Recognize common injuries and overuse conditions that occur to the foot and toes.
Demonstrate applying tapes, wraps, braces, and pads to the foot and toes when preventing, treating, and rehabilitating injuries.
Explain and demonstrate evidence-based practice for the implementation of taping, wrapping, bracing, and padding techniques for the foot and toes within a clinical case.
During athletic, work, and casual activities, the foot and toes must react to acute and chronic forces. As a result, injuries and overuse conditions often occur. Walking produces constant shearing forces between the foot and toes and the ground in anteroposterior, lateral-to-medial, and vertical directions. During running, these same forces increase as speeds increase. In sports, sudden cutting, twisting, and deceleration movements further increase the stresses. A contusion, sprain, or fracture can occur when a football wide receiver decelerates and plants his right foot to make a cut or quick turn to his left, placing anteroposterior, lateral-to-medial, and rotational stresses on the foot and toes. Common injuries to the foot and toes include the following:
Contusions to the foot and toes are caused by compressive forces and weight-bearing activities. A contusion is trauma to the soft tissue. Compression on the dorsal or plantar surface of the area can cause inflammation and pain. For example, activities that require jumping and sudden change of direction can lead to contusion of the calcaneus, referred to as a heel bruise (Fig. 3-1). Training errors and the use of poorly designed shoes may contribute to such injuries.
Sprains to the toes are typically caused by contact with an unmovable object, producing abnormal joint range of motion. A sprain involves trauma to ligaments and may result in only mild pain or complete loss of function. Sprains are commonly categorized as Grade I, II, or III, with III being the most severe. Forced hyperextension of the metatarsophalangeal (MTP) joint of the great toe (turf toe) is associated with excessive flexibility of athletic shoes and sport activities on artificial grass surfaces (see Figs. 3–1 and 3–2). Another sprain to the great toe MTP joint is caused by forced hyperflexion (soccer toe) and may occur with instep ball strike of a soccer ball. 1 Sprains to the MTP and interphalangeal (IP) joints of the toes are caused by valgus and varus stresses and result in injury to the collateral ligaments (see Fig. 3-1). Midfoot sprains occur through excessive plantar flexion, dorsiflexion, or rotational stress that can occur with stepping on an opponent’s foot or stepping into a hole.
Bones and joints of the foot and toes.