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Special Populations
Part 2B: Knee/Ankle/Foot
| Term | Definition |
|---|---|
| Knee Local Stabilizers | Popliteus; vastus medialis oblique (VMO) |
| Knee Global Stabilizers | Soleus; Vasti Muscles |
| Knee Global Mobilizers | Gastrocnemius; hamstrings; rectus femoris; gracilis; sartorius; TFL via ITB |
| Patello-Femoral Pain Syndrome (PFPS) | "Runner's Knee" chronic pain/discomfort in anterior knee/ under patella w/ minimal/no swelling. Symptoms include knee buckling/catching/grinding. Squat/jump bad. |
| Patello-Femoral Pain Syndrome (PFPS) Causes | Imbalance of VMO to lateral pull of quads (especially vastus lateralis + tight lateral retinaculum + ITB, weak VMO w/ bad timing, improper patellar tracking, overpronated foot, hip adductors/ex rot may be weak. |
| Patello-Femoral Pain Syndrome (PFPS) Programming | Exercises for VMO, hip adductors, ex rot + extensors; strengthen foot/lower leg musculature to correct/prevent overpronation. Flexibility focused on hip flexors, hamstrings, quads, ITB and gastroc-soleus complex. Increase load slowly. |
| Iliotibial Band (ITB) Friction Syndrome | Overuse syndrom. Repetitive stress of knee flexion + extension. Pain over lateral knee, lateral hip, running (x2 downhill), standing, stairs. Excessive foot pronation, bow legs, lateral pelvic tilt |
| ITB Friction Syndrome Programming | Exercises to strengthen hip abductors (glute med) glute max, strengthen foot/lower leg musculature. Flexibility work ITB, quad (rectus femoris) hip flexors, hip ex rot (periformis), hip adductors + gastroc-soleus complex. |
| Meniscal Tear | Medial meniscus often caused by internal rot of femur w/ foot on ground. Can injure ACL also. Can be degenerative. Symptoms knee locking, swelling, pain at joint line, catching/locking "giving way", reduced ROM. |
| Meniscal Tear Programming | Exercises for knee flexors, hip abductors, adductors, extensors, strengthen calf muscles. Address flexibility of all these. |
| Knee Ligament Injuries (ACL, PCL, MCL, LCL) | Slow recovery process, knee instability common. Symptoms include locking/catching sensation, gives way/feels like, can't/hard to bear weight. |
| Anterior Cruciate Ligament (ACL) | Common injury. Controls rot + anterior movement of Tibia. Injuries caused by sudden twisting of knee w/ foot planted. Often injured w/ MCL + medial meniscus |
| Posterior Cruciate Ligament (PCL) | Ligament controls posterior (backward) movement of the tibia. Injuries can occur w/ sudden, direct impact. |
| Medial Collateral Ligament (MCL) | Provides stability to inner knee. Injuries occur w/ blow to outer side of knee. |
| Lateral Collateral Ligament (LCL) | Provides stability to outer knee. Injuries occur w/ excess pressure to inside of knee. |
| Ligament Injury Programming | Focus on balance + strength of thigh musculature. Balance strength between quads and hamstrings. Glute + hip musculature strength. Eccentric + concentric hamstring work. |
| Osteoarthritis (OA) | Wear + tear, slowly progressive + degenerative. Knee joint cartilage is damaged. Decreased join space + possible bone spurs, second to increased friction at bones. Stiff/swollen, limit ROM. Pain/swelling worse in AM. Walking/stairs/kneeling hurt. |
| Osteoarthritis Programming | Focus on quads, hamstrings, hip extensors/adductors/abductors, calf strength. Include flexibility work for all these + gastroc-soleus. Integrate correction of biomechanics at hip, knee, foot if needed. Longer warm-up/less tension/mod ROM |
| Knee Replacement (Knee Arthroplasty) Programming | Emphasis on restoring full ROM + strength. Train hamstring, quads, VMO. Address biomechanical issues of lower chain. SL work w/ low spring load. Promote proprioception. Work flexibility hip/thigh/ankle/hamstring/gastroc-soleus. |
| Ankle/Foot Global Stabilizers | Tibialis posterior, tibialis anterior, peroneal (fibularis) muscles, soleus |
| Ankle/Foot Global Mobilizers | Gastrocnemius (also as gastrocnemius-soleus complex), peroneus (fibularis) longus, flexor digitorum longus, flexor hallucis longus, tibialis anterior, extensor digitorum longus, extensor hallucis longus |
| Ankle Sprains: Inversion | Most common. Caused by forceful/traumatic inversion of foot. Damages lateral collateral ligament (anterior + posterior talofibular ligaments + calcaneofibular ligament). |
| Ankle Sprains: Eversion | Caused by forceful/traumatic eversion of foot. Damages deltoid ligament. |
| Ankle Sprain Programming | Focus on restoring ROM. Strengthen w/ closed chain + weight bearing when pain free. Proprioception + balance work, Achilles tendon flexibility. Strengthen peroneal muscles. Eccentric training address gastroc-soleus + posterior tibialis. Mod tension. |
| Achilles tendinopathy (tendinitis + tendinosis) | Symptoms include crepitus (grading/cracking/popping sounds/sensations), tenderness w/ swelling, ankle articulation increases pain. Slow to heal (low blood supply). Often caused by overuse. Biomechanics can impact. Tendinosis more acute. |
| Achilles tendinopathy programming | Slowly increase progression/intensity/duration of strength training + ROM. Stretch + strengthen gastrocnemius-soleus complex (plantar flexors) +calf muscles (dorsiflexors). Work knees extended + flexed. Proprioception + balance training. Biomechanics. |
| Posterior Tibialis Dysfunction (PTTD) | "acquired adult flat foot". Degenerative. Common cause: repetitive overuse. Tendon can be damaged: acute trauma. Symptoms: pain inside foot/ankle, swelling, worse w/ activity, unstable feeling, can't heel raise |
| Posterior Tibialis Tendon | Primary dynamic stabilizer of medial longitudinal arch of foot. It elevates the arch, and is involved in plantar flexion w/ inversion. |
| Posterior Tibialis Dysfunction (PTTD) Programming | Stages 1+2. Strengthen lower leg musculature. Focus on posterior tibialis. Stretch gastrocneumius-soleus complex - back of calf w/ knees extended to focus on gastrocnemius + back of calf w/ knees slightly flexed to focus on soleus. |
| Shin Splints (Tibial Stress Syndrome) | Overuse/repetitive stress. Activity-induced leg pain located in anterolateral or posteromedial portion of tibia. Sharp/dull/throbbing. Increases w/ activity. |
| Anterior Shin Splints | Tight (hypomobile) gastrocnemius-soleus complex and a weak anterior tibialis. Also caused by excess pronation. Pain may increase w/ active dorsiflexion. |
| Posterior Shin Splints | Tight gastrocneumius-soleus complex + weak/inflamed posterior tibialis. Also check for excess pronation. Medial leg pain may increase w/ dorsiflexion + inversion + active supination. |
| Shin Splint Programming | Stretch tight structures, gastrocnemius-soleus complex. Address biomechanical problems. Progress tension, weight-bearing + endurance over time. |
| Anterior Leg Compartment | Tibialis anterior muscle, anterior tibial artery + vein, foot + toe extensors. |
| Lateral Leg Compartment | superficial peroneal nerve and peroneal longus/brevis |
| Superficial posterior leg compartment | Soleus, plantaris, and gastrocnemius muscles |
| Deep posterior leg compartment | posterior tibialis muscle, the toe and foot flexors, the tibial nerve, and the peroneal artery and vein |
| Compartment Syndrome | Elevated tissue pressure within a closed fascial space, resulting in occlusion of vessels and compromised neuromuscular function. Acute elevated intracompartmental pressure w/i lower leg is a medical emergency. |
| Plantar Fasciitis | Repetitive tension causes microtearing and inflammation. Pain/tenderness at bottom of foot. Worse in morning. Decreases w/ activity. Biomechanics (high arch/flatfoot). Tight posterior calf musculature. Improper footwear. |
| Plantar Fasciitis Programming | Gain flexibility by stretching posterior calf (achilles tendon, gastrocnemius + soleus) + plantar fascia. Strengthen posterior calf muscles + posterior tibialis (supports medial longitudinal arch). Biomechanical. Gently stretch in the morning before stand |
| Bunions (Hallux Valgus) | Big toe turns outward. Symptoms include pain, increased w/ walking, swelling + redness w/ callusing. Wearing tight/pointed shoes can cause this. Biomechanics. OA RA. |
| Bunions Programming | Correct biomechanical problems of foot/lower extremity. Strengthen muscles supporting the medial longitudinal arch + big toe adduction. Flexibility/mobility exercises for big toe extension. |
| Deep Vein Thrombosis (DVT) | sdf |
Created by:
barefootnbluejeans89
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