Therapeutic Foot Care Certificate Program Part I: Online Home Study Program 1
Sports-Related Lower Extremity Injuries Justin Wernick, DPM, C.Ped. NY College of Podiatric Medicine Orthopedic Department, New York, NY 2
Sports-Related Lower Extremity Injuries Learning Objectives: At the Conclusion of this Program, Participants Should Be Able to: 1. Describe the Biomechanics and Pathologies Involved In Common Sports-related Injuries 2. Recognize Conservative Management Options for Sports-related Injuries 3. Understand d the Value of Stretching t and Strengthening Exercises for Preventing Injuries 3
Sports-Related Lower Extremity Injuries Overview of Sports-Related Injury Processes Common Sports-Related Lower Extremity Injuries Prevention and Management Strategies For Sports-Related Lower Extremity Injuries 4
Overview Increase In Athletic Activity Increase In Lower Extremity Injuries 5
Overview Understand the Biomechanics of the Gait Cycle Know When to Fit Know When to Refer to Pedorthists, Podiatrists, Orthotists, and Physicians Understand the Sport Mechanics and Potential Injuries Common Sense 6
Common Sports-Related Lower Extremity Injuries Plantar Fasciitis Calcaneal l Spur Sesamoiditis Metatarsal Cuneiform Exostosis Morton s Neuroma Shin Splint Posterior Tibial Tendinitis (PTT) Posterior Heel Problems Achilles Tendinitis Calcaneal Apophysitis Inversion Ankle Sprain Stress Fracture Digital Fracture Limb Length Discrepancy 7
Plantar Fasciitis Inflammation of the Plantar Fascia, the Thick, Ligament-like Tissue that Fans out over the Sole of the Foot Associated with Heel Spurs Common in Participants of Most Sports 8
Calcaneal Spur Syndrome Also Known as Heel Spur Syndrome Related to Plantar Fasciitis Over Time Tensile Forces in the Foot Lead to a Break In the Periosteum with Subsequent Horizontal Exostosis Formation on the Calcaneus Occurs in Same Population as Plantar Fasciitis 9
Sesamoiditis Irritation and Inflammation of the Tissues Surrounding the Sesamoid Bones, Under the First Metatarsophalangeal Joint Usually Due to Repetitive, Excessive Pressure on the Forefoot Common in Ballistic Sports Such as Tennis, Basketball, and Ballet Dancing Be Aware of the Possibility of Fracture 10
Metatarsal Cuneiform Exostosis Enlargement of the Metatarsal Cuneiform Joint Leads to a Spur on the Dorsum of the Foot Also Known as a Saddle Bone Deformity Common in Jumping Sports Such as Basketball, Volleyball, and Soccer 11
Morton s Neuroma Enlarged Nerve in Foot Usually Located in Third Interspace, Between the Third and Fourth Toes More Common in Women than Men Common in Sports Where the Individual s Feet Swell or If He/She Wears Shoes that are Too Snug Neuroma 12
Shin Splint Pain In the Front of the Lower Leg Commonly Caused by: Periostitis, Myositis, Stress Fracture, or Compartment Syndrome Associated with Overuse; Common with Walking and Running Activities Stress Fracture 13
Posterior Tibial Tendon Dysfunction Inflammation and Swelling of the Posterior Tibial Tendon Common in Running and Sport Activities in which a Tremendous Load is Placed on the Foot in the Float Phase Subtalar Jt Oblique MT Jt Ankle Jt Long. MT Jt 14
Posterior Heel Problems Retrocalcaneal Bursitis Bursa Located in Achilles Tendon Becomes Inflamed Common in Sports with Jumping Exercises and/or Rapid Raising of Heel off Ground Abrasion / Contusion Irritation of the Skin Tissue Secondary to Incompatible Shoe Gear Bursitis Common in Any Sport in which the Participant Wears Shoes that Are Incompatible with the Foot Shape Haglund s Disease Increase/Thickening of Lateral Side of Calcaneus, Causing it to Become More Prominent Can Result in Abrasion, Inflammation, and/or Bursitis 15
Achilles Tendinitis Inflammation of the Achilles Tendon, the Large Tendon that Inserts into the Heel of the Calcaneus Common in Jumping Sports where there is a Tremendous Tension Placed on the Gastrocnemius Muscle If Individual Cannot Walk, Consider Tendon Rupture Metatarsals Strain of Achilles Tendon: Inflammation, Swelling, Edema Phalanges Calcaneus 16
Calcaneal Apophysitis Osteochondritic Injury Found in Children Between the Ages of 8 to 12 Also Known as Sever s Disease Inflammation of the Cartilagenous Gap in the Calcaneus Pain Felt on Medial/Lateral Surfaces of the Calcaneus Found in Children Involved in Jumping Sports Epiphyseal Plate 17
Inversion Ankle Sprain Most Common Foot Injury Related to Ankle Anatomy Characterized by Pain, Swelling, and Black and Blue Marks on the Lateral Side of the Foot at the Ankle Recognize Possibility of Fracture to the Base of the Fifth Metatarsal 18
Stress Fracture Common Fracture in the Lower Extremity Characterized by Dull Aching Pain Accompanied by Swelling A Fracture of the Bone When the Loads on the Bone Exceed Its Physiologic Tolerance Stress Fractures Tend to Occur In the Absence of a Noticeable Incident 19
Digit Fracture Common Contact Injury Usually Located at the Fifth Toe, But Also Found at the Third and Fourth Toes Be Aware of the Possibility of Dislocation of Toe or at the Fracture Site Taping Broken Toe to Surrounding Toes Provides Stability 20
Limb Length Discrepancy Difference Between the Lengths of the Upper and/or Lower Legs Usually Asymptomatic and Due to Normal Anatomic Variation, Though Can Be a Result of Injury or Other Cause Management of the Discrepancy May Be Necessary, Especially in an Athletet 21
Injury Management And Prevention RICE Rest Ice Compression Elevation Non-Steroidal Anti- Inflammatory Medications (NSAIDs) Crutches / Canes Stretching Change Activities iti / Surfaces Proper Foot Gear Heel Lift Orthoses 22