The Foot and Toes continued

1
Chapter 4

• The Foot and Toes continued

2
Clinical Evaluation of Foot and Toe Injuries

• May involve evaluation of lower extremity
• Athletic Trainer and athlete/patient must be
  prepared
• Evaluation Map, Page 99

3
History

• Location of pain (Table 4-5, page 100)
• Retrocalcaneal pain
• Heel pain
• Medial arch pain
• Metatarsal pain
• Greta toe pain
• Lateral arch pain
• Onset and mechanism of injury
• Acute onset
• Insidious onset
• Playing surface, distance, duration, shoes

4
Inspection

• Begins immediately
• Gross deformity, swelling, redness
• Inspect footwear for wear patterns and
  appropriateness
• Weight-bearing vs. non-weight-bearing

5
General Inspection of the Foot

• Foot Type (pronated, neutral, supinated)
• Figure 4-11, page 102
• Table 4-6, page 103
• Box 4-1, page 104
• Calluses and blisters
• Improperly fitting shoes, poor biomechanics, or
  underlying bony or soft tissue dysfunction

6
Inspection of the Toes

• General toe alignment (Box 4-2, pg 105)
• Mortons alignment
• Claw toes
• Hammer toes
• Hallux abducto valgus
• Corns
• Ingrown toenail (Figure 4-12, page 104)
• Subungual hematoma (Figure 4-13, page 106)

7
Inspection of Structures

• Medial
• Medial longitudinal arch
• Weight-bearing vs. non-weight-bearing
• Lateral
• Fifth metatarsal
• Dorsal

8
Inspection of Structures

• Plantar Surface
• Plantar warts (Figure 4-14, page 106)
• Verruca vulgaris
• Calloused skin, excessive stress
• stepping on a pebble

9
Inspection of Posterior Structures

• Achilles Tendon
• Relationship/alignment to tibia
• Figure 4-15, page 107
• Calcaneus
• Retrocalcaneal exostosis (pump bump)
• Figure 4-16, page 107

10
Non-Weight-Bearing Inspection of Foot and
Calcaneal Alignment

• Assessment of talar position
• Subtalar neutral position
• Alignment of forefoot and rearfoot
• Mobility of the first ray
• Pes planus hypermobility
• Pes cavus rigid ray

11
Inspection of Foot Alignment

• Forefoot vs. rearfoot
• Weight-bearing, non-weight-bearing and/or both
• Figure 4-18, page 107
• Foot Posture
• Subtalar joint in neutral position
• Box 4-3, page 109
• Plantarflexed first ray
• Pes cavus, genu varum, it is NOT forefoot valgus

12
Palpation

• Patient positioning
• Refer to list of Clinical Proficiencies
• Utilize pages 108 112 in textbook