583 Foot

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583 Foot
2012-12-15 13:55:42
583 Foot

583 Foot
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  1. –Increased foot flexibility
    –Excessive calcaneal eversion
    –Uneven weight distribution
    –Postural symptoms involving leg, knee, hip, and back
    –Is excessively supple and does not resupinate to form a rigid lever for push-off
    Pes Planus (Flat foot)
  2. –Limited pronation
    –Uneven weight distribution
    –Increased tendency to lateral ankle instability
    –Decreased ankle joint dorsiflexion
    –The cavus foot is rigid and will not evert to become supple because it does not pronate to unlock the midfoot and subtalar joint
    Pes Cavus (High Arch Foot)
  3. •“hypomobility” of the joints of the foot and ankle
    •Associated with a rigid structure, decrease shock absorber or adaptor to changing terrain
    •Does not demonstrate a progressive breakdown in tissue (hypermobile foot)
    •An inflexible foot that causes tissue inflammation with possible joint destruction
    Abnormal Supination
  4. •Generally a “flexible flatfoot”
    •Hypermobile unit
    •Decreased push off during gait cycle
    Abnormal pronation
  5. calluses under the 2nd/3rd/4th metatarsal heads are associated with this because of lack of push off provided by the 1st ray.
    Abnormal pronation
  6. calluses under the 1stand 5th metatarsal heads correlates with this
    Pes cavus foot
  7. At what age should orthotics be prescribed?
    After puberty
  8. Treatment for Pes Cavus
    • Footwear adaptations
    • Ankle support
    • Heel and metatarsal pads
    • Adequate toe box height
  9. A broad dense band of longitudinally arranged collagen fibers
    As increased loads are applied it becomes progressively stiffer to resist deformation
    Originates predominently from the plantar medial aspect of the calcaneus
    Plantar Fasciitis
  10. Most common cause of heel pain
    Usually associated with heel spur
    Causes include inadequate flexibility in the calf muscles, lack of arch support, being overweight, suddenly increasing activity, and spending too much time on the feet
    Plantar Fasciitis
  11. Treatment for plantar fasciitis and Exostosis
    • Ice
    • No barefeet
    • Calf stretch and orthotics
    • Strassburg Sock and night splints
  12. An abnormal bony outgrowth extending from the surface of the bone.  It is actually an increase in the bone mass at the
    site of an irritated lesion in response to overuse, trauma, or                            
    Exostosis (Bony Spur/Heel Spur)
  13. Severe pain or cramp in the anterior portion of the metatarsals
    Occurs when forefoot weight bearing is maldistributed.
  14. Treatment for metatarsalgia
    Metatarsal support
  15. Results in hyperextension of the metatarsophalangeal joints and flexion of the proximal and distal interphalangeal joints
    Claw-toe deformity
  16. Treatment for claw-toe and hammer-toe deformity 
    Good shoes with broad toe box, various forefoot devices and orthotics
  17. Consists of an extension contracture at the metatarsophalangeal joint and flexion contracture at the proximal interphalangeal joint; the distal interphalangeal joint may be flexed, straight,
    or hyperextended
    Hammer-toe deformity
  18. Associated with a flexion deformity of the distal interphalangeal        joint. It can occur on any of the four lateral toes. 
    Mallet toe
  19. Treatment for mallet toe
    Not really needed. More cosmetic
  20. •Restricted or loss of motion of the joint connecting the great toe to the metatarsal
    •Condition in which extension of  the big toe is limited  because of osteoarthritis or spurring of the first metatarsophalangeal joint.

    on dorsum of joint on extension
    Hallux Rigidus/Limitus
  21. Treatment for Hallux Rigidus/Limitus
    Limiting extension of joint
  22. Medial deviation of the head of the first metatarsal bone occurs in relation to the center of the body and lateral deviation of the head occurs in relation to the center of the foot.
    Hallux Valgus
  23. Treatment for hallus valgus
    Splints and proper footwear
  24. The second toe is longer than the first.
    Morton's (Atavistic or Grecian) Foot
  25. Neuroma like mass of the neurovascular bundle – intermetatarsal spaces
    Tenderness found between metatarsal heads not on the metatarsal heads
    It is the belief that the interdigital nerve is irritated by the intermetatarsal ligament which sags plantarward toward the nerve as the height of the transverse metatarsal arch decreases
    Morton's Neuroma
  26. Condition is worsened by pronation and excessive toe off
    Usually treated by a device that prevents extension of the first MTP joint
    Result of hyperextension of the first metatarsal phalangeal joint
    Turf Toe
  27. Inflammation and thickening of the bursa of the joint of the great toe, usually with marked enlargement of the joint and lateral displacement of the toe
  28. Causes of bunions (3)
    • 1. Heredity
    • 2. Degenerative bone or joint disease (ie.Arthritis)
    • 3. Wearing of tight fitting shoes and high heels which forces the toes together and displace weight onto the
    • forefoot
  29. Traditionally tailors crossed their legs and held their feet in such a way that the lateral aspect of the 5th metatarsal head rested against the floor
    It is a painful enlargement or prominence of the 5th
    metatarsal head
    Pain generally precipitated by shearing forces of the shoe creating a bursa overlying the 5th MT head
    Tailor's (Bunionette) Bunion
  30. Condition of the thickest and strongest tendon in the body
    Can result from inadequate strength of gastroc-soleus
    complex; overuse of gastroc-soleus complex; degeneration of the tendon
    Achilles Tendonitis
  31. Tenderness at navicular insertion or just behind medial malleolus along the tendon
    Posterior Tibialis Tendonitis
  32. Treatment for Posterior Tibialis Tendonitis
    • Orthotics
    • Stretching
    • Exercises to strengthen weakened muscles
  33. Chronic symptoms in peripatellar area
    Aggravated by climbing stairs or sitting with a flexed knee position
    Abnormal calcaneal eversion leads to excessive internal rotation of tibia relative to femur producing a transverse plane torque at the knee joint 
    Patellofemoral Syndrome
  34. Inflammation of origin of anterior tibialis muscle due to weakness or tight calf muscles
    Shin Splints
  35. Treatment for shin splints
    • Ice
    • Anti-inflammatories
    • Orthotics
    • ROM exercise
    • Support sleeves
  36. Dermatological inflammation as a result of the nail growing in malposition into the edges of the nail bed
    Extra care for diabetics
    Ingrown Toe Nail
  37. Inflammation of the sesamoid bones
    Tx: ice, orthotics, NSAID’s etc
  38. Due to excessive repetitive trauma to a specific area of the foot or leg
    Rest, ice and elevation if edema is present, casting if healing does not occur
    Metatarsal Stress Fracture
  39. Contracture of the plantar fascia
    Surgery for area 
    Recurring cases -> total excision of plantar fasica
  40. Corn or callus?
    Occur to the dorsum of the toes or between the toes
  41. Corns or callus?
    Occur to the plantar aspect of the foot
  42. Treatment for metatarsus adductus
    • Stretching and splints
    • Orthotics
    • Surgery in rare cases
  43. What % of diabetics have diabetic foot disease?
    20 %
  44. •Simple wearing and tearing away of the cartilage of the joints.
    •Age, excessive weight, ill-fitting shoes and trauma (injury) are the basic causes.
    •Causes excessive strain and the wearing away of cartilage in the joints of the foot.
    •Movement becomes very difficult and painful.
    •Pain and swelling worsens while standing or walking, and stiffness usually occurs after periods of rest.
    Osteoarthritis (OA)
  45. • A form of arthritis that also leads to foot complications.
    •Excess uric acid crystals collect in and around the joints of the big toe.
    •The big toe joint is commonly the focal point due to the stress and pressure it experiences during walking and other weight bearing activities.
    •This leads to severe pain in the big toe.
    •More common in men.
  46. •It can develop at any age and there is no  known cause for this condition.
    •Most crippling form of the disease that can affect people of all ages.
    •It can cause severe deformities of the joints with associated fatigue of the entire body.
    •People who suffer from rheumatoid arthritis often develop severe forefoot problems such as bunions, hammer toes, claw toes and others.
    Rheumatoid Arthritis (RA)
  47. Treatment for arthritic foot
    • Proper footwear
    • Orthotics and/or forefoot supports