Common Injuries & Ailments Basic Understanding • Tendonitis/ Soft tissue injuries Tendonitis is an inflammation of a tendon. It typically has a pattern of pain when it’s cool, improves when it warms up, feels bad again when it cools down. As it progresses, pain may occur during activity even when it’s warmed up. This is typical of any soft tissue injury. • Bone Constantly breaking down and remodeling in a 6 week cycle. Chronic tightness of a tendon can contribute to bone spur development Hallux Valgus - Bunions • What is it? A subluxation of the 1st MPJ with a deviation of the great toe towards the second with an enlargement of the medial first metatarsal head. • Causes: Excessive pronation and narrow footwear. Higher incidence amongst women than men. Hereditary factors are listed in some literature. – Symptoms: Reddened skin over the base of the great toe. Pain over the joint where the great toe joins the foot (MPJ) • Effect on Gait: Degraded toe off, excessive pronation due to 1st ray instability. Subluxation: Incomplete Dislocation of Hallux Valgus - Bunions • Solutions – If caused by overpronation, stability or motion control shoe/insert. – Educate on proper non-running footwear choices and pre- accommodation for a bunion. – Calluses may be trimmed. – Icing may help bursitis and pain symptoms – (Surgery is above our pay grade) Hallux Limitus / Rigidus • What is it? – Limitus is diminished motion in the first MPJ (Metatarsal Phalangeal Joint). Rigidus is a continuation. – Ideal ROM at MPJ at toe off is 65 – 70 degrees. In overpronated foot it is more like 30 degrees or less. • Symptoms – Great toe pain and stiffness – Abnormal gait. Toe off must come from a different part of the foot. Hallux Limitus / Rigidus • Solutions: – Over the counter foot orthotic, custom orthotic for more severe conditions. – Metatarsal bar reduces pressure – Rocker Bottom – For severe cases shoe modification – done only be certified professionals – excavation. Hammer Toe / Mallet Toe • What is it? Crooked, bent or buckled toes causing joints to protrude. • Hammer Toe: Generally found on the second toe, it is a contracture of the MPJ with a dorsiflexed proximal phalanges and a plantarflexed medial phalanges. • Mallet Toe: The tip of the toe (distal phalanges) is turned downward (plantarflexed). – Causes: Imbalance of intrinsic and extrinsic muscles, hereditary factors, excessive pronation, poorly fitted shoes, and bunions. Hammer Toe / Mallet Toe • Symptoms: Often asymptomatic but calluses or corns can develop and be painful. • Solutions: – Calluses can be trimmed. – Corn pads and removal of corns can reduce irritation. – If caused by overpronation, a stability or motion control shoe/insert may be helpful. – Shoe with a wide toe box and well placed overlays Hammer Toe / Mallet Toe Hammer Toe Mallet Toe