athletic injury 2

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dvdromm
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285090
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athletic injury 2
Updated:
2014-10-07 00:23:11
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athletic injury
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athletic injury
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athletic injury
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  1. Arch - ball of the foot
    transverse arch
  2. Inside longitudinal arch
    medial longitudinal arch
  3. Outside longitudinal arch
    lateral longitudinal arch
  4. Pronation v. Supination
    • pro -inward
    • sup- outward
  5. Prevention of Foot Injuries
    • appropriate footwear
    • correcting biomechanical structural deficiencies through orthotics
    • paying attention to hygiene
  6. Selecting Appropriate Footwear
    For pronators a rigid shoe is recommended while supinators require more flexible footwear with increased cushioning
  7. Checking foot pulses
    • –Can be assessed at posterior tibial and dorsalis pedis arteries
    • –Dorsalis pedis pulse felt between extensor digitorum and hallucis longus tendons
    • –Posterior tibial located behind medial malleolus along Achilles tendon
  8. Apophysitis of the Calcaneus (Sever’s Disease)
    • Etiology - Traction injury at apophysis of calcaneus, where Achilles attaches
    • Signs -
    • •Pain occurs at posterior heel below Achilles attachment in children and adolescent athletes
    • •Pain occurs during vigorous activity and ceases following activity
  9. Tarsal Tunnel Syndrome
    • Area behind medial malleolus forming tunnel with osseous floor and roof composed of flexor retinaculum.
    • –Etiology
    • •Any condition that compromises tibialis posterior, flexor hallucis longus, flexor digitorum, tibial nerve, artery or vein
    • •May result from previous fracture, tenosynovitis, acute trauma or excessive pronation
  10. Tarsometatarsal Fracture Dislocation (Lisfranc Injury)
    • –Etiology
    • •Occurs when foot hyperplantarflexed with foot already plantaflexed and rearfoot locked resulting in dorsal displacement of metatarsal bases
    • –Sign and Symptoms
    • •Pain and inability to bear weight, swelling and tenderness localized on dorsum of foot
    • •Possible metatarsal fractures, sprains of 4th and 5th tarsometatarsal joints, may cause severe disruption of ligaments
  11. Pes Planus Foot (Flatfoot)
    • –Etiology
    • •Associated with excessive pronation, forefoot varus, wearing tight shoes (weakening supportive structures) being overweight, excessive exercise placing undo stress on arch
    • –Sign and Symptoms
    • •Pain, weakness or fatigue in medial longitudinal arch; calcaneal eversion, bulging navicular, flattening of medial longitudinal arch and dorsiflexion with lateral splaying of 1st metatarsal
  12. Pes Cavus (High Arch Foot)
    • –Etiology
    • Higher arch than normal; associated with excessive supination, accentuated high medial longitudinal arch
    • –Sign and Symptoms
    • •Poor shock absorption resulting in metatarsalgia, foot pain, clawed or hammer toes
    • •Associated with forefoot valgus, shortening of Achilles and plantar fascia; heavy callus
    • development on ball and heel of foot
  13. Morton’s Toe
    • –Etiology
    • •Abnormally short 1st metatarsal, making 2nd toe look longer
    • •More weight bearing occurs on 2nd toe as a result and can impact gait
    • •Stress fracture could develop
  14. *Plantar Fasciitis
    –Catch all term used for pain in proximal arch and heel
    • –Plantar fascia, dense, broad band of connective tissue attaching proximal and medially on the calcaneus and fans out over the plantar aspect of the foot
    • –Works in maintaining stability of the foot and bracing the longitudinal arch
    • –Etiology
    • •Increased tension and stress on fascia (particularly during push off of running phase)
    • •Change from rigid supportive footwear to flexible footwear
    • •Poor running technique
    • •Leg length discrepancy, excessive pronation, inflexible longitudinal arch, tight gastroc-soleus complex
    • •Running on soft surfaces, shoes with poor support
    • --Sign and Symptoms
    • –Pain in anterior medial heel, along medial longitudinal arch
    • –Increased pain in morning, loosens after first few steps
    • –Increased pain with forefoot dorsiflexion
  15. Jones Fracture
    similar symptoms to lateral ankle sprain
    • –Etiology
    • •Fracture of metatarsal caused by inversion and plantar flexion, direct force (stepped on) or repetitive trauma
    • •Most common = base of 5th metatarsal
  16. Metatarsal Stress Fractures
    • –Etiology
    • •2nd metatarsal fracture (March fracture)
    • •Change in running pattern, mileage, hills, or hard surfaces
  17. Bunion (Hallux Valgus Deformity)
    • –Etiology
    • •Exostosis of 1st metatarsal head; associated with forefoot varus; shoes that are too narrow, pointed or short
    • •Bursa becomes inflamed and thickens, enlarging joint, and causing lateral malalignment of great toe
    • •Bunionette (Tailor’s bunion) impacts 5th metatarsophalangeal joint - causes medial displacement of 5th toe
  18. Sesamoiditis
    • –Etiology
    • •Caused by repetitive hyperextension of the great toe resulting in inflammation
    • –Sign and Symptoms
    • •Pain under great toe, especially during push off
    • •Palpable tenderness under first metatarsal head
  19. Metatarsalgia
    • –Etiology
    • •Pain in ball of foot (2nd and 3rd metatarsal heads) 
    • •Restricted extensibility of gastroc-soleus complex
    • •Typically emphasizes toe off phase during gait
    • •Fallen metatarsal arch
  20. Great Toe Hyperextension (Turf Toe)
    • –Etiology
    • •Hyperextension injury resulting in sprain of 1st metatarsophalangeal joint
    • May bethe result of single or repetitive trauma
  21. Ankle
    Lateral ligaments (outside)
    deltoid ligaments (inside)
  22. *Preventing Injury in the
    Lower Leg and Ankle
    • Achilles Tendon Stretching
    • Strength Training
    • Neuromuscular Control Training
    • Footwear
    • Preventive Taping and Orthoses
  23. Ankle Injuries: Sprains
    –Single most common injury in the physically active caused by sudden inversion or eversion moments
    • Inversion Sprains
    • –Most common and result in injury to the lateral ligaments
    • Eversion Ankle Sprains
    •  - Represent 5-10% of all ankle sprains
  24. Syndesmotic Sprain
    • –Etiology
    • •Injury to the distal tibiofemoral joint (anterior/posterior tibiofibular ligament)
    • •Torn w/ increased external rotation or dorsiflexion
    • •Injured in conjunction w/ medial and lateral ligaments
  25. Achilles Tendon Rupture
    • –Etiology
    • •Occurs w/ sudden stop and go; forceful plantar flexion w/ knee moving into full extension
    • •Commonly seen in athletes > 30 years old
    • –Can be observed at any age
    • •Generally has history of chronic inflammation
  26. knee ligaments
    • Anterior Cruciate
    • Posterior Cruciate
    • Medial Collateral
    • Lateral Collateral
  27. Q-Angle
    • –Lines which bisect the patella
    • relative to the ASIS and the tibial tubercle
    • –Normal angle is 10 degrees for
    • males and 15 degrees for females
    • –Elevated angles often lead to
    • pathological conditions associated w/ improper patella tracking
  28. Osteochondritis Dissecans
    –Etiology

    • •Partial or
    • complete separation of articular cartilage and subchondral bone

    • •Cause is
    • unknown but may include blunt trauma, possible skeletal or endocrine
    • abnormalities, prominent tibial spine impinging on medial femoral condyle, or
    • impingement due to patellar facet

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