Regional Foot Pain 1

Front 1

List 2 common and 2 less common rear foot pain

Back 1

• Plantar fasciitis
• Fat Pad Contusions

Less:

• Calcaneal Fractures
• Tarsal Tunnel Syndrome

Front 2

Most Common cause of heel pain?

Back 2

• Plantar Heel Pain

Front 3

Describe characteristics of Plantar Fasciitis?

Back 3

• Insidious (gradually gets worse) with first step pain (first step following rest)
• generally an over use injury, with repetitive tensile load. i.e pes planus- all weight loading on
• medial aspect- all weight on fascia.
• pathological changes comparable to tendinitis (inflammation) and tendinosis (degreneration)

Front 4

Link between heel spur development and plantar fasciitis

Back 4

• Bone growth to compensate, bone not the issue, its soft tissue pulling away from spur that caused pain.

Front 5

Treatment of Plantar Fasciitis

Back 5

• manage symptoms
• stretching- often in combo with calf tightness
• Correct biotech issue through- taping, orthoses, footwear
• decrease irritation i.e activity levels
• surgery

Front 6

Describe Achillies Tendinopathy

Back 6

• Insidious onset
• tendinitis or tendinosis
• swelling tenderness, bursae may be present
• overuse injury but may be extrinsic
• common in runners

Front 7

Precipitating factors of a chillies tendinopathy

Back 7

• Biomech deficits
• Old age
• Male Gender
• Increased body weight and height
• Tight gastro-soleus complex

Front 8

Rx Achillies Tendinopathy

Back 8

• rest w gradual return to activity
• eccentric muscle loading
• correct biomech factors
• steroid injection

Front 9

Name and describe test used to determine achillies injury

Back 9

Thompson Test: Patient is prone and the examiner squeezes the patients proximal 1/3 of calf and plantarflexion shoulder occur. A + test is no plantarflexion.

• Complete rupture: nothing happens- no PF
• Partial: small movement

Front 10

Describe Retrocalcaneal Bursitis

Back 10

• Bursa between Achillies tendon and calcaneus
• inflammed due to extrinsic factors i.e too much lateral force down AT.
• Caused by both pes cavus and pea planus
• Rx includes off-loading and NSAIDS
• Can develop into Haglund Deformity

Front 11

Describe Severs Disease

Back 11

Calcalneal Apophysitis

In Children

Self limiting occurs > Males

Inflammation of the growth plate, starts slightly swollen then calcifies

Front 12

Causes of Severs?

Back 12

Rapid growth

Tight Calfs

Hard Surfaces

Poor Footwear

Front 13

Rx for severs?

Back 13

• Heel raises
• footwear modification
• stretching
• NSAIDS

Front 14

Describe Plantar Fat Pad Contusion and Rx

Back 14

• caused by major trauma
• damage to protective fat pad on plantar surface of calcaneus
• Rx rest, use of heel cup and good footwear

Front 15

List 2 common forms of ankle pain and 2 less common forms, and 1 not to be missed form of ankle pain

Back 15

Common:

• Sinus Tarsi Syndrome
• Tendinitis (PT, FHL and Peroneals)

Less Common:

• Stress fracture (talus/calcaneus)
• Tarsal Tunnel Syndrome

Not to be missed:

• Navicular Stress fracture
• CRPS

Front 16

Describe location of sinus tarsi, how injured and Rx

Back 16

• L side of hind foot, groover between talus and calcaneus
• Interosseous talocalcaneal ligament w/in sinus becomes injured/sprained
• Rx rest, ccsteroid, management of biotech factors and surgery

Front 17

Describe Tarsal Tunnel Syndrome

Back 17

• Constriction of PT nerve through tarsal tunnel
• Tunnel sites between flexor retinaculum and medial malleolus
• Shooting pain, follows line of nerve
• Neural symptoms throughout plantar foot

Front 18

Diagnosis of TTS?

Back 18

• Tinels sign: detects irritated nerve, extend foot and rotate laterally, tap behind m.mall = Pain

Front 19

Describe Tarsal Coalition

Back 19

• Failure of separation of bones either: Calcaneonavicular (most common) or talocalcaneal joint)
• Asymptomatic in adulthood
• Symptomatic in teenage years, painful flat foot
• Need surgery
• Can be fibrous, osseous or cartlaginous

Front 20

Problems with Tarsal Coalition

Back 20

• Increases ankle sprains due to lack of ROM, ligaments take force instead
• Progressive ossification w increasing age, thus decrease ROM- often corresponds with onset of symptoms
• Usually calc first bone to ossify in foot.

Front 21

Rearfoot Pain and Systematic Syndromes: Causes

Back 21

• Diabetes- nerve pain
• Metabolic- gout and pseudo gout
• Inflammatory arthritides- i.e RA
• Pagets Disease
• Neoplastic
• Trauma