Signs and Symptoms Moderate to severe injury with pain in anterior and medial

Signs and symptoms moderate to severe injury with

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Signs and SymptomsModerate to severe injury with pain in anterior and medial anklePoint tenderness in the area of the syndesmosisEcchymosis/swelling at medial anklePain with EROTPain with WB, poor balance, decreased ROM46
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ImagingX-ray to rule out associated fractureStress x-ray in EROT may show diastasisMRI may help show level of disruption to AITFL47
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TreatmentWith no separation, conservative treatment is indicated If there is dital tib-fib diastasis, surgery may be indicated48
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Return to PlayExpected recovery time is 12+ weeks conservativelyWith good management, prognosis is good49
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Plantar Fasciitis50
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Plantar FasciitisPlantar fascia is soft tissue that maintains the integrity of the longitudinal arch51
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Plantar “Fasciitis” Not necessarily an inflammatory conditionTypically results from overuse of the plantar fascia at its attachment site (calcaneus)Damage to collagen fibersMay be called “fasciosis or fasciopathy”, but plantar fasciitis is still commonplace52
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Mechanism of InjuryOveruseCan be caused by high or low archesPoor footwearCan result from repeated ankle plantarflexion with MTP joints in extreme dorsiflexionRunningDancingGymnastics 53
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Risk FactorsTight posterior structuresGastrocSoleusHamstringGlutealsHip stabilizersHigh BMIProlonged work-related WB54
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ExamPoint tender along medial aspect of calcaneus Pain may be worse in AM, and decrease after some walkingAfter enough time, pain may be present throughout the dayObservation of single leg stance or squat may reveal weakness of intrinsic foot musclesToe clawingUltrasound may show thickening of the fascia55
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TreatmentAcuteStretching posterior structuresMassage of PFIceActivity reductionTapingCorticosteroid injectionOrthoses56
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TreatmentLong-termIntrinsic foot muscle strengtheningAnkle and hip strengtheningNew footwear/orthosesNight splintSurgery may be indicated if no success with conservative treatment57
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Turf Toe1stMT joint sprain58
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Turf ToePlantar capsule and 1stMTP joint is injured 59
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Mechanism of InjuryDue to acute or repeated hyperextension of the 1stMTP joint60
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Turf ToeGradeDescriptionTreatmentReturn to Play1Attenuation of plantar structures
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  • Fall '14
  • high ankle sprain

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