Help
Options
Question
dorsiflexion is in the ___ plane
click to flip
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't know
Question
inversion is in the ____ plane
Remaining cards (72)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
therex test 2
210: Management of foot and ankle disorders
| Question | Answer |
|---|---|
| dorsiflexion is in the ___ plane | sagittal |
| inversion is in the ____ plane | frontal |
| •ABD/ADD is in _____ plane | transverse |
| pronation is a combo of what 3 movements? | •DF/EVE/ABD |
| supination is a combo of what 3 movements? | •PF/INV/ADD |
| what makes up the talocrural joint? | •Distal tibia and fibula with talus |
| what motions occur at the talocrural joint | PF and DF |
| what ligaments is the talocrural joint supported by? | •Supported by deltoid ligament medially and anterior & posterior talofibular ligaments laterally |
| closed packed position of talocrural joint | DF |
| what makes up the subtalar joint | talus and calcaneus |
| what motions occur at subtalar joint | inversion and eversion |
| what ligaments support the subtalar joint? | •deltoid and lateral collateral ligaments |
| what ligament is most often involved in an ankle sprain | anterior talofibular ligament (limits inversion) |
| is deltoid ligament frequently injured? | not injured very frequently (limits eversion) |
| what is second most injured ankle ligament | calcaneofibular (limits inversion) |
| what ligament in often only injured in severe ankle sprains or dislocations | posterior talofibular |
| Supination of the subtalar joint is caused by ______ rotation of tibia | lateral |
| Pronation of the subtalar joint is caused by _____ rotation of the tibia | medial |
| when during gait do we see supination? | at beginning and end during toe off |
| supination creates a ___ foot | rigid |
| during loading response: Heel strike in neutral or ____ | supination, |
| the LE rotates ____ during loading response | inward |
| during loading response the ____ conforms to ground contour and absorbs forces | foot |
| DF occurs as the ____ moves over the _____ | tibia, ankle |
| what occurs at the tibia during midstance? | ER |
| what occurs at the foot from midstance --> terminal stance | supination (closed pack) and windlass effect |
| *when do dorsiflexors fire in gait?* | - during heel strike to foot flat - during swing phase |
| *when do plantar flexors fire in gait?* | - eccentrically early in stance to control forward mvmt of tiba - Concentric to initiate push off |
| 2 keys for reducing fall risks | DF ROM and PF strength |
| Overuse (Repetitive Trauma) Syndromes | •Tendinitis/Tenosynovitis/Tendinosis |
| what can cause Achilles tendinitis | •Changes in footwear or poor footwear •Changes in training •Repetitive stresses such as jumping, running **decreased DF ROM and posterior chain flexibility** |
| what position of the foot shortens the calf muscles | pronation - ppl with limited DF often pronate to help advance tibia over talus |
| non operative tx for Achilles tendinitis in protection phase | •Rest •Heel lift - not permanent, can help take load off for a short time •Taping •modalities •Activity modification •AROM, gentle stretching •Isometrics |
| therex for Achilles controlled motion/return to function phase | progress stretching and strengthen - Wall stretches, dynamic stretches - Double calf→single→from stretched position - Closed chain gastroc/soleus exercise, eccentrics - Teach proper warm up - Low impact activities, progress activity level |
| shin splints | •Anterior tib tendinitis or stress fx |
| shin splints can be a ____ syndrome | compartment |
| what causes shin splints | - Overuse of anterior tib is common, also weakness - rigid foot - tight gastroc/soleus complex - inadequate shock absorption - increase in training can precipitate |
| why is a rigid foot a cause of shin splints | rigid foot can't absorb shock properly so it is directed up the chain |
| symptoms of shin splints | - pain with active DF - pain when stretched into PF |
| what mm are involved in Medial/Posterior Shin Splints (Medial tibial stress syndrome) | •Inflamed Posterior tibialis •Soleus and flexor digitorum longus/hallucis longus involved •Can also be medial gastroc |
| what can cause Medial/Posterior Shin Splints | •May be overpronator •Difficulty with deceleration of entire chain •Poor footwear •Tight gastroc-soleus |
| symptoms of Medial/Posterior Shin Splints | •Pain with passive pronation at end range or with overpressure |
| protection phase of shin splint tx | rest, taping, modalities, activity modification, AROM and gentle stretching, Isometrics |
| a ___ may help with shin splints | orthotic - but it cannot be soft |
| shin splints Controlled Motion Return to Function Phase | Progress stretching and strengthening - Wall stretches - Dynamic stretches - Dorsiflexion exercises - Hip exercises to decelerate IR/Pronation - Teach proper warm up - Teach proper warm up - Low impact activities, progress activity level |
| plantar fasciitis | - Pain at medial tubercle of calcaneus |
| what causes plantar fasciitis | - Tight gastroc/soleus complex - Hyperpronation |
| what can develop in plantar fascitis? | heel spur |
| symptoms of plantar fasciitis | Pain in a.m. upon arising or after long periods of sitting |
| plantar fasciitis protection phase | Rest, taping, modalities, activity modification, AROM, gentle stretching, isometrics, night splint, OTS orthotics |
| controlled motion/ return to function phase for plantar fasciitis | Progress stretching and strengthening, wall stretches, dynamic stretches, - Double calf→single→progress to a stretched position, foot intrinsic strengthening, Closed chain gastroc/soleus exercise, eccentrics, Low Impact Activities, teach proper warm up |
| what ligaments are involved in inversion ankle sprain | - Anterior talofibular ligament primary involvement - Posterior talofibular torn with massive inversion stress |
| - Instability of mortise joint if ____ torn | tibiofibular ligaments |
| what motion at tibia causes inversion ankle sprain | forced DF and ER (tibial) |
| therex in ankle ligamentous injury protected motion phase | - RICE - grade 1 mobs - PROM, AROM - assistive devices - bracing or taping (horseshoe or kinesiotape- pic 23) |
| therex in controlled motion phase of ankle ligamentous injury | - Friction massage - Grade II Mobilization - AROM - Gentle Stretching gastroc/soleus - Isometrics - Light PREs - Bicycle - Balance Board in sitting, progress to PWB, FWB |
| therex in return to function phase of ankle ligamentous injury | - progress PRE - proprioceptive exercise - CKC - toe raise progression - return to sport activities |
| general considerations for ankle injuries | - address swelling: circulation can be poor -joint mobs grade 1 and 2 - braces: be careful, injury can still occur - shoe or no shoe |
| what should you generally start with for treating ankle injuries | - start with ROM and progress |
| - Long periods of immobilization can be followed by _____pain when WB is begun | plantar surface foot |
| when should a pt wear their shoes during tx? | - if they can't control foot motions - if they have orthotics |
| indications for Total ankle arthroplasty | •Severe arthritis that has failed conservative treatment •Post traumatic arthritis •RA •Avascular necrosis of the talus |
| TAA May be accompanied by lengthening procedure of ____ if decreased DF | Achilles |
| TAA May be accompanied by ____ fusion if significant hindfoot deformity | subtalar |
| max protection phase for TAA | •WB may be restricted from 3-6 weeks •Progression of WB will start in a boot or some type of immobilizer •Work ROM - begin mm setting |
| what motion is no longer available after hindfoot fusion | inversion and eversion |
| TAA post op guidelines | - Progress ROM especially for DF and PF •Progress strengthening, particularly mm endurance •Begin balance/proprioceptive activities |
| how long does non weight bearing last after TAA | varies - generally 12-16 weeks |
| •**NO _____ FOR TRIPLE ARTHRODESIS—PF/DF ONLY | INV/EVE |
| you may not see a TAA pt until ___ weeks | 6 - start from ground zero/ max protection phase |
| thompson test is for the ___ | Achilles tendon |
| anterior drawer test is for ____ | ACL |
| talar tilt test is for ___ | calcaneal fibular ligament |
Created by:
bdavis53102
Popular Physical Therapy sets