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MSK 3 > Ankle/Foot > Flashcards

Ankle/Foot Flashcards

1
Q

Ottawa Ankle Rules

A
  • pain on palpation: distal 6cm fibula; posterior, midline
  • pain on palp: distal 6cm tibia; post, midline
  • pain on palp: base 5th MT
  • pain on palp navicular tubercle (medial)
  • unable to WB immediately after
  • over age 18, under age 55
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2
Q

Ottawa Foot Rules

A
  • pain in midfoot (and 1+ following)
  • unable to WB immediately and in ED for 4 steps
  • bone tenderness at navicular or base of 5th MT
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3
Q

Lateral Ankle Sprain

A
  • acute

- chronic ankle instability

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4
Q

Components to Chronic Ankle Instability

A
  • mechanical (lax ligaments)

- neuromuscular (decr proprioception)

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5
Q

Treatment of Acute Lateral Ankle Sprain

A
  • ice
  • K-tape
  • joint mobes (grade I/II and distraction)
  • AROM: pain free (ankle pumps)
  • Modalities
  • gait in water
  • aerobic exercise
  • strengthening
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6
Q

Talar Position after sprain

A
  • inversion/plantarflexion stress
  • tear of ATFL
  • talus glides ant
  • ant impingement
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7
Q

Manual Therapy Techniques for Lateral Ankle Sprain–Acute Phase

A
  • TC joint manip
  • AP TC mob
  • mobilization with movement (MWM)
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8
Q

Strengthening After Lateral Ankle Sprain–Acute Phase

A
  • isometrics (submax)
  • proximal hip
  • opposite extremity
  • UE
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9
Q

High Correlation between:

A

-hip weakness and lateral ankle sprains

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10
Q

Lateral Ankle Sprain Subacute Phase

A
  • minimize pain/swelling
  • ROM (& check arthrokinematics)
  • Strength
  • Aerobic Conditioning
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11
Q

Cuboid can

A
  • sublux plantarly
  • treat with cuboid whip then cuboid pad under
  • peroneus longus attached to it
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12
Q

Problems with balance with chronic ankle sprain

A
  • proprioceptive deficits
  • decrease stability when landing from a jump
  • reduced postural control
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13
Q

Bracing?

A
  • brace/tape while rehabing, not forever

- 3-6 months

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14
Q

Prevention:

A
  • strengthening

- balance training

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15
Q

Best Functional Tests to Return to Sport

A
  • Figure 8 Single Leg Hopping
  • Lateral Hopping Test

-no more than 10% difference between limbs

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16
Q

Surgical Treatment of Ankle Instability

A

-Brostrom Procedure

17
Q

Brostrom Procedure

A
  • surgical reattachment of ATFL and calcaneofibular ligament
  • reinforce with peroneus brevis
  • -then do PT
18
Q

Plantar Fascia (Aponeurosis)

A

-main stabilizer of medial longitudinal arch

19
Q

Plantar Fasciopathy

A
  • heel pain–medial tubercle

- Heel spur not cause of pain

20
Q

Management of Plantar Fasciopathy

A
  • massage
  • stretching
  • tape/orthoses
  • night splints
  • manual therapy/exercise
21
Q

Management of Plantar Fasciopathy

A
  • massage
  • stretching
  • tape/orthoses
  • night splints
  • manual therapy/exercise
  • strengthening
  • rest
  • Lateral glides of subtalar joint
  • eccentric calf program

–check arthrokinematics

22
Q

May be a relationship between plantar fasciitis and:

A

-posterior chain tightness (hamstrings, gastroc-soleus)

23
Q

2 Achilles Tendinopathy Factors

A
  • Intrinsic Factors

- Extrinsic Factors

24
Q

Intrinsic Factors of Achilles Tendinopathy

A
  • extreme foot types (planus, cavus)
  • decreased ankle flexibility
  • growth spurt in young athletes (sever’s disease)
25
Q

Extrinsic Factors of Achilles Tendinopathy

A
  • training too much too soon
  • shoewear, cleats
  • heel height change
  • playing surface
26
Q

Achilles Tendinopathy Management Framework

A

-EdUReP

  • Educate
  • Unload
  • Reload
  • Prevent
27
Q

EdUReP:

Unload

A
  • Heel lift (1/2 inch)
  • active rest with alternative exercises
  • immobilization=last resort
28
Q

EdUReP:

Education

A
  • not inflammation, no direct association with pain

- kennedy stages

29
Q

EdUReP:

Reload

A
  • Eccentric Program
  • 12 weeks
  • Slow
  • Progress: load and speed
30
Q

EdUReP:

Prevent Recurrence

A
  • hip strength
  • lumbar spine
  • normal foot mechanics
31
Q

Chronic Management of Achilles Tendinopathy

A
  • soft tissue mobilization (ART)
  • Cross friction massage
  • dry needling
  • orthotics
32
Q

TENEX

A
  • TENEX Health TX

- Invasive: Ultrasonic energy to break down and remove diseased tissue

33
Q

EdUReP:

Education

A
  • not inflammation, no direct association with pain
  • ice won’t help
  • not as worried about pain, more about function
  • kennedy stages

MSK 3 (18 decks)

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