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Feb 15 - feet and toes.doc

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Physical Education and Sport
Brad Kern

Feb 15 – Feet and Toes Metatarsal Arch Strain Cause of injury • Hyper mobility of metatarsals caused by laxity in ligaments – results in excessive splay of foot • Will appear to have fallen arch • Caused by laxity in the ligaments and your metatarsal arch will drop Signs of Injury • Pain or cramping in metatarsal region. Should be able to feel the extra sleigh in the foot • Point tenderness (metatarsalgia), weakness • Heavy callus may form in area of pain Care • Pad to elevate metatarsals just behind ball of foot. We could tape the metatarsals or just put a lift so the metatarsals are arched • Strengthening of foot muscles and heel cord stretching Longitudinal Arch Strain Cause of Injury • Result of increased stress on arch of foot • Flattening of foot during mid-stance causing strain on arch • Could be caused by running with weights or jumping from a height Signs of Injury • Pain with running and jumping, below posterior tibialis tendon (right along the arch on the medial side), accompanied by pain and swelling • May also be associated with sprained calcaneonavicular ligament (called the spring ligament. If you sprain this ligament, you lose the spring in your step) and flexor hallucis (hallucis refers to big thumb) longus strain Care for Longitudinal Arch Strain • Immediate care, RICE, reduction of weight bearing • Weight bearing must be pain free • Arch taping may be used to allow pain free walking Fractures and Dislocations of the Phalanges Cause of Injury • Kicking un-yielding object, stubbing toes, being stepped on or anything causing a direct blow to the feet Signs of Injury • Immediate and intense pain • Swelling and discoloration • Obvious deformity with dislocation • If it is dislocated, we need it to be reduced through bioposition Care for Fractures and Dislocation of the Phalanges • Dislocations should be reduced by a physician • Casting may occur with great toe or stiff soled shoe • Buddy taping is generally sufficient • Shoe with larger toe box may be necessary (toe will be swollen so we will need it to have a lot of space) Bunion (Hallux Valgus Deformity) Cause of Injury • Exotosis of 1 metatarsal head; associated with forefoot varus; shoes that are too narrow, pointed or short • Bursa becomes inflamed and thickens, enlarging joint and causing lateral malalignment of great toe Sign of Injury of a Bunion (Hallux Valgus Deformity) • Tenderness, swelling, and enlargement of joint initially • As inflammation continues, angulation increases causing painful ambulation • We can also see calcification and bone will develop. Surgery will be needed Care st • Wear correct fitting shoes, appropriate orthotics, pad over 1 metatarsal head, tape splint between 1 and 2 ndtoe • Buy a wider shoe or skate to deal with this inflammation • Surgery may be required during later stages of condition • Bursa can become chronically inflammed Morton’s Neuroma Cause of Condition • Thickening of nerve sheath (common plantar nerve) at point where nerve divides into digital branches • Commonly occurs between 3 and 4 metatarsal heads where media and lateral plantar nerves come together Signs of Condition • Burning paresthesia and severe intermittent pain in forefoot • Pain relieved with non-weight bearing activities • Toe hyperextension increases symptoms Care • Teardrop pad can be place between metatarsal heads to increase
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