ankle/foot specific conditions

Question 1

Cuboid subluxations often mimic s/s of ___.

Answer 1

plantar fasciitis

Question 2

Displacement of the cuboid results in pain where?

Answer 2

4th and 5th met heads
over the cuboid
referral to the heel

Question 3

Cuboid displacement results in pain due to the stress placed on the ______ when the foot is in PRON.

Answer 3

peroneal muscles

Question 4

In PRON, the cuboid moves ___ and ___.

Answer 4

inferior and medial

Question 5

What is the MOI of cuboid subluxation?

Answer 5

PRON and trauma

Question 6

definition: Head of the 1st met, toe assumes a valgus position

Answer 6

hallux valgus deformity (bunions)

Question 7

Bunions are commonly associated with forefoot ____ or a flexible _____.

Answer 7

varus, 1st ray, OR a flattened Transverse arch

Question 8

What is the most common nerve problem of the LE?

Answer 8

Morton Neuroma

Question 9

definition: a mass occurring about the nerve sheath of the common plantar nerve while it divides into 2 digital branches

Answer 9

neuroma

Question 10

Morton neuromas are often located where?

Answer 10

Located between 3rd and 4th met heads where nerve is thickest

Question 11

What are the s/s of morton’s neuroma?

Answer 11

• severe intermittent pain radiating into the tips of the toes from the distal met heads
• Relief with NWB
• Irritation with collapse of the transverse arch which puts the transverse metatarsal ligaments under stretch thus compressing the common digital nerve and vessels
• Excessive foot pronation = predisposing factor
• Patient c/o burning parasthesia in the forefoot, localized in 3rd web space, radiating into toes

Question 12

Turf toe is a ___ injury common in the athletic population.

Answer 12

hyperEXT

Question 13

What does turf toe result in?

Answer 13

sprain of the 1st MTP joint

Question 14

Turf toe is linked to artificial turf due to flexible foot wear allowing greater _____ of the Great toe.

Answer 14

DF

Question 15

___-___ weeks rest in severe cases of turf toe may be required to reduce pain to point where patient can push off

Answer 15

3-4 weeks

Question 16

What are the MOIs of tarsal tunnel syndrome?

Answer 16

• Overuse
• over pronation
• trauma

Question 17

What are s/s of tarsal tunnel syndrome?

Answer 17

• pain
• numbness
• parasthesia
• TTP over tibial nerve behind the medial malleolus

Question 18

What are the aggs of morton neuroma?

Answer 18

Symptoms worsened by squatting, stair climbing, running, wearing shoes with narrow toe box, & high heels

Question 19

Where are stress fractures in the foot commonly found?

Answer 19

navicular
second MT
diaphysis of the 5th MT

Question 19

Where are stress fractures in the foot commonly found?

Answer 19

navicular
second MT
diaphysis of the 5th MT

Question 20

What is the MOI for navicular and/or 2nd MET Fx?

Answer 20

excessive PRON

Question 21

What is the MOI for 5th MET Fx?

Answer 21

rigid pes cavus foot

Question 22

Those with navicular and 5th MET Fx should be NWB in a short leg cast for __-__ weeks if it is a nondisplaced Fx

Answer 22

6-8 weeks

Question 23

Those with 2nd Met Fx should have modified rest and NWB exercise/pool running/UBE/Bike/Nu-step for ___-__ weeks

Answer 23

2-4 weeks

Question 24

What is immediately indicated for active patients if they have a navicular and/or 5th met FX?

Answer 24

immediate internal fixation

Question 25

What is the common presentation of plantar fasciitis/fasciosis?

Answer 25

- Pain in the proximal arch and heel - Patient c/o pain in the anteromedial aspect of the heel - Most painful in the morning - Pain with toes and forefoot DF during terminal stance

Question 26

Those with plantar fasciitis/fasciosis are in a Short leg walking cast for ___-___ weeks

Answer 26

4-6 weeks

Question 27

Symptoms of plantar fasciitis/fasciosis can persist up to ____ weeks which requires patient compliance with POC

Answer 27

12 weeks

Question 28

What is the most common ankle sprain?

Answer 28

Inversion sprains

Question 29

What is the weakest ligament of the three lateral ligaments?

Answer 29

ATFL

Question 30

(true/false) Deltoid ligament may also be involved with an inversion sprain due to impingement between the fibular malleolus and the calcaneus.

Answer 30

true

Question 31

Why are eversion sprains less common than inversion sprains?

Answer 31

- bony and ligamentous anatomy - strength/thickness of deltoid ligaments - fibular malleoli extends further inferiorly

Question 32

(true/false) Eversion sprains may take longer to heal than inversion due to severity of injury

Answer 32

true

Question 33

What is the initial priority for rehabilitation of ankle sprains?

Answer 33

DF and PF

Question 34

What is minimized early in rehabilitation when treating an ankle sprain?

Answer 34

Inversion and eversion

Question 35

Dislocation of the peroneal tendons occur in response to what?

Answer 35

due to rupture or laxity of the retinaculum

Question 36

What can possibly occur with subluxation/dislocation of the peroneal tendons?

Answer 36

Avulsion fx of the distal fibula may co-occur with sublux or dislocation

Question 37

What are the MOIs for subluxation/dislocation of the peroneal tendons?

Answer 37

- Sudden forceful contraction of the peroneal muscles with DF and Eversion - Pt feels or hears a “pop” and complain of ”giving way”

Question 38

A person with peroneal tendon dislocation/subluxation is in a short leg cast in slight ____ and NWB for 5-6 weeks

Answer 38

PF

Question 39

When treating subluxation/dislocation of the peroneal tendons, after the short cast is removed, (gentle/aggressive) ankle rehab is started.

Answer 39

aggressive

Question 40

Where is tendinopathy most commonly found in the ankle?

Answer 40

Posterior tibialis tendon behind the medial malleolus

Question 41

What is the typical presentation of tendinopathy in the ankle?

Answer 41

- Pain both with active movement and passive stretch - Swelling around tendon area - Crepitus with movement - Stiffness and pain following periods of inactivity, particularly in the morning

Question 42

How long does it take for tendinopathy to resolve if the correct course of treatment is taken immediately?

Answer 42

10-14 days

Question 43

What is a dome Fx?

Answer 43

Non-displaced compression Fx of the talus

Question 44

With an ankle Fx, a patient should be full WB with a walking brace by ___ weeks.

Answer 44

6 weeks