Foot and Ankle (Orthopedic)

Posture, general appearance, ambulation
Special Tests
ROM (DF/PF, inversion/eversion, knee extension)
Strength (DF/PF, inversion/eversion, knee flexion/extension, hip ABD, hip extension)
Joint mobility 
Palpation
Muscle length testing (gastrocnemius/soleus)

Outcome Measures: FFI, FAAM, PSFS, pVAS



Talar/Talocrural glides

Subtalar tilt


Plantar Fasciitis

https://www.orthopt.org/uploads/content_files/files/Heel%20Pain%20Revision%20Decision%20Tree.pdf 



Ankle Sprain


Interventions
-Acute phase: If in protective motion phase, they will have acute swelling. Manual lymph drainage can reduce swelling. 
-If limitations in ROM, soft tissue mobilization to triceps surae. 
-Graded mobilization to talocrural joint with posterior glide. Posterior glide of fibular malleolus for improvements in DF. To improve PF, anterior glide at talocrural joint. Joint mobilization with movement using a stool and a mobilization belt while patient goes into DF. Can also glide the fibula with same motion by patient. Perform thrust technique with long axis traction. 
-Improve balance of ankle eversion and inversion in a closed manner: lifting arch without flexing toes while foot flat on floor. Progress to full weight bearing with squats, lunges, while maintaining arch.



Protocols: https://medicine.osu.edu/departments/sports-medicine/education/medical-professionals/rehabilitation-protocols

Comments

Post a Comment

Popular posts from this blog

Calf strain: rehabilitation-protocol-for-hamstring-injury-non-operative.pdf (massgeneral.org) The Assessment, Management and Prevention of Calf Muscle Strain Injuries: A Qualitative Study of the Practices and Perspectives of 20 Expert Sports Clinicians (springeropen.com) Meniscal: https://www.brighamandwomens.org/assets/BWH/patients-and-families/rehabilitation-services/pdfs/knee-meniscal-tears-bwh.pdf 12/12/23. ---------------------- SkM Hypermobility component. Doctor believes they would benefit from cervical and core strengthening. SoC Presentation and physical therapy management of upper cervical instability in patients with symptomatic generalized joint hypermobility: International expert consensus recommendations - PMC (nih.gov)   --------------------------------------- MaF - Eval for R shoulder scope, R sub pec biceps tenodesis performed Feb 9th, 2024 (10 days post op) Biceps tenodesis: https://medicine.osu.edu/-/media/files/medicine/departments/sports-medicine/medical-profession
Read more

Modalities

Image
Electrotherapy TENS (Conventional high-rate/sensory TENS) Frequency: 100-150 pps. Pulse Duration: 50-80  µs. Amplitude: sensory. Treatment Time: whenever there is pain. Duration of Action: only while on. Typical Conditions: acute injury or repetitive strain. Duration of application: unlimited. TENS  (Low-rate/motor TENS) Frequency: <10 pps. Pulse Duration: 200-300  µs. Amplitude: small muscle contractions. Treatment Time: maximum 20-30 minutes every 2 hours. Duration of Action: 4-5 hours aftertreatment. Typical Conditions: chronic conditions. Duration of application: 20-30 minutes maximum.  Interferential Current  (Acute pain) Frequency: 100-150 Hz. Time: throughout duration of pain. May be used for 24 hours/day if needed. Modulation: use if available. Amplitude: to produce tingling. Interferential Current  (Chronic pain) Frequency: 2-10 Hz. Time: 20-30 minutes. Modulation: none. Amplitude: to visible contraction. Neuromuscular Electrical Stimulation (NMES)  Muscle Strengthening:  P
Read more