Ankle & Foot

Question 1

Achilles Tendinopathy

Answer 1

-painful overuse of tendon; male athletes
-Tendinitis: presence of inflammatory cells
-Tendinosis: degeneration, absence of inflammatory cells

S/S: pain at insertion site, swelling of tendon

Cause: overuse, trauma, eccentric loading, pronation, flat floot, weakness

Better: rest

Worse: walking, running, jumping

Treatment:
-PT:
Acute: compression, cryotherapy, rest, heel wedge
Chronic: stretching, night splints, strengthening

Question 2

Ankle Sprains

Answer 2

-sprain of ankle ligaments
-lateral ligaments MC
-Syndesmotic sprains
-Medial ligaments LC

S/S: pain, swelling, redness, loss of ROM, cannot bear weight

Cause: rapid inversion (L), eversion (M), planted DF with ER (H)

Better: NWB, immobilization

Worse: WB

Treatment:
-PT: mobilizations
Phase 1: inflammation, edema
Phase 2: decrease pain, ROM, proprioception
Phase 3: ROM, strength, return to function

Question 3

Shin Splints

Answer 3

-pain on anterior/medial shins
-Medial tibial stress syndrome
-common in runners

S/S: pain over shin, increased with WB

Cause: training issues, biomechanical issues, shoes, obesity, increased pronation

Better: NWB, Rest

Worse: walking, jogging, running

Treatment:
-PT: contributing factors, activity modification, NWB, education, stretching, strengthening

-Surgery: fasciotomy

Question 4

Plantar Fascitis

Answer 4

-inflammation of plantar fascia
-MC at proximal insertion

S/S: medial heel pain, morning pain

Cause: bone spurs, chronic use, obesity, mechanics, low arches, pronated foot

Better: avoidance of knee flexion

Worse: prolonged sitting, running, walking

Treatment:
-PT: contributing factors, avoid flexion based things, avoid last 30 of extension