ll 1 deformities and interventions

hallucis limited to 50% of normal extension, fusion of 1st MTP joint, bony growth on dorsum limiting extension

presentation of hallucis rigidis

overuse or injury, arthritis, more prevalent in females

mechanism of hallucis rigidis

stiff sole with rocker toe, carbon orthotic shoe insert

intervention for hallucis rigidis

lesser toe deformities, painful if rigid, blisters and redness; tends to occur with neurological problems

presentation of mallet/hammer/claw toes

trauma or disease, muscle imbalance

mechanism of mallet/hammer/claw toes

extra deep shoe, FO to redistribute pressure, surgery

intervention for mallet/hammer/claw toes if rigid

splinting (ex. Boudin's splint), stretching, massage, FO to redistribute pressure

intervention for mallet/hammer/claw toes if flexible

bunion

layman's word for hallux abducto valgus

pain at skin or deep within 1st met; limited motion of 1st met

presentation of hallux abducto valgus

excessive pronation after mid-stance "unlocks" the foot, so joint subluxes and alters cartilage. 1st met is pushed upward by GRF and tendons of foot pull great toe laterally

mechanism of hallux abducto valgus

FO- proximal to met head trimline, medial hind foot posting

intervention for hallux abducto valgus

formation of exostosis on dorsal aspect of 1st MTP joint, which mechanically blocks extension of MTP during 3rd rocker; pain on dorsum of joint that increases w/ activity

presentation of dorsal bunions

benign bone tumor

what is an exostosis

limited motion at MTP which subluxes during pre-swing, resulting in compressive forces on dorsum of MTP joint

mechanism of dorsal bunions

FO that redistribute weight and return 1st MTP joint to normal ROM; metatarsal bar or rocker bottom

intervention for dorsal bunions

formation of callus under IP joint of hallux as a result of ossified cartilage

presentation of interphalangeal sesamoids

1st MTP elevates and locks, IP joint hyperextends; excessive force on cartilage under IP joint and ossifying it

mechanism of interphalangeal sesamoids

surgery for larger sesamoids; FO that limits ROM and has soft top cover

intervention for interphalangeal sesamoids

thickened skin on medial hallux; painful or leads to ulcers in diabetics

presentation of pinch callous

limited dorsiflexion at MTP joint, external rotation of foot during pre-swing, shear forces on medial aspect of foot

mechanism of pinch callous

trimming of callous, FO to reduce pronation, proper footwear

intervention for pinch callous

varying pain, numbness and burning, feels like something is "in shoe"

presentation of Morton's neuroma

excessive pronation or instability of foot compresses intermetararsal nerve, thickenening the sheath

mechanism of Morton's neuroma

cortisone, surgery; FO with met pad, rocker, or met bar

intervention for Morton's neuroma

supports great toe while others move freely

what does Morton's extension do?

proximal to met heads

where is the met pad for a Morton's neuroma FO places?

metatarsalgia

other name for sub-metatarsal bursitis

pain at met heads, feels like something in shoe, callous formation

presentation of sub-metatarsal busitis

excessive pronation or trauma; metatarsal drops closer to plantar surface, leading to poorly-distributed loading and formation of protective bursa

mechanism of sub-metatarsal bursitis

FO with met pad

intervention for sub-metatarsal bursitis

pain at 5th met head with overgrowth of bone

presentation of Tailor's bunion

bunionette

other name for Tailor's bunion

GRF shifts 5th met dorsally and laterally, sometimes as a result of incorrect shoe foot

mechanism of Tailor's bunion

FO, proper shoes, surgery in severe cases

intervention for Tailor's bunion

shin splints

common name for tibialis anterior tendonitis

pain on anterior leg that worsens after vigorous activity

presentation of tibialis anterior tendonitis

excessive pronation, repetitive motion on hard surfaces

mechanism of tibialis anterior tendonitis

FO to decrease force needed to maintain arch; taping

intervention for tibialis anterior tendonitis

enlarged navicular

presentation of accessory navicular

congenital, usually asymptomatic

mechanism of accessory navicular

CAM boot, FO to support MLA and move navicular laterally, surgery

intervention for accessory navicular

pain in heel or entire plantar aspect after period of inactivity

presentation of plantar fasciitis

inflammation of plantar fascia due to lengthening and stress, potentially creating heel spur on calcaneus

mechanism of plantar fasciitis

FO to shorten length of plantar fascia with MLA and soft heel cup; stretch ligament in PT; night-time splint

intervention for plantar fasciitis

heel spur

what other foot condition is associated with plantar fasciitis

pain on medial calcaneus, usually after period of inacitivity

presentation of heel sput

plantar fascia pulls calcaneus, resulting in ossification of bone

mechanism of heel spur

FO with MLA to shorten length of plantar fascia, plus use soft heel cup; cortisone shots, PT, surgery if severe

intervention for heel spur

inflammation of bursa on heel, burning sensation that gets worse as day progresses

presentation of sub-calcaneal bursitis

excessive eversion of calcaneus; overuse

mechanism of sub-calcaneal bursitis

FO to distribute weight (use soft top cup and soft heel cup)

intervention for sub-calcaneal bursitis

flat feet; foot pain and fatigue

presentation of pes planus

normal in children under 6; congenital, acquired due to trauma

mechanism of pes planus

FO and posting; more treatable if flexible

intervention for pes planus

high MLA with pain on lateral border and met heads; callouses at met heads and heel

presentation of pes cavus

congenital; associated with NM disorders, hard to absorb shock

mechanism of pes cavus

FO to redistribute weight and have soft top cover for shock absorption

intervention for pes cavus