Anatomy- BonesAnatomy- Bones 28 bones (called phalanges)28 bones (called phalanges) Each toe has three bones (proximal, middle, distal) except the big Each toe has three bones (proximal, middle, distal) except the big

toe which only has the proximal and distal toe which only has the proximal and distal Toe joints are Toe joints are interphalangeal jointsinterphalangeal joints Bones under big toe are called Bones under big toe are called sesamoidssesamoids which ease muscular which ease muscular

movement over a bony surface (assist flexion)movement over a bony surface (assist flexion) MetatarsalsMetatarsals are long bones of the foot (numbered 1 to 5) are long bones of the foot (numbered 1 to 5) Metatarsophalangeal jointsMetatarsophalangeal joints are joints between the metatarsals are joints between the metatarsals

and phalanges and phalanges MidfootMidfoot contains small several bones that joint together at the joint contains small several bones that joint together at the joint

and produce small movements and produce small movements Calcaneus is the heel bone Calcaneus is the heel bone Medial malleolusMedial malleolus is the end of the tibia on the medial side and the is the end of the tibia on the medial side and the

end of the fibula end of the fibula Lateral malleolusLateral malleolus is the end of the fibula at the lateral aspect is the end of the fibula at the lateral aspect

Anatomy Anatomy Arches of the Foot Arches of the Foot

3 arches on planter (bottom) of 3 arches on planter (bottom) of foot foot

Purpose of archesPurpose of arches shock shock absorbant absorbant

Transverse archTransverse arch in front of the in front of the heel and goes to the fifth heel and goes to the fifth metacarpal to the navicular bone metacarpal to the navicular bone

Longitudinal archLongitudinal arch runs from the runs from the calcaneus to the metatarsal heads calcaneus to the metatarsal heads

Metatarsal archMetatarsal arch runs along the runs along the metatarsal heads metatarsal heads

Anatomy- MusclesAnatomy- Muscles

Peroneal muslces Peroneal muslces ((proneus brevis and proneus brevis and proneus longus) attatch to proneus longus) attatch to the lateral aspect and the lateral aspect and under side of the foot to under side of the foot to stabilize the lateral aspect stabilize the lateral aspect of the footof the foot

GastrocnemiusGastrocnemius attaches attaches by the Achilles tendon and by the Achilles tendon and allows the athletes to allows the athletes to propel themselves when propel themselves when

runningrunning

Anatomy- Ligaments Anatomy- Ligaments

Lateral ligamentsLateral ligaments include anterior include anterior talofibular, posterial talofibular, talofibular, posterial talofibular, calcaniofibular ligamentscalcaniofibular ligaments hold bony hold bony structures together on lateral side (weaker structures together on lateral side (weaker than medial side)than medial side)

Medial ligamentsMedial ligaments includes deltoid includes deltoid covers the entire medial side, maintains covers the entire medial side, maintains stability (especially during eversion)stability (especially during eversion)

Prevention Prevention Wear shoes!!! Wear shoes!!! they they

provide ankle and foot provide ankle and foot support support

Supportive ankle tapping to Supportive ankle tapping to prevent ankle inversion prevent ankle inversion

Wear shin guardsWear shin guards to to prevent contusions of the prevent contusions of the lower leglower leg

Strengthing and conditioning Strengthing and conditioning programs programs

If physicians find a weakness If physicians find a weakness in the leg they should be in the leg they should be replaced in rehabilitationreplaced in rehabilitation

Ligament Injuries Ligament Injuries

Great Toe SprainsGreat Toe Sprains Excessive force is applied to the Excessive force is applied to the

great (big) toe during flexion or great (big) toe during flexion or extensionextension

Cause: stubbing your toe, Cause: stubbing your toe, suddenly stopping when suddenly stopping when running, and landing awkwardly. running, and landing awkwardly.

Symptoms: pain, tenderness, Symptoms: pain, tenderness, unable to move toe, swelling, unable to move toe, swelling, and bruising and bruising

Treatment: PRICE Treatment: PRICE

Ligament injuries Cont…Ligament injuries Cont…

Arch SprainArch Sprain Causes: prolonged stress on the feet, Causes: prolonged stress on the feet,

overstretching overstretching Symptoms: pain, tenderness, and sometimes Symptoms: pain, tenderness, and sometimes

bruising on bottom of foot bruising on bottom of foot Treatment: PRICE Treatment: PRICE

Ligament Injuries Cont…Ligament Injuries Cont…

Lateral and Medial Ankle sprains Lateral and Medial Ankle sprains When the ankle is inverted the lateral ligaments are injured, When the ankle is inverted the lateral ligaments are injured,

when everted the deltoid ligaments are injuredwhen everted the deltoid ligaments are injured 85% of ankle sprains are caused by excessive inversion 85% of ankle sprains are caused by excessive inversion The ankle is the most often sprained part of the bodyThe ankle is the most often sprained part of the body Causes: awkwardly planting the foot, stepping on an irregular Causes: awkwardly planting the foot, stepping on an irregular

surface, during athletic events when one player steps on surface, during athletic events when one player steps on anotheranother

Symptoms: swelling, pain, and joint may throb, difficulty walking, Symptoms: swelling, pain, and joint may throb, difficulty walking, discoloration, redness, and warmthdiscoloration, redness, and warmth

Treatment: PRICE!Treatment: PRICE!

Ligament Injuries Cont… Ligament Injuries Cont…

Ankle dislocationAnkle dislocation Causes: foot is forcefully flexed Causes: foot is forcefully flexed

downwards injuring the downwards injuring the posterior aspect, or the heel posterior aspect, or the heel strikes the ground forcefully strikes the ground forcefully injuring the anterior aspectinjuring the anterior aspect

Symptoms: pain, athlete will Symptoms: pain, athlete will refuse to move, inability to refuse to move, inability to move the foot, deformity, rapid move the foot, deformity, rapid swellingswelling

Treatment: call 911, splint the Treatment: call 911, splint the lower leg/ankle, ice, team lower leg/ankle, ice, team physician should relocate the physician should relocate the bonebone

Muscle and Tendon Injuries Muscle and Tendon Injuries Achilies tendonitis Achilies tendonitis

Inflammation of the achilles tendon Inflammation of the achilles tendon Causes: repetitive running jumping Causes: repetitive running jumping

and landing, causes the cells in the and landing, causes the cells in the tendon to break down prematurely tendon to break down prematurely

Symptoms: gradual onset of pain, Symptoms: gradual onset of pain, tenderness, swelling, redness, tenderness, swelling, redness, crepitus, and you can sometime feel crepitus, and you can sometime feel it creaking when you press your it creaking when you press your fingers into the tendon and ankle fingers into the tendon and ankle

Treatment: ice and pressure, refer to Treatment: ice and pressure, refer to physician, gentle stretching and physician, gentle stretching and strengthening exercises strengthening exercises

Muscle and Tendon Injuries Cont…Muscle and Tendon Injuries Cont…

Achilles Tendon Rupture Achilles Tendon Rupture Largest tendon in the bodyLargest tendon in the body Grow weak and thin with age Grow weak and thin with age Illnesses such as arthritis and Illnesses such as arthritis and

diabetes and some antibiotics diabetes and some antibiotics increase the chance of this injury increase the chance of this injury

Most commonly occurs in middle-Most commonly occurs in middle-aged male athletes aged male athletes

Causes: forceful push off while Causes: forceful push off while knee is straight, trip or stumble, fall knee is straight, trip or stumble, fall from high heights from high heights

Symptoms: severe pain on tendon Symptoms: severe pain on tendon sound of a loud pop or snap, feel sound of a loud pop or snap, feel gap in tendon, swelling and gap in tendon, swelling and stiffness, bruising, weaknessstiffness, bruising, weakness

Treatment: iced, call 911, surgeryTreatment: iced, call 911, surgery

Bone InjuriesBone Injuries

Fifth Metatarsal Avulsion Fracture (Jones Fifth Metatarsal Avulsion Fracture (Jones Fracture) Fracture)

Most common avulsion fracture Most common avulsion fracture When the ankle is forced into inversion the When the ankle is forced into inversion the

muscles contract forcefully to stabilize the lateral muscles contract forcefully to stabilize the lateral aspect of the ankle and the proneus brevis aspect of the ankle and the proneus brevis tendon pulls apart of the bone away at its tendon pulls apart of the bone away at its attachment attachment

Symptoms: swelling, bruising, pain in the middle Symptoms: swelling, bruising, pain in the middle out side of the footout side of the foot

Treatment: cast, doctor Treatment: cast, doctor

Bone Injuries Cont…Bone Injuries Cont…

Epiphyseal Injury of Distal Tibia and Fibula Epiphyseal Injury of Distal Tibia and Fibula Growth plates become injured when ankle is forced Growth plates become injured when ankle is forced

into planter flexion and inversioninto planter flexion and inversion Symptoms: pain, swelling, difficulty walking Symptoms: pain, swelling, difficulty walking Treatment: splint, refer to a doctor Treatment: splint, refer to a doctor

Stress FractureStress Fracture Most commonly occurs on tibia, fibula, and Most commonly occurs on tibia, fibula, and

metatarsals metatarsals Causes: repetitive stress, usually running Causes: repetitive stress, usually running Symptoms: pain, swelling, Symptoms: pain, swelling, Treatment: rest, refer to physician, sometimes castedTreatment: rest, refer to physician, sometimes casted

Other Common InjuriesOther Common Injuries Shin splintsShin splints

Causes: wearing bad shoes, being Causes: wearing bad shoes, being out of shape for the type of running out of shape for the type of running event, tight calf musclesevent, tight calf muscles

Symptoms: pain, swelling, lumps Symptoms: pain, swelling, lumps rednessredness

Treatment: PRICE Treatment: PRICE Anterior Compartment Syndrome Anterior Compartment Syndrome

Muscles on the anterior aspect of Muscles on the anterior aspect of the tibia are enclosed by the tibia are enclosed by connective tissue and if overused connective tissue and if overused or severely impacted the tissue or severely impacted the tissue swellsswells

Symptoms: pain, hot, red, loss of Symptoms: pain, hot, red, loss of movement, area is hardmovement, area is hard

Treatment: refer to physician Treatment: refer to physician immediately where they will make immediately where they will make an incision an incision

Other Common Injuries Cont…Other Common Injuries Cont… Contusions Contusions

Impact of a ball stick or foot on Impact of a ball stick or foot on shin shin

Symptoms: swelling, pain, Symptoms: swelling, pain, discoloration, limp, loss of discoloration, limp, loss of motionmotion

Treatment: ice and rest Treatment: ice and rest Toe abnormalitiesToe abnormalities

Hammer Toe- the middle joint Hammer Toe- the middle joint of the toe is flexed and the of the toe is flexed and the metatarssal and distal metatarssal and distal phalangeal joint is phalangeal joint is hyperextendedhyperextended

Halux Valgus (Bunion) – Halux Valgus (Bunion) – excessive pressure on the excessive pressure on the great toe toward the midline great toe toward the midline from poor footwear from poor footwear

Other Common Injuries Cont…Other Common Injuries Cont…

Ingrown Toenail – Ingrown Toenail – where the nail grows where the nail grows into the surrounding into the surrounding soft tissue from poor soft tissue from poor trimming of the nail. trimming of the nail. (trim nail straight (trim nail straight across and not too across and not too short)short)

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