Ankle Anatomy & Injuries

CLASSES
Common Injuries

Injury Management or Treatment LINKS

P.R.I.C.E.
What is a Strain or Sprain
Orthotic Inserts
Compartment Syndrome
Other Links Of
Interest
American Podiatric Medical
Association

Plantar Fasciitis

American Orthopaedic Foot & Ankle

Society

Foot & Ankle

Dr Z. (Great Graphics & "layman"

explinations)

Sole Supports Custom Orthotic Inserts

These are
suggestions and NO
information on this
website should
replace the opinion or
advice of a Licensed
Physician. If you have
any questions at all
about your injury
please contact the
nearest licensed
healthcare
professional,
physician, or
emergency room.  THIS
WEBSITE IS FOR
INFORMATIONAL PURPOSES
ONLY AND SHOULD NOT
TAKE THE PLACE OF
APPROPRIATE MEDICAL
TREATMENT!

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Last updated on 27 January 2005 19:29:48

 Foot & Ankle Anatomy
Bones & Joints
      Foot 28 bones
  Phalanges or Toes
   1 to 5
   All except 1 (great toe) have 3 bones
st
   Great toe or 1 digit has 2 bones
   Interphalangeal Joints
   Joints in between toe bones
»   Proximal
»   Distal
st
   Under 1 toe 2 sesmoid bones
   Make up ball of foot & assist with flexion of toe
Bones of Foot
      Metatarsals
  Long bones of foot
  Numbered 1-5
  Metatarsophalangeal Joints
   Joints between phalanges & metatarsals
 
Bones of the MidFoot
      Region-between Metatarsals & the Talus & Calcaneus
  Several bones of that articulate between metatarsals & talus & calcaneus of
ankle
      Ankle
   Junction/Joint between talus & calcaneus of foot & the fibula & tibia of lower leg
 
Ankle
      Tibia & Fibula articulate @ both proximal & distal ends
    Held together by ligaments & muscles
    Tibia (distal)
    forms Medial Malleoli of ankle
    Fibula (distal)
    Forms Lateral Malleoli of ankle
 
Arches of the Foot
      3 Arches, to absorb shock, on the Plantar Aspect
   Transverse
th
    Front of calcaneus to 5 metatarsal
   Metatarsal
    Runs along metatarsal heads
   Longitudinal
    Calcaneus to metatarsal heads
 

Flat foot/Poor Shock Absorption

Muscles of the Lower Leg

      Peroneal Muscles
   Peroneus Brevis & Longus
   Run along lateral aspect of foot
   Helps stabilize ankle
Muscles of the Lower Leg
      Gastrocnemius
   Calf attaches to Achilles Tendon
   Helps with propulsion
      Soleus
   Part of calf complex
   Under Gastrocnemius
   Helps with propulsion
Ligaments of the Lateral Ankle
      Anterior TaloFibular (ATF)
    Most often sprained
      Posterior TaloFibular (PTF)
nd
    2 most often
      CalcaneoFibular (CFL)
      Ligaments on lateral side not as strong as medial ligament (Deltoid)
Ligaments of the Medial Ankle
      Deltoid Ligament
    Very strong, stronger than all lateral ligaments combined
    3 bands to deltoid
    Anterior
    Middle
     Posterior
    Usually Fx rather than sprain Medial aspect
      Posterior Talocalcaneal (PTC)
      Posterior Talotibial (PTT)
Foot & Ankle Injuries
Ligament Injuries
      Sprains
  Grades I-III
  Joint forced beyond normal ROM
      Sprains of LE
  Great toe
  Arch
  Lateral ankle
  Medial ankle
1st Toe/Great Toe Sprain
      Function
    Push off when walking or running & maintain balance
      Cause of sprain
    Excessive force in flexion or extension
    More common with turf vs. grass
      Signs & Sx
    Pain
    Swelling
    Discoloration
    Inability to walk or run normally
      Tx
    PRICE
    Tape toe
Arch Sprain
      Transverse & Longitudinal
      Cause
    Running on hard surface
    Improper footwear
    Repetitive stress
      Signs & Sx
    Pain with walking & running
    Swelling over plantar aspect
      Tx
    PRICE
    Possibly pad
    Strengthening Exercises for arch
    Stretching exercises
Lateral Ankle Sprains
       Most common ankle sprain 85%
       Cause:
     Excessive inversion of ankle
     Severity depends on:
     Force
     Shoe type
     Strength of muscles
      Prior Hx & Tx
       Signs & Sx:
     Decreased AROM
     Pain
     Swelling
     May discolor
       Tx:
     PRICE
     Crutches may be necessary based on severity
Medial Ankle Sprains
       Only 15% of sprains are due to eversion
     Strength of Deltoid
     Bony block Fibula
       Severity depends on:
     Force
     Shoe type
     Strength of muscles
     Prior Hx & Tx
       Signs & Sx:
     Decreased AROM
     Pain
     Swelling
     May discolor
       Tx:
     PRICE
     Radiographs usually necessary to r/o Fx
     Crutches usually necessary based on severity
Ankle Dislocation
      Anterior Dislocation
    Heel strikes ground forcefully
      Posterior Dislocation
    Blow to anterior portion of leg with ankle plantarflexed
      Signs & Sx:
    Pain
    Refusal to move
    Refusal to allow palpation
    Deformity & inability to move or use foot
    Swelling rapid
      Tx: Immediate activation 911
    Splint lower leg & ankle
    Ice over splint
Achilles Tendonitis
      Overstretching or excessive tension to tendon
      Signs & Sx:
    Pain with palpation
    Increases with dorsiflexion
    Crepitus
    Weak plantarflexion
      Tx: PRICE
    Stretching
     strengthening
 
Achilles Tendon Rupture
       Athlete falls immediately in Pain
       shot in back of leg
       Cause:
    Forceful dorsiflexion
    Blow to Achilles tendon
    Sudden forceful gastrocnemius contraction
       Signs & Sx:
    Difficulty or inability to walk
    Weakness
    Complete loss of plantarflexion
    Swelling
    Depression of Achilles
    Pain
       Tx: PRICE
    Splint
    Crutches for NWB
    Refer to physician for surgical repair of tendon
Bone Injuries
      Cause:
    Direct impact
    Repetitive use of stress
      Signs & Sx:
    Pain
    Swelling
    Pressure
    Inability to move part
    Crepitus
    Possible displacement
      Tx:
    PRICE
    Splint
    Refer to physician
5th Metatarsal Avulsion Fx
(Jones Fx)
      Most common avulsion Fx
      Forceful inversion
   Muscles contract to stabilize ankle & peroneus brevis is pulled from attachment
      Tx: PRICE
   Refer to team physician
Epiphyseal Injury Tibia or Fibula
      Fx of the growth plate on tibia or fibula
      Forceful plantarflexion & inversion
      Signs & Sx:
  Pain & swelling over epiphysis
  Difficulty walking or running
      Tx:
  Splint
   Refer for Radiographs
   Serious because has potential to stunt growth
Stress Fx
      Common in tibia, fibula, & or metatarsals
      Repetitive stress, usually running
      Signs & Sx:
   Pain, usually increases at night & after activity
   Swelling may be present over bone
   Painful with percussion or vibration
   + Bone scan (will not show on X-ray 3 wks)
      Tx:
   4-6 weeks (minimum) rest
   Crutches to eliminate FWB
   Potentially serious if overlooked
Medial Tibial Stress Syndrome
Shin Splints
      Muscles on medial tibia torn & irritated
      Signs & Sx:
    Athlete c/o inability to walk or run without pain
    May be swelling
    Tenderness along medial tibia
    Tight or poor flexibility of gastrocnemius
      Tx: PRICE
    Change activity to aerobic, but NWB
    Tape?
    Shoes
    Stretching
    Orthotic inserts
Anterior Compartment Syndrome
       Often mistaken for shin splints
       Muscles of compartment enclosed in sheath of connective tissue
     Overuse or Impact causes swelling in compartment
     Pressure on connective sheath increases
       Signs & Sx:
     Pain increases with activity
     Pain does not subside after rest
     Red, hot, skin, decreased AROM of foot
       Tx:
     Refer to team physician immediately
     Incision to relieve pressure
     Bandage or support
Contusions
      Shin guards designed to help prevent
      Impact causes:
   Swelling
   Pain
   Discoloration
   Decreased AROM
      Tx:
   Ice
   Restore full AROM
   Donut pad for protection under shin guard