Lab 5: Foot and Toes

Lab 5: Foot and Toes Complete the following activities during your lab class under the guidance of your instructor. Objectives of Lab: • Identify common injuries and overuse conditions that occur to the foot and toes. • Demonstrate application of tapes, wraps, braces, and pads to the foot and toe for the purpose of preventing, treating, and rehabilitating injuries. Lab Activity 1: The Foot and Toes 1. Look at the model and show your partner each of the bones of the foot/ankle/lower leg by name. Palpate these bones on your partner’s lower leg and ankle. a. Tibia/Fibula d. Calcaneus g. Cuboid b. Sesamoids e. Navicular h. Metatarsals c. Talus f. Cuneiforms i. Phalanges 2. Identify and palpate the following muscles and describe their function in the space provided. a. Flexor hallucis longus/brevis: Flexes the first MTP joint and maintains the medial longitudinal arch. Assists with toe-off phase of gait providing increased push off b. Flexor digitorum longus/brevis: Movement and curling of the 2nd, 3rd, 4th, and 5th toes c. Extensor hallucis longus/brevis: Extend the big toe, dorsiflex the foot and assist with eversion and inversion d. Extensor digitorum longus/brevis: Extends toes and extends foot at ankle e. Tibialis anterior: Extends and inverts foot at ankle. Holds up medial longitudinal arch f. Tibialis posterior: Plantar flexes and inverts foot. Supports medial longitudinal arch g. Peroneal longus/brevis: Plantar flexes and everts foot. Supports lateral longitudinal and transverse arches h. Peroneal tertius: Extends and everts foot 3. Look at the model and show your partner each of the following ligaments of the foot/ankle. Palpate these ligaments on your partner’s foot/ankle. List the function of each in the space provided. a. Plantar fascia: Stabilizes the arch of the foot and allows flexion of the first metatarsal, enabling the first metatarsal to carry the majority of the body weight b. Plantar calcaneonavicular: Maintain the medial longitudinal arch of the foot and provides support to the head of the talus which bears the major portion of the body weight 2 4. Look at the model and show your partner each of the following ligaments of the foot. a. Longitudinal arch b. Transverse arch c. Metatarsal arch Lab Activity 2: Prevention of Common Conditions 1. Identify three effective prevention strategies and the associated common conditions related to the foot and toes. a. Ankle Brace b. Strengthening c. Stretching Lab Activity 3: Application of Taping, Wrapping, Bracing, and Padding Practice and demonstrate your ability to appropriately apply these techniques with a partner, as demonstrated and instructed in class. Additionally, list two common conditions that each of these techniques would be useful with during treatment and rehabilitation. 1. Taping a. Circular arch: Treating longitudinal arch strains and managing pes cavus conditions b. X-arch: Provides mild support to the longitudinal arch and forefoot in the treatment of arch strains, plantar fasciitis c. Low dye: Designed to off-load the plantar fascia d. Toes strips: Protect the MTP by preventing it from being bent upwards 2. Bracing a. Walking boot: Sprain and Strains b. Heel cups: Reduce heal pain associated with contusions, spurs, plantar fasciitis, and lower leg, knee, and back injuries and conditions. c. Soft insoles: Provide shock absorption for the entire plantar surface of the foot. d. Night splint: Designed to keep the foot and ankle in 5 degrees of dorsiflexion to provide a static stretch of the plantar fascia and Achilles tendon while the individual is sleeping to reduce pain in treating plantar fasciitis. e. Semirigid orthotics: Preventing and treating many rearfoot and forefoot injuries and conditions such as MTP sprain, arch strains, interdigital neuroma, sesamoid fractures, metatarsalgia, bunions, and plantar fasciitis. 3 3. Padding a. Metatarsal bar: Reduce stress and load on the metatarsal heads treating sesamoiditis and metatarsalgia. b. Tear drop: Provides mild support to the metatarsal arch in treating interdigital neuroma. c. “J”: Used to treat sesamoiditis fractures to unload or lessen stress to the area. d. Heel pads: Used in treating plantar fasciitis to provide shock absorption and relief of pain by compressing the fat pad under the calcaneus. Also, maty be used to lessen stress on the Achilles tendon. Commonly used when soft heel cups are not available. Lab Activity 4: Case Scenarios 1. Alisha, a women’s soccer athlete, reports to the athletic training room complaining of right foot pain. The patient complains of pain under the great toe, especially during a push-off. There is palpable tenderness under the first metatarsal head. a. What conditions could this athlete be experiencing with the given information? Turf Toe, Metatarsalgia b. What applications would likely be effective for lessening the symptoms associated with the conditions you have selected? Toe Strips Tape her into a flexed or neutral position 2. Late in the season, a collegiate softball outfielder begins to demonstrate pain over the medial heel. Upon examination, you notice the athlete has pes planus and tight gastrocnemius/soleus complex. a. What condition is this athlete most likely experiencing? Fat Pad Contusion, Spur b. What management techniques could we implement to help reduce symptoms? Explain in detail. Heel Cup because it provides cushion, X-arch because we are supporting the arch, J-Pad around the painful area to take pressure off when she hits the ground, Semirigid orthotic to take pressure off when she hits the ground, Heel Pad to provide cushion 4 3. After practice, a high school football athlete removes his cleats and walks to the locker room with bare feet. He steps on a rock and suffers a contusion to the right calcaneus. The next day, he experiences moderate pain with weight-bearing activities. What bracing or padding techniques can you use to treat his heel? Heel Pad, Heel Cup, Orthotic, Soft Insoles, don’t walk around barefoot, J-Pad, Donut Pad REFERENCES Prentice, W. E. (2017). Principles of athletic training: a guide to evidence-based clinical practice. New York, NY: McGraw-Hill Education. (n.d.). Retrieved from http://www.meddean.luc.edu/lumen/MedEd/GrossAnatomy/dissector/mml/pert.htm 5