210: Management of foot and ankle disorders
Help!
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| dorsiflexion is in the ___ plane | show 🗑
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| inversion is in the ____ plane | show 🗑
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| •ABD/ADD is in _____ plane | show 🗑
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| pronation is a combo of what 3 movements? | show 🗑
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| supination is a combo of what 3 movements? | show 🗑
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| show | •Distal tibia and fibula with talus
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| what motions occur at the talocrural joint | show 🗑
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| show | •Supported by deltoid ligament medially and anterior & posterior talofibular ligaments laterally
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| closed packed position of talocrural joint | show 🗑
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| what makes up the subtalar joint | show 🗑
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| show | inversion and eversion
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| show | •deltoid and lateral collateral ligaments
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| show | anterior talofibular ligament
(limits inversion)
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| show | not injured very frequently
(limits eversion)
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| show | calcaneofibular
(limits inversion)
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| what ligament in often only injured in severe ankle sprains or dislocations | show 🗑
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| show | lateral
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| Pronation of the subtalar joint is caused by _____ rotation of the tibia | show 🗑
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| show | at beginning and end during toe off
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| supination creates a ___ foot | show 🗑
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| during loading response: Heel strike in neutral or ____ | show 🗑
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| the LE rotates ____ during loading response | show 🗑
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| during loading response the ____ conforms to ground contour and absorbs forces | show 🗑
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| show | tibia, ankle
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| what occurs at the tibia during midstance? | show 🗑
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| show | supination (closed pack) and windlass effect
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| show | - during heel strike to foot flat
- during swing phase
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| show | - eccentrically early in stance to control forward mvmt of tiba
- Concentric to initiate push off
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| show | DF ROM and PF strength
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| show | •Tendinitis/Tenosynovitis/Tendinosis
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| what can cause Achilles tendinitis | show 🗑
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| what position of the foot shortens the calf muscles | show 🗑
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| non operative tx for Achilles tendinitis in protection phase | show 🗑
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| show | 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
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| show | •Anterior tib tendinitis or stress fx
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| shin splints can be a ____ syndrome | show 🗑
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| show | - Overuse of anterior tib is common, also weakness
- rigid foot
- tight gastroc/soleus complex
- inadequate shock absorption
- increase in training can precipitate
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| show | rigid foot can't absorb shock properly so it is directed up the chain
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| symptoms of shin splints | show 🗑
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| show | •Inflamed Posterior tibialis
•Soleus and flexor digitorum longus/hallucis longus involved
•Can also be medial gastroc
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| what can cause Medial/Posterior Shin Splints | show 🗑
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| symptoms of Medial/Posterior Shin Splints | show 🗑
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| show | rest, taping, modalities, activity modification, AROM and gentle stretching, Isometrics
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| show | orthotic - but it cannot be soft
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| shin splints Controlled Motion Return to Function Phase | show 🗑
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| show | - Pain at medial tubercle of calcaneus
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| show | - Tight gastroc/soleus complex
- Hyperpronation
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| show | heel spur
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| symptoms of plantar fasciitis | show 🗑
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| show | Rest, taping, modalities, activity modification, AROM, gentle stretching, isometrics, night splint, OTS orthotics
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| show | 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
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| show | - Anterior talofibular ligament primary involvement
- Posterior talofibular torn with massive inversion stress
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| show | tibiofibular ligaments
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| what motion at tibia causes inversion ankle sprain | show 🗑
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| therex in ankle ligamentous injury protected motion phase | show 🗑
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| show | - Friction massage
- Grade II Mobilization
- AROM
- Gentle Stretching gastroc/soleus
- Isometrics
- Light PREs
- Bicycle
- Balance Board in sitting, progress to PWB, FWB
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| show | - progress PRE
- proprioceptive exercise
- CKC
- toe raise progression
- return to sport activities
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| show | - address swelling: circulation can be poor
-joint mobs grade 1 and 2
- braces: be careful, injury can still occur
- shoe or no shoe
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| show | - start with ROM and progress
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| show | plantar surface foot
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| when should a pt wear their shoes during tx? | show 🗑
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| show | •Severe arthritis that has failed conservative treatment
•Post traumatic arthritis
•RA
•Avascular necrosis of the talus
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| show | Achilles
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| show | subtalar
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| show | •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
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| show | inversion and eversion
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| show | - Progress ROM especially for DF and PF
•Progress strengthening, particularly mm endurance
•Begin balance/proprioceptive activities
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| show | varies - generally 12-16 weeks
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| •**NO _____ FOR TRIPLE ARTHRODESIS—PF/DF ONLY | show 🗑
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| you may not see a TAA pt until ___ weeks | show 🗑
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| show | Achilles tendon
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| show | ACL
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| talar tilt test is for ___ | show 🗑
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