Ankle and Foot Ligaments Quiz
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Questions and Answers

What type of injury occurs due to excessive tensile loads?

  • Peritendinopathy injury
  • Midportion injury (correct)
  • Compressive injury
  • Insertion injury

What is the primary management strategy for peritendinopathy?

  • Resistance training
  • Managing the peritendon first (correct)
  • Surgery
  • Ice application

Which scenario represents a combination of compressive and tensile loads?

  • Pushing off in end range dorsiflexion (correct)
  • Hanging heel off the edge of the step
  • Jumping
  • Repetitive plantarflexion and dorsiflexion

What is the typical symptom of tendinopathy when examining tenderness?

<p>Less tenderness with maximal dorsiflexion (C)</p> Signup and view all the answers

Which type of load primarily causes insertion injuries?

<p>Compressive loads (B)</p> Signup and view all the answers

What is the primary function of the syndesmosis ligament?

<p>Support the foot during rotational activities (A)</p> Signup and view all the answers

Which test is specifically used to identify syndesmosis injuries?

<p>Squeeze test (B)</p> Signup and view all the answers

What injury pattern is typically associated with syndesmosis injuries?

<p>Foot pinned to the ground during external rotation (C)</p> Signup and view all the answers

Which of the following management strategies is recommended for syndesmosis injuries?

<p>POLICE method (D)</p> Signup and view all the answers

In terms of injury sequence, which ligament is typically injured before the syndesmosis ligament?

<p>ATFL (Anterior Talofibular Ligament) (A)</p> Signup and view all the answers

What is a positive indication of a syndesmosis injury when performing the valgus tilt test?

<p>Excessive movement of the fibula relative to the tibia (D)</p> Signup and view all the answers

What is the main origin point for the syndesmosis ligament?

<p>Medial aspect of the distal fibula (D)</p> Signup and view all the answers

When assessing for internal rotation of the leg, which position of the foot typically indicates a syndesmosis injury?

<p>Foot fixed in external rotation and dorsiflexion (B)</p> Signup and view all the answers

What is turf toe primarily associated with?

<p>Injury to plantar structures of the 1st metatarsophalangeal joint (B)</p> Signup and view all the answers

Which testing method is noted for its 100% sensitivity in tibial bone stress injuries?

<p>Hop test (B)</p> Signup and view all the answers

What is the purpose of taping in the management of turf toe?

<p>To restrict excessive dorsiflexion of the hallux (D)</p> Signup and view all the answers

What is required to perform hyperdorsiflexion taping?

<p>2 thin strips (D)</p> Signup and view all the answers

Which of the following is NOT part of the POLICE management for turf toe?

<p>Rehabilitation (B)</p> Signup and view all the answers

Hyperplantarflexion taping requires how many strips of tape?

<p>2 thin strips (D)</p> Signup and view all the answers

What does the taping for turf toe aim to provide at the first metatarsophalangeal joint?

<p>Plantarflexion and abduction force (D)</p> Signup and view all the answers

Which of these injuries results from an external force applied to the hallux?

<p>Turf toe (B)</p> Signup and view all the answers

What is the primary purpose of taping for sand toe?

<p>To restrict excessive plantarflexion of the hallux (D)</p> Signup and view all the answers

What additional support does the thin tape provide when applied loosely around the base of the hallux?

<p>Dorsiflexion and abduction force at the first MPJ (B)</p> Signup and view all the answers

Which components are necessary for the management of sand toe?

<p>POLICE, taping, stiff soled shoe, orthotics (C)</p> Signup and view all the answers

What does the thick strip of tape applied for plantar plate injury achieve?

<p>Reduces plantarflexion force during walking (D)</p> Signup and view all the answers

What are the benefits of using a standard ankle taping technique?

<p>Provides stability, support, and compression (B)</p> Signup and view all the answers

Which action is performed first in the taping process for sand toe?

<p>Tape from the dorsal surface to the heel (D)</p> Signup and view all the answers

What is a common indication for using ankle taping?

<p>Managing ankle instability (A)</p> Signup and view all the answers

How does taping benefit patients with plantar plate injuries?

<p>By providing force to reduce strain during gait (A)</p> Signup and view all the answers

What is the purpose of the heel lock technique when applied in the opposite direction?

<p>Provides additional ankle support (B)</p> Signup and view all the answers

Which taping technique starts above the heel on the medial side, wrapping around to the lateral side?

<p>Heel compression (B)</p> Signup and view all the answers

What is the first step in the low-dye taping method?

<p>An anchor strip going horizontal under met heads (D)</p> Signup and view all the answers

Which of the following conditions is specifically addressed by low-dye taping?

<p>Plantar heel pain (D)</p> Signup and view all the answers

What is the last step in the low-dye taping method?

<p>Apply a loose strip dorsally (A)</p> Signup and view all the answers

What is a key feature of the figure of 6 taping technique?

<p>Wraps around both sides of the ankle and heel (D)</p> Signup and view all the answers

How many vertical strips are involved in the low-dye taping method?

<p>Three (A)</p> Signup and view all the answers

What condition is primarily treated by heel compression taping?

<p>Plantar heel pain (C)</p> Signup and view all the answers

Which clinical test is commonly used for assessing posterior ankle impingement?

<p>Dorsal impingement sign (B)</p> Signup and view all the answers

What is a common symptom of syndesmosis injury?

<p>Inability to weight bear (B)</p> Signup and view all the answers

Which mechanism of injury is most associated with Lisfranc ligament injury?

<p>Axial and/or rotational load (C)</p> Signup and view all the answers

In midfoot osteoarthritis, what physical examination finding may be noted?

<p>Joint stiffness (B)</p> Signup and view all the answers

Which test is NOT typically used to assess deltoid ligament injury?

<p>Piano key test (C)</p> Signup and view all the answers

What symptom is most likely associated with anterior ankle impingement?

<p>Pain during dorsiflexion (B)</p> Signup and view all the answers

What imaging study is typically recommended to evaluate midfoot injuries?

<p>Standard WB x-ray (D)</p> Signup and view all the answers

What type of management may be considered if conservative treatments fail for posteromedial ankle impingement?

<p>Bracing for increased demands (D)</p> Signup and view all the answers

In syndesmosis injury, what test can help reproduce the pain?

<p>Point test (D)</p> Signup and view all the answers

Which symptom is commonly experienced with chronic deltoid ligament injuries?

<p>‘Giving way’ feeling (C)</p> Signup and view all the answers

Which pathology is often indicated by the presence of bony spurring in the ankle?

<p>Posteromedial ankle impingement (B)</p> Signup and view all the answers

What activity is likely to exacerbate symptoms of midfoot arthritis?

<p>Long-distance running (D)</p> Signup and view all the answers

Which of the following ankle taping techniques may provide support during rehabilitation?

<p>High dye taping (C)</p> Signup and view all the answers

Flashcards

Syndesmosis Injury

Injury to the syndesmosis ligament, a supporting structure in the ankle.

Squeeze Test

A test used to diagnose syndesmosis injuries at the ankle.

Lisfranc Ligament

Ligament connecting the medial cuneiform to the base of the 2nd metatarsal.

Valgus Tilt Test

An examination to identify possible ankle or foot ligament injuries.

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Anterior Draw Test

A test to assess the integrity of ligaments that help keep the ankle in place; done with slight Pf and Abd force.

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Foot Supination

Turning the sole of the foot inward.

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POLICE

An acronym for a common protocol (protection, optimal loading, ice, compression, elevation) used for ankle injuries or other soft tissue injuries.

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External Rotation

The act of twisting the leg's lower portion outward relative to the upper leg.

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Insertion injury

Injury caused by excessive compression and tensile loads at the tendon's attachment point (insertion).

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Midportion injury

Injury located in the middle of a tendon, usually caused by high tensile stress.

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Peritendinopathy (sheath)

Injury to the tendon sheath, often from friction; pain often doesn't improve with warmup.

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Compressive & Tensile loads

Forces pushing down and pulling on the tendon, respectively. These affect injury location and can occur during movement.

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Tendinopathy management

Managing tendinopathy involves modifying activities, educating the patient, and gradually returning to activities (rehabilitation).

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Calcaneus

A bone in the foot, specifically the heel bone.

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Cuneiform

Three bones in the midfoot, shaped like wedges.

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Cuboid

A bone in the foot, located near the little toe.

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Sesamoids

Small bones near joints, often protecting them.

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Axial Compression Test

A test for ankle/foot injuries, applying force axially.

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Hop Test

A test for ankle/foot injuries; jumping and landing.

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Hyperdorsiflexion Taping

Taping technique to limit excessive upward bending of the foot.

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Turf Toe

Injury to the joint at the big toe; Hyperdorsiflexion

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Sand Toe Taping

Taping technique to restrict excessive plantar flexion of the big toe, used for sand toe injuries.

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Sand Toe Cause

External force to the hyper-plantar flexed big toe, often while running or kicking.

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Digital Plantarflexion Taping

Taping technique for plantar plate injuries, applying plantar flexion to reduce force during gait.

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Plantar Plate Injury

Injury to the plantar plate, a ligament that supports the metatarsal bones.

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Ankle Instability Taping

Ankle taping technique providing stability, support, and compression for ankle instability.

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Ankle Taping Anchor

An ankle taping technique starts with a strip anchored to the ankle.

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Heel Lock Taping

Technique to prevent ankle re-injury and support during activity.

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Ankle Ligament Sprain

Injury or damage to the ligaments that support the ankle joint.

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Figure-of-6 Taping

Ankle taping technique that uses a figure-eight pattern to stabilize the ankle.

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Heel Lock Taping

Ankle taping technique that stabilizes the heel by wrapping around the Achilles tendon.

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Low-Dye Taping

Ankle taping for medial arch support and plantar heel pain, using horizontal and vertical strips.

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Heel Compression Taping

Ankle taping that compresses the heel for support and pain relief.

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Taping for Ankle Ligament Sprains

Taping techniques (like figure-eight, heel lock) used to stabilise injury and decrease pain.

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Taping for Plantar Heel Pain

Taping aimed at reducing pain and supporting the heel, often using low-dye patterns or compression

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Taping for Tendinopathies

Taping methods to support and reduce stress on tendons.

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Securing Taping Strips

Technique used to hold the tape firmly and effectively.

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Ankle taping

Method of supporting the ankle using adhesive tape.

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Anterior ankle impingement

Pain in the front of the ankle, often worsened with activity.

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Posteromedial ankle impingement (POMI)

Pain behind the medial ankle, often related to activity and previous injury.

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Syndesmosis injury

Injury to the ligaments stabilizing the ankle, often caused by rotational force.

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Deltoid ligament injury

Injury to the medial ligament complex of the ankle, often causing instability.

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Spring ligament injury

Injury to the ligament complex supporting the medial arch of the foot; often caused by rotational injuries.

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Lisfranc ligament injury

Injury to the ligaments connecting the tarsal and metatarsal bones in the midfoot, causing instability.

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Midfoot OA

Osteoarthritis of the midfoot, characterized by pain, stiffness, and potential bony enlargements.

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1st MPJ OA

Osteoarthritis of the first metatarsophalangeal joint, often associated with hallux limitus or hallux valgus.

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Piano key test

Diagnostic test for Lisfranc ligament injury in the midfoot.

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Valgus tilt stress test

Test used to check ankle lateral ligament integrity by applying a rotational force.

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Squeeze test

Evaluation method used to diagnose syndesmosis injury in the ankle.

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Anterior draw test

Evaluation of the integrity of ankle ligaments.

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ER stress test

Test for assessing injury of the ligaments in the ankle/foot complex.

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Provacation test

A clinical test used to provoke pain or instability at the midfoot joint during stress.

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Study Notes

Lateral Ligaments

  • Origin: Lateral malleolus of fibula
  • Insertion: Talus (ATFL), Calcaneus (CFL), Posterior talus (PTFL)

Medial Ligaments

  • Deltoid Ligament (deep component):
    • Posterior tibiotalar ligament
    • Anterior tibiotalar ligament
    • Tibiocalcaneal ligament
    • Tibionavicular ligament
  • Deltoid Ligament (superficial component):
    • Origin: Tibia
    • Insertion: Navicular/Calcaneus

Clinical Assessment Tests

  • Tests for ATFL instability: Anterior Drawer Test
  • Tests for ATFL instability: Anterolateral Drawer Test
  • Tests for CFL instability: Talar Tilt Test
  • Tests for deltoid/medial ligament instability: Valgus tilt stress test

Spring/Deltoid Ligament

  • Origin: Calcaneus
  • Insertion: Navicular

Syndesmosis Ligament

  • Origin: Medial aspect of distal fibula
  • Insertion: Lateral aspect of distal tibia

Lisfranc Ligament

  • Origin: Medial cuneiform
  • Insertion: Base of 2nd metatarsal

Plantar Plate Injuries

  • Insertion: Proximal phalanx
  • Ligament on plantar surface of MPJs

Morton's Neuroma

  • Located between 3rd/4th metatarsals

Achilles Injury

  • Origin: Gastroc/soleus muscle
  • Insertion: Calcaneus

Bone Stress Injuries

  • Calcaneal Squeeze Test
  • Navicular 'N' Spot
  • Tenderness over calcaneus when squeezing heel from both sides

Taping

  • Hyperdorsiflexion (turf toe)
  • Hyperplantarflexion (sand toe)
  • Digital Plantarflexion (plantar plate)
  • Standard ankle taping with heel lock
  • Low dye taping
  • Heel compression

Load Management, Rehabilitation and Exercise Prescription

  • 45yr old runner - Achilles Tendinopathy
  • 35yr old runner - Plantar Fasciopathy
  • 65yr old retiree - Plantar Fasciopathy

Physical & Psychobehavioural Factors

  • Running time
  • Running pace
  • Weight lifted
  • Weight lifting tempo
  • Weights (sets/reps)
  • Time on feet (eg: work)
  • Stress
  • Family/occupational
  • Social environments
  • Economic factors

Outcome Measures

  • PROM: Patient reported outcome measures, via questionnaire
  • Disease/specific or generic assessments

Rehabilitation Programming

  • Mechanotransduction—The body converting mechanical loads into cellular responses
  • Mechano Therapy—Using therapeutic exercise to promote the repair or re-modelling of injured tissue

Clinical Decision Making for Exercise Prescription

  • Assess patient's current status
  • Identify involved/injured tissues
  • Stage of tissue healing
  • Identify criteria and timing for exercise progression
  • Understand contextual factors
  • Understand specificity and dosage principles

Types of exercise/movement

  • Stretching
  • Isometrics
  • Isotonics
  • Plyometrics
  • Power
  • Force x Velocity

Exercise selection + exercise dosage = tissue response

  • Plyometrics
  • Strength/power
  • Hypertrophy
  • Endurance

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Description

Test your knowledge on the anatomy of the ankle and foot ligaments. This quiz covers topics like lateral and medial ligaments, clinical assessment tests, and specific ligament injuries. Perfect for students in orthopedic studies or anatomy classes.

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