 Ice should be applied for 15 minutes about
every hour and a half
 Heat is a vasodilator – increases blood flow to
an area. *Should never be applied to an acute
injury (within 24 hours).
Rehab
 Phase I – ROM, ABC’s, circles, etc.
 Phase II- strengthening
 Phase III – functional strengthening