Thursday, January 31, 2008

foot problems in sport (article in GP 1/2/08)

synovitis (metatarsalgia)

trauma and overuse cause metatarsalgia - pain in the forefoot, a synovitis of the mtp joints
treat - nsaid, orthotics, foot stretching exercises

turf toe

forced hyperextension of big toe
nsaid + rest

stress fractures

commonest 2nd metatarsal 9 esp. if have mortons foot - ie 2nd m/t longer than the 1st

sesamoid disorders

2 sesamoid bones in tendons of flexor hallucis brevis, damaged with jump type trauma or a wrenching up of big toe
rice/ nsaid

mortons neuroma

base 3rd + 4th toes thickened nerve tissue, causes pain and numbness of webspace, usually no pain barefoot!
confirmatory test - local in intermetatarsal space
orthotics, injection, neurolysis or excision

lisfranc injury

lisfranc ligament disruption

mid foot stress fracture

sprinting/jumping/hurdling - navicular bone

mid foot tendinopathy

overuse - local tenderness/pain on passive stretch or actice resisted movt
rice/nsaid

heel pain

avoid steroid injections for plantar fasciitis - cause fat necrosis in heel pad
physio to stretch gastrocnemius

tarsal tunnel syndrome

positive tinels test behind medial malleolus

heel contusion

fat in heel acts as a shock absorber and contusions are very painful

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