Sports Medicine 1

Intro to Injuries of
the Lower Extremity
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 Objectives
Identify the MOI and anatomy involved in
different lower extremity injuries

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1 Beginning

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Give One-Get One
• Fold your paper in half
• One half title “Give One” and the other
“Get One”
• On the “Give One” side think of any lower
extremity injuries you have experienced or
seen and list as many as you can think of

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Vocabulary- KIM Chart
• “itis”
• Tendon
• Sprain
• Strain
• Dislocation
• Subluxation

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Ask the Expert
• Pick an Expert from your group who will
teach everyone else about your vocabulary
word and how to remember it.
• We will rotate every 3 minutes.

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Jumbled Sort
• Pick the correct Injury with the correct
anatomy that might be affected due to this
injury.
• Pick the correct MOI with the correct
injury and anatomy.

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 Injuries
1. Dislocations
a. MOI: Traction or twisting
b. Joints, most common is the phalanges
2. Avulsion Fractures
a. MOI: 3rd Degree Sprain/Strain
b. Most Common ATFL with Fibula or Peroneus Brevis with Base of the 5th
3. Lateral Ankle Sprain
a. MOI: Plantarflexion and inversion
b. Anterior talofibular ligament (ATFL), Calcaneofibular Ligament (CF), sometimes PTFL
4. Medial Ankle Sprain
a. MOI: Dorsiflexion and eversion
b. Deltoid LIgament
5. High Ankle Sprain
a. MOI: Excessive plantarflexion or dorsiflexion
b. Anterior Tibiofibular Ligament
6. Acute Muscle Strains
a. MOI: Overstretching of the muscles
b. Any Muscle
7. Plantar Fasciitis
a. MOI: Shoes, overweight, activity on hard surfaces, overuse, poor mechanics, fatigue.
b. Plantar Fascia, Medial Calcaneus

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 Injuries
1. Acute Compartment Syndrome
a. MOI: Direct blow or tearing of muscle fibers causes swelling
b. The entire anterior muscle group of the lower leg
2. Contusions
a. MOI: Direct Contact
b. Any tissue that is exposed to contact
3. Achilles Tendon Rupture
a. MOI: Forceful pushing off (forceful plantarflexion)
b. Achilles Tendon
4. Medial Tibial Stress Syndrome (Shin Splints)
a. MOI: Flat feet, Overweight, poor conditioning, poor shoes, overuse/muscle weakness, etc.
b. Muscles, tendons, and bone tissue all around your tibia
5. Jones Fracture
a. MOI: Direct hit to lateral side of foot or repetitive weight bearing and pivoting on foot
b. Base of the 5th
6. Tibial Stress Fracture
a. MOI: Overuse injury usually caused by malnutrition and repetitive running/contact
b. Tibia
7. March Fracture
a. MOI: Overuse injury caused by malnutrition and repetitive stress to the foot
b. Metatarsals

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 3-2-1
➢ On the back of your Give One-Get One write
○ 3 lower leg injuries you learned today
○ 2 things you want to learn more about involving
lower extremity injuries
○ 1 thing you are going to do on your own to help
you learn the injuries

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Lateral Ankle
Sprains
MOI:
Anterior Talofibular-
plantarflexion and
inversion
Calcaneofibular-
inversion
Posterior Talofibular-
severe inversion or
dislocation (rare)
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 Medial Ankle Sprains

MOI:
Deltoid Ligament
MOI- eversion and dorsiflexion

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 High Ankle
Anterior Tibiofibular Ligament
MOI- excessive dorsiflexion or
plantarflexion

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 General Ankle Sprain
Signs/Symptoms
• Swelling
• Pain with WB (weight bearing)
• Instability
• Ecchymosis (bruising/discoloration)
• Anterior Drawer Test- ATF ligament
• Talar Tilt Test- CF and Deltoid ligaments
• Kleiger’s Test- Tib/fib ligament

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General Ankle Sprain
Acute Care
• PRICE (POLICE) with
horseshoe
• NSAIDs

• Crutches?

• Referral 15
 Acute Muscle Strains
• MOI:
o Due to violent contraction/twisting of foot
o Awkward landing
o Eccentric contraction (stretching of muscle)
• S/Sx:
o Pain with AROM or RROM
o Possible pain with WB
o Swelling or crepitus
• Rx:
o PRICE (POLICE)
o Taping/bracing
o Monitor for acute compartment syndrome
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 Achilles Tendon
Strain/Rupture
• S/Sx: Pain/inability to plantarflex
o Feels like they were “kicked in calf”
o Positive Thompson Test
o Deformity
• Rx:
o PRICE (POLICE)
o Referral if rupture is suspected

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 “What’s My Injury?”

• With a partner, choose an injury

from today’s lesson
• Write a creative scenario about
that injury including the etiology,
pathology, and treatment for the
injury
• Be prepared to share with the
class
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 “Before & After”
BELLWORK
Answer the following questions on the blank lines
below your Bellwork answers to assess new learning.
1. How do you get a strain?
2. How do you get a sprain?
3. What does a strain look like?
4. What does a sprain look like?
Turn in for credit.

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 Dislocations
• Rare in ankle, but common in phalanges
• MOI:
o Traction or twisting
• S/S:
o Deformity
o Possible fractures
o Inability to move extremity
• Rx:
o Immobilize
o Cold
o Referral for reduction or Emergency Action
Plan (EAP)
 Acute Fractures-
Specialties
• Avulsion Fractures
o MOI: 3rd Degree Sprain/Strain
o Common for ATF Ligament to fracture lateral malleolus
(looks like 3rd Degree sprain)
o Jones Fracture- Peroneus brevis pulls off proximal 5th
metatarsal with forced inversion
 • MOI: Direct hit or
repetitive weight
bearing and pivoting
on foot
• The most common
type of fracture of the
metatarsal and is a
break of the fifth
metatarsal bone of
the foot.

Jones Fracture
 Acute Fractures
• Rx:
• S/S: o PRICE
o Localized Pain o Referral for x-ray
o Deformity? o Be prepared to
o Swelling activate Emergency
Action Plan (EAP)
o Ecchymosis
if open fracture or
o Crepitus signs of shock
o Pain with WB
 Tibial Stress Fracture
A very small crack in the lower part of
the tibia.
a. MOI: Overuse injury usually caused by
malnutrition and repetitive running/contact

• Stress Tests:
o Tap Test- tibia, fibula, talus or calcaneus
o Calf squeeze/compression- tibia or fibula
 March Fracture

• Stress Fracture to metatarsals due to

repetitive activity
o MOI: Overuse injury caused by malnutrition
and repetitive stress to the foot
• Stress Tests:
o Long Bone Compression Test
 Stress Fractures
• Extremely common due to repetitive action
• S/S: point tenderness; especially in WB position
• Rx:
o NWB (non-weight bearing) > week or more
o Walking boot or cast possible
o Out of activity 3-4 weeks
o Gradual resumption of activity
 “What’s My Injury?”
• With a partner, choose an injury
from today’s lesson
• Write a creative scenario about
that injury including the etiology,
pathology, and treatment for the
injury
• Be prepared to share with the
class
 “Before & After”
CLOSURE
On your Before and After bellwork sheet, answer the
following questions on the line below your “Before”
answers.
This will assess your new learning for the day!
1.How do you get a fracture?
2.How do you get a dislocation?
3.What does a fracture look like?
4.What does a dislocation look like?
 Contusions
• MOI: direct blow
• S/S:
o Can limit ROM
o Swelling
o Ecchymosis
• Rx:
o PRICE (POLICE)
o Padding for protection
o Monitor for acute compartment syndrome

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 Acute Compartment
Syndrome
• The entire anterior muscle group of the lower leg
• MOI: direct blow or tearing of muscle fibers causing
swelling
• S/S:
o Pain becoming worse; eventually numbness
o Loss of foot ROM
o Leg swelling

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 Acute Compartment
Syndrome
• Rx: Medical Emergency! Refer Immediately
o Apply cold and elevate (NO Compression!)
o Surgical intervention is probably necessary

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 Plantar Fasciitis
MOI:
• Shoes
• Overweight
• Activity on hard surfaces
• Overuse
• Poor mechanics
• Fatigue

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Plantar Fasciitis
• S/S:
o Morning pain
o Swelling
o Pain with WB
o Crepitus
• Rx:
o Good shoes/orthotics
o Stretching
o Ice
o Taping
o Referral?

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• Muscles, tendons, and bone Shin splints
or Medial
tissue all around your tibia
• MOI:
o Pes planus (flat feet)
o Overweight
o Poor conditioning
Tibial Stress
o Poor shoes
o Activity on hard surfaces
Syndrome
o Overuse/Muscle
weakness

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 MTSS:
S/S: Rx:
• Pain- usually found on • PRICE (POLICE)
medial side of leg • Check shoes
• Pain with activity that gets • Stretch
progressively worse over • Strengthen
time
• NSAIDs
•Stress Tests:
• Cross Train
Tap Test- tibia, fibula, talus
• Rest
or calcaneus
• Refer for fracture or
compartment syndrome

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 “What’s My Injury?”
• With a partner, choose an injury
from today’s lesson
• Write a creative scenario about
that injury including the etiology,
pathology, and treatment for the
injury
• Be prepared to share with the
class
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 “Before & After”
CLOSURE
On your Before and After bellwork sheet, answer the following
questions on the line below your “Before” answers. This will
assess your new learning for the day!
1. How do you get inflammation?
2. What is tendonitis and its symptoms?
3. What do you think compartment syndrome does to the
body?
4. What is faciitis?

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