22.3: Foot and Ankle
This 6-monograph series reviews foot and ankle biomechanics as it relates to a systematic and evidence-based clinical examination process. Select topics cover common pathologies and specifically the evaluation and treatment of adult acquired flatfoot disorders. Development of proper rehabilitation strategies are covered along with specific interventions dealing with orthotics, bracing, and taping as viable treatment options. Learning Objectives
Upon completion of this course the participant will be able to do the following:
Topics and Authors
- Describe the anatomy and biomechanics of the foot and ankle.
- Identify terminology commonly applied to the examination and description of foot and ankle biomechanics.
- Distinguish between normal and abnormal foot and ankle biomechanics during walking, running, and other tasks.
- Appreciate the influence of foot and ankle function to hip and knee motion.
- Apply the World Health Organization (WHO) and International Classification of Function (ICF) models to the evaluation of the foot ankle complex.
- Apply sound clinical reasoning skills and reliable clinical measures to the evaluation process.
- Understand exercise physiology of range of motion, strength, flexibility, soreness, neuromuscular adaptation, and return to function as they pertain to exercise prescription for various foot and ankle pathologies.
- Implement an exercise program for the entire lower extremity, given a foot and ankle dysfunction or impairment.
- Distinguish between when to prescribe open- and closed-kinetic chain exercise for the foot and ankle.
- Critically appraise and summarize the general benefits of manual therapy intervention strategies for the foot and ankle complex.
- Determine the efficacy of taping interventions on proprioception, alterations in lower extremity biomechanics, and healing.
- Summarize the evidence concerning the reliability and validity of a biomechanical examination and the concept of normal subtalar neutral position.
- Create an intervention program consisting of manual therapy, taping techniques, and exercise for the various conditions including hallux abducto-valgus, cuboid syndrome, tendinopathies, ankle syndesmosis problems, and plantar fasciitis.
- Evaluate the role of custom and prefabricated foot orthoses as an intervention used by physical therapists in treating overuse conditions of the lower limb.
- Describe current theories related to why foot orthoses may be beneficial.
- Describe the etiology and pathophysiology associated with adult acquired flatfoot deformity secondary to posterior tibial tendon dysfunction.
- Understand the physical examination and develop clinical staging methodology as a way of evaluating and treating patients with flatfoot deformity.
- Discuss nonoperative and operative treatment options for adult acquired flatfoot deformity.
- Describe rigid flatfoot deformity secondary to tarsal coalition and treatment options associated with the disorder.
- Describe how patients with inflammatory and noninflammatory arthritis develop flatfoot deformity, and treatment options for affected patients.
- Exercise Progressions for the Foot and Ankle—Clarke Brown, PT, DPT, OCS, ATC (Subject Matter Expert: Christopher R. Carcia, PT, PhD, SCS, OCS)
- Examination of the Ankle and Foot—Todd E. Davenport, PT, DPT, OCS (Subject Matter Expert: Rob Roy Martin, PT)
- Biomechanics of the Foot and Ankle for the Physical Therapist—Jeff Houck, PT, PhD (Subject Matter Expert: Christopher R. Carcia, PT, PhD, SCS, OCS)
- Taping, Mobilization, and Exercises for the Foot and Ankle—Stephen Paulseth, PT, DPT, SCS, ATC, and RobRoy Martin, PhD, PT, CSCS (Subject Matter Expert: Todd E. Davenport, PT, DPT, OCS)
- The Effectiveness of Foot Orthoses for the Treatment and Prevention of Lower Extremity Overuse Injuries—James W. Matheson, PT, DPT, MS, OCS, SCS (Subject Matter Expert: Deb Nawoczenski, PT, PhD)
- Adult Acquired Flatfoot Disorders—Brandon E. Crim, DPM, and Dane K. Wukich, MD (Subject Matter Expert: Christopher R. Carcia, PT, PhD, SCS, OCS)
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