Lower Leg and Foot Injuries

Recognition and Management of Foot Injuries

• Heel bruise

Cause: sudden stop and go; sudden horizontal and vertical movements

S&S: severe heel pain; warmth; unable to weight bear

Care: ice; rest; non-weight bearing for 24 hrs; heel cup; doughnut

• Plantar fascitis

Cause: leg length discrepancy; inflexibility of longitudinal arch; gastroc/soleus tightness; shoes w/o arch support

S&S: pain worse in am or long periods of sitting; lessens after first few steps

Care: vigorous heel cord stretching; orthotics; heel cup; arch tape; massage

• Fractures of the metatarsals

Cause: direct force

S&S: swelling; pain; deformity; pt. tenderness

Care: rest; immobilization;

• Jones Fracture (5th metatarsal)

Cause: inversion and plantar flexion (ankle sprain); direct force; repetitive stress

S&S: immediate swelling; pain over 5th metatarsal

Care: controversial; surgery recommended; rehab

• Bunions

Cause: painful deformity of head of 1st metatarsal (mt); narrow shoes

S&S: tenderness; swelling; enlargement with calcification of head of 1st mt

Care: Shoes; doughnut; orthotics; possible surgery

• BlistersCause: shearing forces acting on skin

S&S: fluid - clear, bloody, or infected

Care: petroleum jelly; doughnut; second skin; drain; antibiotic ointment; socks; be sure to keep clean and covered to prevent infection

• Morton’s Neuroma

Cause: mass that occurs above the nerve sheath of the plantar nerve; usually between 3rd and 4th mt; collapsed arch; pronation

S&S: burning parasthesia; severe intermittent pain in the forefoot; pain relieved with non-weight bearing

Care: padding; shoes; surgery

• Turf toe

Cause: hyperextension of 1st MTP joint; sudden trauma; overuse; turf

S&S: pain; swelling

Care: tape; steel insoles; rest

• Ingrown toenail

Cause: poor fitting shoes; improper nail trimming; trauma

S&S: pain; swelling

Care: soak in hot water (105 - 110F) for 20 min then pry out of skin, lift the nail and insert a piece of cotton to keep the nail out of the skin; trim nail straight across

• Toenail hematoma

Cause: stepped on; dropping object; kicking object

S&S: extreme pain; bleeding in nail bed

Care: drill nail to drain fluid needs to be done immediately before blood dries