Running Injuries in foot & ankle
Stress fx	·       Insidious ·       Focal pain in navicular or metatarsals ·       RF: sudden ⤴️ in intensity of training, poor running mechanics, 👩🏻 w/ anorexia nervosa
Plantar fasciitis	·        Plantar surface of the heel ·       Worse when initiating running ·       Worse at first step of the day
Achilles tendinopathy	Buming pain or stiffness 2-6 cm above the posterior calcaneus
Morton neuroma	·       Numbness or pain between the 3rd & 4th toes ·       Clicking sensation when palpating space between 3rd & 4th toes while squeezing the metatarsal joints
Tarsal tunnel syndrome	·       Compression of the tibial nerve at the ankle ·       Buming, numbness & aching of the distal plantar surface of the foot/toes

Achilles tendinopathy ·       exercise-induced heel pain, ·       tenderness are prominent at the posterior heel, ·       palpable thickening of the tendon. ·       pain is reproduced by passive dorsiflexion of the ankle (which stretches the Achilles tendon) Calcaneal stress fractures ·       inexperienced athletes after initiation of a high-impact exercise. ·       Like plantar fasciitis, they cause pain at the heel that is worse with weight bearing. ·       pain is elicited by firm palpation at the sides of the heel Charcot joint (neurogenic arthropathy) ·       Poorly controlled DM, ·       deformity of the foot and significant sensory deficits. ·       Disorder relates to recurrent trauma due to loss of proprioception and pain sensation, ·       The associated pain is typically mild. Tarsal tunnel syndrome ·       Caused by compression of the tibial nerve where it passes under the flexor retinaculum at the medial aspect of the ankle. ·       presents w/ numbness and paresthesia at the toes and distal sole. ·       The pain is nocturnal and is provoked by percussion at the tarsal tunnel (not stretching of the plantar fascia, as seen in this patient).

	Heel Pain
Plantar fasciitis	·       Pain maximum upon first stepping out of bed ·       Local point tenderness with dorsiflexion of the toes
Ruptured plantar Fascia	·       Sudden-onset pain ·       Loss of height of the arch ·       Visible swelling or ecchymosis
Bone infection/metastasis	·       Constant throbbing pain ·       Nocturnal worsening
Calcaneal stress fracture	·       Worse with activity ·       Palpation of the bone elicits tenderness (squeeze test)
Tarsal tunnel syndrome	·       Pain, paresthesia & numbness on the sole of the foot ·       Percussion tenderness over the posterior tibial nerve in the tarsal tunnel

	Stress fx
RFs	·       Repetitive activities (Running, gymnastics) ·       Abrupt ⤴️ in physical activity ·       Inadequate calcium & vitamin D ·       Female athlete ∆👩🏻: ·       low caloric intake, ·       hypomenorrhea/amenorrhea, ·       low bone density
Clx	·       Point tenderness at fx site ·       May have ⊖ x-ray in first 6 weeks
Tx	·       Reduced weight bearing for 4-6 ws ·       Referral to orthopedic surgeon for fracture at high risk for malunion (anterior tibial cortex, 5th metatarsal)

	Plantar Fasciitis
RF	·       Pes Planus (flat foot) ·       Obesity ·       Working or exercising on hard surfaces
S/S	·       Pain at plantar aspect of heel & hindfoot ·       Worse with weight bearing (especially after prolonged rest)
Dx	·       Tenderness at insertion of plantar fascia ·       Pain with dorsiflexion of toes ·       Presence of heel spurs on x-ray has low sensitivity & specificity
Tx	·       Activity modification ·       Stretching exercises ·       Heel pads/orthotics

Morton Neuroma

What is it? mechanical induced neuropathy Sx: degeneration of nerves b/w digits Presents w/ numbness b/w 3rd-4th toes. Pain ⊕ when u palpate 3rd-4th toes It does not cause significant deformity, and gross inspection of the foot is typically normal.