DPT 642: Foot & Ankle

walking, jumping, running

how are the feet used for mobility?

balance- they are the base for dynamic and static movements

how are the feet used for stability?

catching yourself when you slip, walking over uneven surfaces and change shape when walking on different surfaces/on different shoes

how are the feet used for adaptation?

feel changes in pressure.. Pressure sensors are a big part of balance.

how are the feet considered a sensory organ?

forefoot, midfoot and rearfoot

3 parts of the foot

talocrural joint

a joint in the ankle found between the tibia, fibula, and talus

high ankle sprain

sprain interosseous ligament which allows tibia and fibula to separate more than they should

loss of the tight fitting of the tibia and fibula

what is the cause of instability during a high ankle sprain

the more we weight bare, the more changes in the orientation of bone occurs

what is the correlation between bone orientation and weight bearing in the talocrural joint?

Calcaneus, distal metatarsal head of the big toe, lateral 5th met head during gait

what are the weight bearing bones of the foot?

fat pads

the weight bearing bones of the foot contain these, which provide shock/pressure absorption and cushioning

everywhere

where does motion happen in the foot?

flexibility

the open space within the subtalar joint gives it...?

plantarflexion, dorsiflexion, abduction, adduction, inversion, eversion

straight plane motions of the subtalar joint

eversion, abduction, dorsiflexion

what three movements make up pronation?

inversion, adduction, plantarflexion

What three movements make up supination?

the tibia and fibula supporting the sides of the talus

what makes it hard to invert/evert the foot?

inversion

is more inversion or eversion allowed?

fibula drops more distally

why is inversion more freely permitted?

anterior talofibular ligament and the calcaneofibular ligament

what are the 2 most commonly sprained ligaments of the ankle?

plantarflexion and dorsiflexion

what is the only motion that the talocrural joint allows?

roll backwards, slide forward

what are the arthrokinematics of open chain plantarflexion of the talocrural joint?

roll forward, slide backward

what are the arthrokinematics of open chain dorsiflexion of the talocrural joint?

roll forward, slide backward

what are the arthrokinematics of closed chain plantarflexion of the talocrural joint?

roll backward, slide forward

what are the arthrokinematics of closed chain dorsiflexion of the talocrural joint?

push off

during gait, the greatest degrees of freedom of the talocrural joint occurs during which part

stability, mobility

regarding the talocrural joint:

In dorsiflexion, there's a lot of ________

In plantarflexion, there's a lot of _________

Talus, calcaneus, and navicular

the subtalar joint is a tripod with 3 facets located on which bones

subtalar

which joint has the most off axis movement?

abduction and adduction

which motions cannot be done voluntarily?

adaptation- conform to ground and shoes for stability

why is inversion and eversion important for the foot?

transverse tarsal joint

comprised of the calcaneocuboid joint and subtalar joint

supination of an unloaded foot

Tibia posterior pulls lateral column of foot under medial column - primarily spin at talonavicular joint

calcaneus

if we stabilize this bone, it isolates the transverse tarsal joint motion

closed chain supination

Tibia externally rotates

Arch raises

Talus everts

Forefoot adducts

open chain pronation

Fibularis longus lowers the medial side, raises lateral side - primarily spin at talonavicular joint

closed chain pronation

Tibia internally rotates

Arch collapses/lowers

Talus inverts

Forefoot abducts

locked

If subtalar joint fully supinated (inverted) - transverse tarsal joints are ______

mobile

If subtalar joint is pronated (everted) - transverse tarsal joints _______

talonavicular

this joint is the keystone for the medial longitudinal arch

medial longitudinal arch

comprised of the calcaneus, talus, navicular, cuneiforms, 3 medial metatarsals

pes cavus

Abnormally high arch of the foot

pes planus

Collapsed arch of the foot; also known as flat feet.

eversion

Closed chain:

When internally rotating the foot, the _________ of the calcaneus causes the arch to collapse

inversion

Closed chain:

When externally rotating the foot, the ________ of the calcaneus causes the arch to raise

internally rotating

during open chain inversion, the foot is doing what?

externally rotating

during open chain eversion, the foot is doing what?

distal intertarsal joints

Allow the foot to shape to the shape it needs to be for its functions (accommodation/adaptation)

into it

inversion of the 1st metatarsal joint involves the metatarsal rolling where in relation to the foot?

away from

eversion of the 1st metatarsal joint involves the metatarsal rolling where in relation to the foot?

bunions

Metatarsal everts, causing WB to be on medial/lateral side of met head

windlass effect

Dorsiflexion of the big toe creates tension on plantar fascia and causes the 1st metatarsal and calcaneus to move closer together, height of arch increases , gives elastic energy when walking

plantarflexors

group of muscles that produce the most power during gait