EHR520 Weeks 5 - 10
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Questions and Answers

What is the typical progression of exercises used to treat radicular symptoms?

  • Strengthening exercises, flexibility, pelvic-neutral exercises, and extension exercises
  • Pelvic-neutral exercises, flexibility, strengthening exercises, and extension exercises
  • Flexibility, strengthening exercises, pelvic-neutral exercises, and extension exercises
  • Extension exercises, flexibility, strengthening exercises, and pelvic-neutral exercises (correct)

    • A facet joint in flexion is closed.

    False

    What happens if radicular symptoms worsen during treatment?

    You must re-evaluate the current exercises.

    A facet joint in extension is ______________________.

    <p>closed</p> Signup and view all the answers

    Match the following types of disc lesions with their corresponding locations:

    <p>L4/5 IVD = Disc lesion between L4 and L5 vertebrae L5/S1 IVD = Disc lesion between L5 and S1 vertebrae</p> Signup and view all the answers

    What is the characteristic arrangement of muscles in the Upper and Lower Crossed Syndromes?

    <p>Anterior muscles that are weak diagonally correlated with posterior muscles that are tight</p> Signup and view all the answers

    People with upper crossed syndrome often have lower crossed syndrome as well.

    <p>True</p> Signup and view all the answers

    What is the result of hip flexor tightness in Lower Crossed Syndrome?

    <p>pulling the lumbar spine anteriorly to exaggerate the lumbar lordosis</p> Signup and view all the answers

    Upper Crossed Syndrome is associated with a forward head with _______________ cervical lordosis.

    <p>upper</p> Signup and view all the answers

    Match the following conditions with their associated injuries:

    <p>Upper Crossed Syndrome = Headaches, neck pain, thoracic outlet syndrome Lower Crossed Syndrome = Low-back pain, facet dysfunction, sacroiliac dysfunction</p> Signup and view all the answers

    What are the three main regions of the vertebral column?

    <p>Cervical, Thoracic, and Lumbar</p> Signup and view all the answers

    The spinal cord and nerve roots are located in the sacrum.

    <p>False</p> Signup and view all the answers

    What is the primary function of the intervertebral discs?

    <p>Shock absorbers</p> Signup and view all the answers

    The transverse and spinous processes are attachments for _______________.

    <p>ligaments and muscles</p> Signup and view all the answers

    Match the following muscles with their location in the body:

    <p>Superficial = Muscles of the Back Deep = Muscles of the Back Anterior = Muscles of the Trunk Lateral = Muscles of the Abdomen</p> Signup and view all the answers

    Which muscles provide spinal stability?

    <p>Both deep core and global muscles</p> Signup and view all the answers

    Core instability is linked to acute and chronic knee injuries.

    <p>True</p> Signup and view all the answers

    What are some common issues in low back pain?

    <p>Reduced proprioception, reduced muscle endurance, lack of muscle co-activation, delayed recruitment of core muscles, diminished LBP with co-activation, hip muscle strength imbalances, and reduced stability.</p> Signup and view all the answers

    Maintaining correct posture is primarily a ______________________ activity.

    <p>endurance</p> Signup and view all the answers

    Match the following muscles with their primary fibre type:

    <p>Deep core muscles = Slow twitch Global muscles = Fast twitch Latissimus dorsi = Fast twitch</p> Signup and view all the answers

    What is the first step in treating weakened muscles?

    <p>Correcting tightness</p> Signup and view all the answers

    A maintenance program for patients should be created after the goals of the program are achieved.

    <p>True</p> Signup and view all the answers

    What are the two primary components of a maintenance program for patients with formerly tight and weak muscles?

    <p>Flexibility exercises for formerly tight muscles and a strength-maintenance program for formerly weak muscles.</p> Signup and view all the answers

    Signs and symptoms of sprains and strains include ______________________ during contraction.

    <p>Painful</p> Signup and view all the answers

    Match the following types of injuries with their characteristic signs and symptoms:

    <p>Sprains and Strains = Tenderness on palpation, Painful during contraction</p> Signup and view all the answers

    What should be avoided during weeks 0-6 post-injury in downhill skiing crash rehabilitation?

    <p>Hip adduction, flexion, and trunk flexion</p> Signup and view all the answers

    Overuse injuries such as bursitis and tendinopathies are caused by faulty biomechanics through repetitive motion.

    <p>True</p> Signup and view all the answers

    What typically causes ITB syndrome?

    <p>Excessive foot pronation, medial tibial and femoral rotation, and pelvic drop</p> Signup and view all the answers

    During weeks 6-8 post-injury, the rehabilitation program includes ______________________.

    <p>stationary cycling</p> Signup and view all the answers

    Match the following exercises with their corresponding time frames in the rehabilitation program:

    <p>Week 10 = Treadmill walking Week 12 = Incline walking Week 14-16 = Jogging Weeks 20-30 = Running and performance-specific activities</p> Signup and view all the answers

    What is the outcome of a compromised ligament sprain?

    <p>Compromised form closure</p> Signup and view all the answers

    The outer core muscles include the transverse abdominis and diaphragm.

    <p>False</p> Signup and view all the answers

    What does the Thomas Test measure?

    <p>Flexibility of the hip flexors</p> Signup and view all the answers

    What is the outcome of maintaining pelvic neutral?

    <p>Minimizes injury risk and optimizes load transfer</p> Signup and view all the answers

    Muscle imbalances can cause soft tissue injuries and pain around the pelvis, hip, and thigh.

    <p>True</p> Signup and view all the answers

    Abdominal hollowing facilitates the activation of ______________________ and multifidus.

    <p>transverse abdominis</p> Signup and view all the answers

    What is typically observed with lumbar lordosis?

    <p>Tight hip flexors and weak hip/lumbar extensors</p> Signup and view all the answers

    Muscle imbalances are characterized by tightness of a muscle group and ______________________ of the antagonist muscle group.

    <p>weakness</p> Signup and view all the answers

    Match the following tests with their descriptions:

    <p>Standing Forward-Bend Test = Thumbs on L &amp; R PSIS, thumbs should move inferiorly as client bends forward (nutation) Seated Forward-Bend Test = As for standing test Kinetic Test (Gillet Test) = To test left SIJ: Left thumb on left PSIS, Right thumb on sacrum at same level</p> Signup and view all the answers

    Match the following special tests with their purposes:

    <p>Thomas Test = Measures flexibility of the hip flexors FABER Test = Non-specific provocation test of the hip and SIJ FADDIR Test = Provocation test for femoroacetabular impingement or labral tear OBER Test = To identify tightness in the ITB and TFL</p> Signup and view all the answers

    What percentage of total force required for overhead activities is contributed by the lower extremities and trunk?

    <p>50-55%</p> Signup and view all the answers

    A posterior pelvic tilt places the hips in slight flexion.

    <p>False</p> Signup and view all the answers

    What happens when the gluteus medius is weak during single leg stance?

    <p>A Trendelenburg gait or leaning of the torso over the weight-bearing leg</p> Signup and view all the answers

    Hip muscles, especially hip extensors, abductors, and _______________, contribute to core stability during single leg activities.

    <p>ER's</p> Signup and view all the answers

    Match the following hip positions with their corresponding effects on the pelvic tilt:

    <p>Anterior pelvic tilt = Hips in slight flexion Posterior pelvic tilt = Hips in slight extension</p> Signup and view all the answers

    What are the three bones that form the pelvis?

    <p>Ilium, pubis, and ischium</p> Signup and view all the answers

    The sacroiliac joints (SIJ's) have a wide range of movement.

    <p>False</p> Signup and view all the answers

    What is the importance of lumbopelvic-hip stability?

    <p>Lumbopelvic-hip stability is important for the transmission of forces through the kinetic chain (efficient movement) and prevention of back and pelvic pain (pain-free movement).</p> Signup and view all the answers

    The lumbopelvic-hip complex includes the _______________________________________ spine, pelvis, and hips.

    <p>lumbosacral</p> Signup and view all the answers

    Match the following terms with their descriptions:

    <p>Form closure = Anatomical stability of pelvic ring Lumbopelvic-hip complex = Spine, pelvis, and hips Sacroiliac stabilization = Stability of the sacroiliac joint</p> Signup and view all the answers

    What is the typical mechanism of injury for Patellar Tendinopathy?

    <p>Sudden or forceful repetitive knee extension</p> Signup and view all the answers

    Iliotibial Band (ITB) Syndrome is usually caused by posterior pelvic tilt.

    <p>False</p> Signup and view all the answers

    What is the outcome of maintaining pelvic neutral?

    <p>Minimal stress on the spine and optimal muscle function</p> Signup and view all the answers

    Knee Osteoarthritis is characterized by a breakdown of ______________________.

    <p>articular cartilage</p> Signup and view all the answers

    Match the following tests with their descriptions:

    <p>Patellar Grinding Test = checks for patellar mal-tracking Anterior Draw Test = checks for anterior cruciate ligament instability Posterior Draw Test = checks for posterior cruciate ligament instability Valgus Stress Test = checks for medial collateral ligament instability</p> Signup and view all the answers

    What is the primary function of the intervertebral discs?

    <p>to absorb shock and provide cushioning</p> Signup and view all the answers

    Total joint replacement is used as an 'end of the road' treatment option for knee OA.

    <p>True</p> Signup and view all the answers

    Patellofemoral Pain Syndrome is characterized by tenderness over the ______________________ facet of the patella.

    <p>lateral</p> Signup and view all the answers

    What is the outcome of a compromised ligament sprain?

    <p>Chronic instability and potential for further injury</p> Signup and view all the answers

    What is the primary function of the collateral ligaments in the knee?

    <p>Provide medial, lateral, and rotational stability</p> Signup and view all the answers

    The patella glides inferiorly during knee extension.

    <p>False</p> Signup and view all the answers

    What is the screw-home mechanism in the knee?

    <p>The screw-home mechanism is a mechanism that 'locks' the knee into extension, where the tibia rotates laterally and the femur rotates medially.</p> Signup and view all the answers

    The quadriceps angle (Q-angle) is formed by a line from the _____________ to the middle patella and a line from the middle patella to the tibial tuberosity.

    <p>ASIS</p> Signup and view all the answers

    What is the primary cause of ligament sprains in the knee?

    <p>External force</p> Signup and view all the answers

    Match the following types of ligament sprains with their corresponding mechanisms:

    <p>ACL = External force, non-contact, valgus knee force PCL = External force, hyperextension, tibia driven backwards MCL = Direct blow to lateral knee, valgus force LCL = Blow to medial knee, varus force</p> Signup and view all the answers

    What is a common injury that can cause significant functional limitations in the knee joint?

    <p>All of the above</p> Signup and view all the answers

    The knee is one of the least frequently injured joints in the body.

    <p>False</p> Signup and view all the answers

    What are some common knee and thigh injuries?

    <p>Ligament sprains, meniscus injuries, patellofemoral pain, muscle strains and contusions, and bone injuries.</p> Signup and view all the answers

    The knee is one of the most frequently injured joints in the body, causing significant ______________________ limitations.

    <p>functional</p> Signup and view all the answers

    Match the following knee and thigh injuries with their descriptions:

    <p>Ligament sprains = Injuries to the ligaments that connect bones Meniscus injuries = Injuries to the cartilage between the bones Patellofemoral pain = Pain in the front of the knee Muscle strains and contusions = Injuries to the muscles and soft tissues</p> Signup and view all the answers

    What is an important aspect of rehabilitation after a knee injury?

    <p>Strengthening the surrounding muscles</p> Signup and view all the answers

    The knee joint is not essential for daily activities.

    <p>False</p> Signup and view all the answers

    Why is it important to rehabilitate the knee and thigh properly after an injury?

    <p>To prevent future injuries and maintain proper function.</p> Signup and view all the answers

    What is the primary function of the subtalar joint?

    <p>Pronation and supination</p> Signup and view all the answers

    Pes Planus is characterized by an abnormally high longitudinal arch.

    <p>False</p> Signup and view all the answers

    What is the name of the joint that connects the talus and calcaneus bones?

    <p>Subtalar joint</p> Signup and view all the answers

    The lower leg has _______________ muscle compartments.

    <p>four</p> Signup and view all the answers

    Match the following deformities with their characteristics:

    <p>Pes Cavus = Abnormally high longitudinal arch Pes Planus = Abnormally low longitudinal arch</p> Signup and view all the answers

    Ankle ligament sprains are one of the least common sports injuries.

    <p>False</p> Signup and view all the answers

    What is the result of supination of the foot?

    <p>Foot adduction, plantarflexion, and inversion</p> Signup and view all the answers

    How many extrinsic muscles of the lower leg and foot are there?

    <p>12</p> Signup and view all the answers

    What is a common sign of a Soleus Strain?

    <p>Sudden pain in the calf</p> Signup and view all the answers

    Achilles Tendinopathy is a sign of poor footwear.

    <p>True</p> Signup and view all the answers

    What is Medial Tibial Stress Syndrome (MTSS) also known as?

    <p>Shin splints or exercise-related leg pain</p> Signup and view all the answers

    Plantar Fasciitis is a common injury that affects the ________________ surface of the foot.

    <p>plantar</p> Signup and view all the answers

    What is a common mechanism of injury for Achilles Tendinopathy?

    <p>All of the above</p> Signup and view all the answers

    Medial Tibial Stress Syndrome (MTSS) is typically treated with rest and ice-massage.

    <p>True</p> Signup and view all the answers

    Match the following injuries with their corresponding signs and symptoms:

    <p>Soleus Strain = Sudden pain in the calf, local tenderness and swelling Achilles Tendinopathy = Pain and swelling, crepitus felt over tendon Plantar Fasciitis = Heel pain under load, morning stiffness and limp</p> Signup and view all the answers

    What is the primary function of the plantar aponeurosis?

    <p>Protects structures of plantar foot, provides flexibility for shock absorption, and creates windlass mechanism</p> Signup and view all the answers

    What is a common underlying cause of Medial Tibial Stress Syndrome (MTSS)?

    <p>All of the above</p> Signup and view all the answers

    What is the most common mechanism of injury (MOI) for ankle ligament sprains?

    <p>Inversion and plantarflexion</p> Signup and view all the answers

    Grade III ankle sprains are the most common type of ankle sprain.

    <p>False</p> Signup and view all the answers

    What is the primary goal of treatment for ankle sprains?

    <p>To enhance recovery time</p> Signup and view all the answers

    The _______________ ligament is commonly sprained in lateral ankle sprains.

    <p>anterior talofibular</p> Signup and view all the answers

    Match the following types of ankle sprains with their corresponding grades:

    <p>Grade I = Stretching of ATFL Grade II = Tearing sensation &amp; Snap or pop Grade III = Severe pain over lateral malleolus area</p> Signup and view all the answers

    What is the primary cause of medial ankle sprains?

    <p>Pronated or hypermobile feet</p> Signup and view all the answers

    Syndesmosis sprains occur between the tibia and fibula.

    <p>True</p> Signup and view all the answers

    What is the typical location of a gastrocnemius strain?

    <p>Medial head at musculotendinous junction</p> Signup and view all the answers

    Study Notes

    Functional Anatomy and Rehabilitation of the Vertebral Column

    Vertebral Column Structure

    • Consists of Cervical spine (C1-C7), Thoracic spine (T1-T12), Lumbar spine (L1-L5), Sacrum (S1-S5), and Coccyx
    • Components: Intervertebral discs (shock absorbers), Ligaments (stability), Muscles (movement), Spinal cord, nerve roots, and peripheral nerves

    Functional Anatomy and Biomechanics

    • Movements: Flexion, lateral flexion, extension (limited), and rotation
    • C3-L5: Transverse and spinous processes (attachments for ligaments and muscles)
    • Articular processes

    Intervertebral Discs (IVDs)

    • Contain nociceptive fibers, contributing to pain
    • Both IVDs and facets can contribute to pain

    Muscles of the Back

    • Superficial: [list of muscles]
    • Deep: [list of muscles]
    • Anterior Trunk: [list of muscles]
    • Trunk: [list of muscles]

    General Rehabilitation Considerations

    • Exercise rehabilitation should be commenced early
    • Includes posture, stability, flexibility, strength, and endurance exercises
    • Posture examination: Standing and sitting posture
    • Include body mechanics/ADLs (e.g., picking up objects from the floor, sit to stand)
    • Gait examination: ROM, strength, special tests, palpation, outcome measures

    Rehabilitation Techniques

    • Soft Tissue Mobilisation: used to release trigger points in muscles, providing pain relief
    • Flexibility Exercises: generally held for 30 seconds or more, repeated several times daily, to restore muscle imbalances, improve posture, and regain lost joint ROM
    • Posture, Core, and Stabilisation Exercises: core (lumbo-pelvic-hip complex) provides spinal stability, increases intra-abdominal pressure, and involves transverse abdominis, multifidus, pelvic floor, and diaphragm

    Disc Lesions and Radiculopathy

    • L4/5 IVD and L5/S1 IVD
    • Treatment: use of extension exercises, flexibility, strengthening exercises, and pelvic-neutral exercises

    Facet Injuries

    • Can be difficult to identify
    • Often require investigative skills to identify
    • Facet impingement and positional dysfunction: facet restriction can occur from an impingement following a traumatic event

    Upper and Lower Crossed Syndromes

    • Feature a cross-pattern arrangement of weak and tight muscles
    • Upper Crossed Syndrome: forward head, upper cervical lordosis, thoracic kyphosis, protracted and winged scapulae, and internally rotated or abducted shoulders
    • Lower Crossed Syndrome: excessive anterior pelvic tilt, hyperextension of the knees, and hip flexor tightness
    • Treatment: patient education, postural changes, soft-tissue treatments, correction of muscle imbalances with flexibility and strengthening exercises

    Sprains and Strains

    • Signs and symptoms: tenderness on palpation, painful during contraction
    • Treatment: REST, ice, compression, elevation, and rehabilitation exercises

    Functional Anatomy and Rehabilitation of the Pelvis and Hip

    Functional Anatomy and General Considerations

    • The pelvis is composed of the left and right hemipelvis, joined at the pubic symphysis and sacroiliac joints (SIJs)
    • The lumbopelvic-hip complex includes the spine, pelvis, and hips, with each segment influencing the other in terms of alignment and function
    • The pelvis can tilt anteriorly or posteriorly, affecting the position of the hips and lumbar spine
    • A total of 4-6 degrees of movement is possible at the SIJs, which can become hyper- or hypomobile

    Sacroiliac Stabilization

    • Sacroiliac stabilization is important for the transmission of forces through the kinetic chain and prevention of back and pelvic pain
    • Three components of sacroiliac stabilization: form closure (anatomical stability of pelvic ring), force closure (muscles provide stability), and neuromotor control (proper activation and sequential recruitment of muscles)
    • Ligament sprain compromises form closure, and focus is on improving force closure through strengthening and activation exercises to re-establish lumbopelvic-hip stability

    The Core

    • The core consists of inner (deep) core muscles (transverse abdominis, diaphragm, multifidus, and pelvic floor) and outer core muscles (erector spinae, rectus abdominis, external oblique, gluteal muscles, and thoracolumbar fascia)
    • Core instability is linked to knee injuries, ankle sprains, and patellofemoral pain syndrome
    • Hip muscles not only provide hip motion but also influence pelvis and trunk motion

    Pelvic Neutral

    • Pelvic neutral serves as a platform for lumbopelvic-hip stability and extremity performance
    • The pelvis is stable when it is in pelvic neutral, which minimizes injury risk and optimizes load transfer
    • Maintaining pelvic neutral in all activities is important for optimal function

    Combining Local and Global Core Muscles

    • Abdominal hollowing facilitates transverse abdominis and multifidus activation, but does not activate outer core muscles
    • Abdominal bracing activates outer core muscles, and progressive exercises should be incorporated into functional activities

    Pathological Sacral Alignment – Movement Tests

    • Investigation of the sacroiliac region should include posture, alignment, and lumbar spine range of motion
    • Tests for sacroiliac joint dysfunction include the standing forward-bend test, seated forward-bend test, kinetic test (Gillet test), and others

    Here are the study notes for the text:

    Functional Anatomy and Rehabilitation of the Knee and Thigh

    Introduction

    • Knee injuries are common and can cause significant functional limitations
    • Knee joint is a complex structure that relies on sound function for daily activities such as walking, standing, and sitting
    • Need to examine the entire kinetic chain to understand knee injuries, as restrictions or weakness in surrounding joints can contribute to knee pain

    Knee Structure

    • Tibiofemoral joint: concave tibial platform and convex femur
    • Knee joint capsule surrounds the joint and merges with collateral ligaments
    • Collateral ligaments provide medial, lateral, and rotational stability
    • Cruciate ligaments provide anterior-posterior and rotational stability
    • Medial and lateral meniscus cushion the joint, deepen the socket, and provide joint congruity
    • Screw-home mechanism occurs in the last 30° of extension, where the tibia rotates laterally and the femur rotates medially

    Patellofemoral Joint

    • Patella sits in the femoral groove and glides superiorly during knee extension and inferiorly during knee flexion
    • Patella stability is maintained by static (femoral groove, patellofemoral ligaments) and active (quadriceps) structures
    • Quadriceps angle (Q-angle) is the angle formed by a line from the ASIS to the middle patella and a line from the middle patella to the tibial tuberosity

    Factors Affecting Post-Injury Strength

    • Oedema shuts down quadriceps function and is proportional to the quantity of fluid
    • Pain can cause reflex inhibition and reduced muscle output
    • Ambulation can cause weakness and bad habits to develop

    Ligament Sprains

    • Most knee ligament injuries result from an external force
    • Anterior cruciate ligament (ACL) sprains are common, particularly in females
    • Signs and symptoms of a grade 3 ACL rupture include a "pop" sound, immediate disability, knee instability, rapid swelling, and a positive anterior drawer test
    • Treatment for ACL sprains includes PRICER, definitive diagnosis, arthroscopic examination, and reconstruction surgery

    Posterior Cruciate Ligament (PCL) Sprain

    • Mechanisms include external force and hyperextension
    • Signs and symptoms include a "pop" sound, tenderness in the popliteal area, laxity in the posterior "sag" drawer, and rapid swelling
    • Treatment includes PRICER, definitive diagnosis, arthroscopic examination, and reconstruction surgery

    Collateral Ligament Sprains (MCL and LCL)

    • Mechanisms include external force and rotation
    • Non-surgical treatment includes bracing, crutches, active ROM exercises, and strength training

    Meniscal Injuries

    • Mechanisms include rotation while weight-bearing on the leg
    • Signs and symptoms include severe pain, loss of movement, and peripheral tears
    • Treatment includes conservative management vs. surgical repair/meniscectomy

    Patellofemoral Pain Syndrome (PFPS)

    • Mechanisms include lateral tracking of the patella, tight hamstrings, and excessive foot pronation
    • Signs and symptoms include tenderness over the lateral facet of the patella, swelling, stiffness, and crepitus
    • Treatment includes strengthening the VMO, adductors, and abductors, improving core strength, and stretching hamstrings and ITB

    Iliotibial Band (ITB) Syndrome

    • Mechanisms include postural problems, tight quads, and hip flexors
    • Signs and symptoms include sharp stabbing pain over the lateral knee area
    • Treatment includes addressing predisposing factors, training volume, posture education, flexibility and strength exercises, and corticosteroid injection

    Patellar Tendinopathy (Jumper's Knee)

    • Mechanisms include sudden or forceful repetitive knee extension
    • Signs and symptoms include pain and tenderness at the inferior pole of the patella
    • Treatment includes ice, correcting muscle strength and flexibility imbalances, eccentric strength training, and corticosteroid injection

    Quadriceps Contusion ("Corky")

    • Mechanisms include direct blow to the thigh
    • Signs and symptoms include pain, loss of function, stiffness, and weakness
    • Treatment includes PRICER, gentle passive stretching, and surgical intervention in extreme cases

    Knee Osteoarthritis

    • Characterized by a breakdown of articular cartilage, inflammation, narrowing of the joint space, and osteophyte formation
    • Treatment includes normalizing biomechanics, increasing physical activity levels, reducing body mass if overweight or obese, pain medication, corticosteroid injection, and total joint replacement

    Knee - Special Tests

    • Patellar Grinding Test
    • Anterior Draw Test
    • Posterior Draw Test
    • Valgus Stress Test
    • Varus Stress Test
    • Apley's Test
    • McMurray's Test

    Functional Anatomy and Biomechanics of the Ankle and Foot

    • The lower leg consists of the tibia, fibula, and four muscle compartments.
    • The tibia has a proximal tibiofemoral joint and tibial tuberosity (patella tendon), and a distal talocrural (ankle) joint that allows for plantarflexion and dorsiflexion.
    • The subtalar joint, located between the talus and calcaneus, enables pronation and supination.
    • Supination involves foot adduction, plantarflexion, and inversion, while pronation involves foot abduction, dorsiflexion, and eversion.

    Muscle Function

    • There are 12 extrinsic and 11 intrinsic muscles of the lower leg and foot.

    Common Structural Deformities

    • Pes Cavus: an abnormally high longitudinal arch, resulting in a rigid foot position with limited force absorption, increasing the risk of stress fractures and overuse injuries.
    • Pes Planus: an abnormally low longitudinal arch, which may be rigid or flexible, and can cause little supination during gait, placing rotational stress on the hip, knee, plantar fascia, and Achilles tendon.

    Ankle Ligament Sprains

    • Ankle ligament sprains are one of the most common sports injuries, with a high risk in jumping sports (e.g., basketball, netball, volleyball) and running, especially on rough or uneven surfaces.
    • Early treatment enhances recovery time.
    • The most common mechanism of injury is inversion and plantarflexion.
    • The ligaments commonly sprained are the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament.
    • Grading of ankle ligament sprains:
      • Grade I: stretching of the anterior talofibular ligament, with mild pain and disability, and no loss of function.
      • Grade II: tearing of the anterior talofibular ligament, with a tearing sensation, diffuse swelling, and point tenderness.
      • Grade III: severe pain, diffuse swelling, and tenderness over the entire lateral ankle, with all three ligaments torn.

    Lateral Ankle Sprains

    • Treatment for Grade I sprains:
      • PRICE (protection, rest, ice, compression, and elevation)
      • Gentle ROM exercises
      • Gradual weight-bearing
      • Taping
      • Rehabilitation exercises
    • Treatment for Grade II sprains:
      • PRICER (protection, rest, ice, compression, elevation, and rehabilitation)
      • X-ray
      • Crutches
      • Air cast or camboot
      • PF/DF exercises
      • ROM and proprioceptive exercises
      • 1-2 weeks of resumed weight-bearing
      • Taping
      • Graduated rehabilitation
    • Treatment for Grade III sprains:
      • PRICER
      • Short walking cast for 4-6 weeks
      • Similar to Grade II but with a longer healing time
      • Problems can remain for 8-10 months
      • Or surgery due to severe laxity and instability

    Medial Ankle Sprains

    • Medial ankle sprains are less common (<10% of ankle sprains) and often occur due to pronated or hypermobile feet.
    • Mechanism of injury: usually ankle eversion.
    • Signs and symptoms: pain, inability to weight-bear, and 2nd and 3rd degree sprains can cause significant instability.

    Syndesmosis Sprain

    • Syndesmosis sprains occur between the tibia and fibula, including the anterior talofibular ligament, posterior talofibular ligament, and interosseous membrane.
    • Signs and symptoms: tenderness and swelling at the junction of the tibia and fibula, pain on weight-bearing, and talus may slip laterally and be unstable.

    Gastrocnemius Strain

    • Medial head at the musculotendinous junction is the most common site of injury.
    • Mechanism of injury: quick starts and stops during sports (e.g., tennis, squash).
    • Signs and symptoms: sudden pain in the calf, difficulty walking, especially on toes, local tenderness, and swelling.
    • Treatment: PRICE, AROM/gentle stretches, and rehabilitation exercises to prevent scarring and repeated rupture.

    Soleus Strain

    • Signs and symptoms: pain located deep in the calf, pain triggered by tiptoe walking, bruising may appear on the medial border of the tibia, and deep local tenderness over the injured area.
    • Treatment: PRICE, AROM/gentle stretches, and training the muscle to pain threshold with increasing load.

    Achilles Tendinopathy

    • Causes: overuse, prolonged and repeated stress, increased mileage, poor shoes, uneven surfaces, and pes cavus.
    • Prevention: warm-up and stretching of both gastrocnemius and soleus, good quality training and competition shoes, and heel wedge if tension is felt in the Achilles tendon.
    • Signs and symptoms: pain and swelling, crepitus felt over the tendon, erythema, weakness in plantarflexion, restricted dorsiflexion, and point tenderness.

    Medial Tibial Stress Syndrome (MTSS)

    • Also known as "shin splints" or "exercise-related leg pain."
    • Causes: malalignment of the foot or lower leg, muscle fatigue, overuse stress, and sudden changes in training habits.
    • Signs and symptoms: tenderness over the middle to distal medial margin of the tibia, pain occurring after activity, pain affecting performance, and local inflammation.
    • Treatment: rest and ice-massage, taping, alternate heat and cold, stretching gastrocnemius, soleus, and deep PF's, aquatic rehabilitation, and orthotics.

    Plantar Fasciitis

    • One of the most common foot injuries, affecting the plantar aponeurosis, a thick fibrous band covering the plantar surface of the foot.
    • Causes: pes cavus, pronated feet, increased mileage, poor shoes, and restricted dorsiflexion.
    • Signs and symptoms: heel pain under load, morning stiffness, tenderness on pressure, pain if standing on tiptoes or heels, and sometimes heel spurs form.
    • Treatment: rest and ice in acute stages, crutches to decrease load, tape to unload, checking shoes, and self-massage.

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    Related Documents

    Week 5 - Functional Anatomy and Rehabilitation of the Vertebral Column PDF
    Week 6 - Functional Anatomy and Rehabilitation of the Pelvis and Hip PDF
    Week 9 - Functional Anatomy and Rehabilitation of the Knee and Thigh PDF
    Week 10 - Part 1 - Functional Anatomy and Rehabilitation of the Ankle and Foot PDF

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    Quiz on functional anatomy and rehabilitation, covering topics related to EHR520 Week 5. Test your knowledge of human anatomy and rehabilitation techniques.

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