Foot and Toes | |||
History Location of the Pain Retrocalcaneal Inflammation of the Retrocalcaneal bursa or Achilles tendon Trigonum pathology. Heel Plantar fasciitis or heel spur Referred pain from lumbar nerve roots or their peripheral nerves Medial arch Tarsal tunnel syndrome Midfoot sprain Plantar fasciitis Navicular fracture Tibialis posterior tendonitis. Metatarsal Stress fracture (March fracture) Impingement of the intermetatarsal nerves Metatarsalgia Toes Hallux rigidus Hallux abducto Valgus Sesamoiditis Gout (A form of arthritis marked by inflammation and pain in the distal joints) Lateral arch Compression of the posterior tibial nerve Fracture of the fifth MT (Jones’ fracture) Peroneal tendinitis Onset of Injury Acute onset Insidious onset Mechanism of injury Playing surface Running distance & duration Shoes Inspection General Inspection Callus and blister Tinea Pedis (A fungal infection of the foot and toes) Foot type (Pronated / Supinated foot) Toes Morton’s alignment Second ray during push off, causing hypertrophy of the second MT Claw toes (Pes cavus) Hammer toe Hallux (abducto) Valgus Cerebral palsy (A birth-related neurologic defect that results in motor dysfunction) Rheumatoid arthritis Osteoarthritis Bunion Bunionette (lateral aspect of the fifth MTP joint) Corns Hard corns (heloma dura) on toes and PIP joints Soft corns (heloma molle) between the toes Ingrown toenail Subungual hematoma Medial Structures Medial arch Pes planus (flat foot) Pes cavus (high arch foot) Lateral Structures Fifth metatarsal Dorsal Structures Plantar Surface Plantar warts Callus Posterior Structures Achilles tendon Pes planus (Bowing of the tendon) Calcaneus Retrocalcaneal Exostosis (Haglaund’s deformity or “pump bumps”) Foot Alignment Forefoot varus Forefoot Valgus Rearfoot varus (Calcaneovarus); supination of subtalar joint associated with calcaneal inversion. Rearfoot Valgus (Calcaneovalgus); pronation of subtalar joint caused by eversion of Calcaneus. Non-Weight Bearing Inspection of foot alignment Assessment of talar position Palpation Medial Structures First MTP joint First metatarsal First cuneiform Navicular Talar head Sustentaculum tali Spring ligament Medial talar tubercle Calcaneal dome Flexor Digitorum longus Flexor Digitorum longus Tibialis posterior Posterior tibial artery Lateral structures Fifth MTP joint Fifth metatarsal Styloid process Cuboid Lateral border of the Calcaneus Peroneal tendons Dorsal structures Sinus tarsi Dome of the talus Cuneiforms Rays Tibialis anterior Extensor hallucis longus Extensor Digitorum longus Extensor Digitorum brevis Inferior extensor retinaculum Dorsalis perdal artery Intermetatarsal neuromas Plantar structures Medial calcaneal tubercle Plantar fascia Sesamoid bones of the great toe Metatarsal heads Range of Motion Tests Toes AROM/ PROM/ RROM (Flexion & Extension) Related Motions Subtalar joint (Inversion & eversion) Talocrural joint (Dorsiflexion & plantarflexion) Ligamentous Capsular Tests MTP and IP joints Valgus stress testing (MCL sprain) Varus stress testing (LCL sprain) Metatarsal and Tarsal joints Intermetatarsal glide (Transverse metatarsal ligament or interosseous ligament) Tarsometatarsal joint glide Midtarsal joint glide Mobility of the first ray Neurologic Tests Tarsal tunnel Peroneal nerve Sciatic nerve Lumbar or sacral nerve root impingement Special Tests |