AFFECTATIONS OF THE ANKLE AND FOOT FUNCTIONS OF THE FOOT 1. Support for the weight of the body 2.

Act as a lever in raising and propelling the body forward in walking and running Muscles of the leg - provides power - together with the tendons supply balance for the foot Head o the metatarsals fulcrum 2 main arches Longitudinal or Long Arch - Compose of 2 components: Medial More obvious Comprise of: - Calcaneus - Talus - Navicular - 3 cuneiform bones - 1st 3 metatarsal heads Rests on the head of the 1st metatarsal and on the calcaneus -

Lateral Consist of: - Calcaneus o Supports the back - Cuboid - 4th and 5th metatarsal bones o Supports the front

Transverse or Metatarsal Arch Formed by 5 metatarsal bones most prominent at the level of their bases Standing no arch at their level because they bear weight

Movements of the foot and ankle most important in diagnosis and treatment of the foot Neutral 0 position of the ankle permits: o Extension (dorsiflexion) of 20o o Flexion (plantar flexion) of 50o Motions occur in subtalar joint between talus and calcaneus and in transverse tarsal or midtarsal joint between talus and navicular and between calcaneus and cuboid o Foot is inverted or in varus position when so rotated and plantar surface faces medially o Foot is everted or in valgus position plantar surface faces outwardly Primary motion of the transverse tarsal joint of the anterior portion of the foot: o Adduction or inward swinging o Abduction or outward swinging o Pronation the combination of eversion and abduction o Supination the combination of inversion and adduction FOOT STRAIN

Common overuse condition Characterized by pain and tenderness about the longitudinal arch Usually the result of excessive and unaccustomed standing and walking CHRONIC STRAIN o Occurs when person changes from a sedentary job desk to one that requires prolonged standing o Obesity rapid weight gain, places excessive burden on the feet Pronation of flatfoot may deformity may develop as result of chronic foot strain

Clinical Picture - May be acute or chronic - Frequently affects adults and rare in children - ACUTE FOOT STRAIN o Pain and tenderness in the region of the longitudinal arch to such degree that the patient is unable to bear weight on the foot - CHRONIC FOOT STRAIN o Complains fatigue and aching in the feet o Discomfort is felt chiefly on the longitudinal arch but may extend up on the calves o Symptoms are worse towards the end of the day o Evening feet may feel tight and swollen o Most important physical finding localized tenderness beneath navicular bone and at the apex of the longitudinal arch o Pronation of the foot is obvious in standing Treatment - Immediate problem of pain and tenderness responds to local treatment - Hot soaks and contrast baths may relieve the discomfort - Support for the longitudinal arch should be provided - ACUTE CASE o Adhesive strapping - CHRONIC STRAIN o Use of felt or sponge rubber arch pad is helpful o Shoe with a long counter and firm shank will give increase support o Thomas heel extended forward medially to give support beneath the navicular o Medial border of the heel may be raised in 5mm o Restoring strength aided in doing exercise on both long and short muscle - Weight reduction may be helpful - Modification of job is occasionally necessary