non operative management

Plantar Fasciitis

Definition

 

Pain at attachment of thickened central part of plantar aponeurosis to Medial Calcaneal Tuberosity

 

Anatomy Plantar Fascia

 

Origin 

- medial calcaneal tuberosity

 

Inserts 

- 5 bands superfical & deep layers

 

Superficial

- insert transverse MT ligament & skin

 

Deep 

- flexor sheath, volar plate & periosteum of P1

 

Tendonitis / Tendonopathy

Anatomy

 

Lateral compartment of leg

- run through retromalleolar groove

- pass superior and inferior to peroneal tubercle

- covered by inferior peroneal retinaculum

 

Peroneus longus

- origin lateral condyle of tibia and head fibula

- tendon PL superficial and inferior to brevis in retromalleolar groove

- runs in cuboid groove 

- insert plantar surface base of 1st MT and lateral aspect medial cuneiform

Dislocation

Definition

 

Anterior displacement of peroneal tendons out of peroneal groove

 

Epidemiology

 

Most common in young adults

 

Acute injury often missed 

 

Aetiology

 

Congenital

 

3 % neonates

- resolves spontaneously

 

Traumatic  

 

Occurs following sporting activities

Freiberg's

Definition

 

Crushing osteochondritis of metatarsal head

 

Frieberg's

 

Epidemiology

 

Usually 2nd metatarsal (80%)

- occasionally third

- can occur in any

 

Age 10-15 years

- peak 15 year old girls

- F:M = 3:1

- occurs during the growth spurt at puberty

 

Bilateral in 6%

 

Aetiology

 

Lumbar Herniated Discs

Epidemiology

 

Sciatica > 2/52 1.6%

 

M:F = 1:1

 

Most common L4/5 

L5/S1 inherently stable 

 

Risk factors

 

Sedentary lifestyle

Smokers

Frequent driving

Heavy lifting 

 

Anatomy

 

Annulus Fibrosis

- circumferential, multilayered rim