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Turftoe Presentation Hannah Schindel and Abby Barraza

1B Sports Medicine Class
by

Hannah Schindel

on 14 November 2012

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Transcript of Turftoe Presentation Hannah Schindel and Abby Barraza

By Hannah Schindel and Abby Barraza Turftoe What is Turftoe? References: 1)“Turf toe” is the common term used to describe a sprain of the ligaments around the big toe joint.

2) Associated with football players: (most commonly)
-artificial turf
3)Occurs in other sports such as:
-soccer
-basketball
-wrestling
-gymnastics
-dance 1)It’s a condition that’s caused by jamming the big toe or repeatedly pushing off the big toe forcefully as in running and jumping.

2)This is caused by hyperextending the toe.

3)Sprain to the ligaments around the big toe joint. Mechanisms of the Injury: 1)Ligaments serve as hinge.
-permits up/down movements .

2)Behind big toe are two pea-shaped bones. These bones are called sesamoids.
3)Sesamoids are in ball of foot that move the big toe.
4)Sesamoids:
-provide leverage when you walk/run
-absorb weight pressing on ball of foot. Mechanisms of Injury (cont.) 1)Hyperextension occurs and if is repeated over time and with enough force causes a sprain in the ligaments that surround the joint.

2)Injuries are sudden(typically).

3)Often occurs in athletes wearing flexible shoes that let the foot bend too far forward. Mechanisms of Injury (cont.) Anatomy of Area:(Metatarsophalangeal Joint Sprain) Anatomy of Area(explanation): 1)Metatarsophalangeal joint sprain.
2)Injury of the joint and connective tissue between the 1st toe and the foot.
3)With this condition, the joint can become bruised or the ligaments and joint capsule can be torn. Turftoe Signs/Symptoms: 1)Sign-something visibly seen by all.


Turftoe Signs:
1)Limp while walking.
2)The outside of the toe may appear red and bruised.
3) Swelling of toe. Turftoe Signs/Symptoms (cont.) 2)Symptoms-something you feel(person who is affected).


Turftoe Symptoms:
1)Pain
2)Limited joint movement at base of big toe.
3)Repetitive Injury: slowly and gradually over time get worse.
4)Forceful Injury: painful immediately and worsens within 24 hours. Also may worsen as season progresses. Turftoe Signs/Symptoms (cont.) 3)Sometimes a "pop" can be felt.
4)Usually the entire joint is involved, and toe movement is limited.
5)Soreness at base of big toe.
6)Unable to push off of foot.
7)Mild conditions of turf toe:
-little damage to the area of bone beneath the cartilage in the big toe.
-signs and symptoms of swelling inside the joint.
8)Severe cases of turf toe:
-the signs and symptoms will be worse
damage to the area of bone beneath the cartilage/surface of the joint/both. These types of injuries are usually visible on x-rays or an MRI SCAN. Types of Turftoe/Grades: GRADE I: In this type, the ligaments and joint capsule are stretched.

GRADE II: In this type, the ligaments and joint capsule are partially torn.

GRADE III: In this type, the ligaments and joint capsule are completely torn.
1) these stages are how turftoe is diagnosed
2) these range from the least severe to most severe
3)more severe the injury, longer recovery time Emergency Response Steps: Initial/Long Term Treatment Plan 1)Rest—Do not try to run or play sports until you can walk , jump, and push off from your injured foot without pain.

2)Ice-Apply ice or cold pack to your toe for 15 to 20 minutes, 4 times a day for 2 to 3 days or until the pain goes away. Wrap the ice or cold pack in a towel. Do not apply ice directly to your skin. Initial/Long Term Treatment Plan(cont.) 3)Compression—Wrap an elastic compression bandage around your big toe. Do not cut off blood circulation to your toe or any body part when using such wraps, do not make them very tight. Put several wraps around the big toe and then include the rest of the forefoot within the bandage. This will limit swelling and support your toe.

4)Elevation-Keep the injured foot raised above the level of your heart for 48 hours (such as up on a pillow). This will help drain fluid and reduce swelling.

5)Stiff-soled shoes or rigid orthotics—Wear stiff-soled shoes or rigid orthotic inserts in your shoes to keep your toe from hyperextending. 1)Run and check on the injured person.
2)Assess the situation, make sure it's safe before you proceed, and stay calm, ask if they need help.
3)Don't move a person unless there is a life-or-death reason to do so.Do not want to create any more of an injury.
4) Ask the injured person what happened.
4) Evaluate injury. Ask them about their history. Emergency Response Steps(cont.):
6)After you have stabilized the injured person, go get professional medical help.


7)Don't give the ill or injured person anything to eat or drink, including medications, unless it is necessary. Long Term Treatment Plan: 1)Nonsteroidal anti-inflammatory drugs (NSAIDs) may help minimize pain and inflammation.
2)In some cases, a short leg cast with a toe spica in slight plantarflexion or a walker boot may be used for the first week to help decrease pain. Gradual range of motion begins in 3-5 days following injury.
3)When conservative treatment fails, surgical therapy may be indicated.
4)Surgery is only needed to repair turf toe if:
A)A small piece of bone has been broken off by the injury to the ligament
B)Ligament is torn completely
5). Sometimes surgery is used to remove any bone spurs that may have formed near the big toe. A bone spur is a knobby, abnormal bone growth. Rehabilitation Exercises: Medications: The following drugs may help reduce inflammation and pain:

1)Ibuprofen (eg, Motrin, Advil)
2)Naproxen (eg, Aleve, Naprosyn)
3)Acetaminophen (eg, Tylenol)
4)Aspirin (eg, Bayer) Rehabilitation Exercises: Toe flexion:
Stand with the injured foot a few inches in front of the other. Slightly bend the injured-side knee and turn the injured toes under so that the top of the toes face or are in contact with the floor. Put both hands on the injured-side thigh. Place weight on the injured toe and press down on the thigh with both hands to the point of significant pain. Hold this position for 5 seconds. Stand straight with the body erect, hands at the sides, and soles of the feet flat on the floor. Relax for 10 seconds. Perform this sequence 5 times, 3 times daily. Toe extension:
Stand with the injured foot a few inches in front of the other. Slightly bend the injured side knee, raise up on the toe, and place both hands on the injured side thigh. With weight on the injured toe, press down with both hands to the point of significant pain and hold this position for 5 seconds. Stand straight with body erect, feet flat on the floor, and hands at sides. Relax for 10 seconds. Perform this sequence 5 times, 3 times daily. Rehabilitation Exercises: All fours toe extension:
Kneel on all fours with toes underneath the buttocks. Slowly lower the buttocks over the toes to the point of significant pain and hold this position for 5 seconds. Return to the starting position and relax for 10 seconds. Perform this sequence 5 times, 3 times daily. Rehabilitation Exercises: Toe raises:
Stand with the injured side next to a chair or other supporting structure and place the injured-side hand on the support. Lift the uninjured-side foot from the floor, placing body weight on the injured foot. Raise upward on the injured foot to the point of significant pain and hold this position for 5 seconds. Return to the starting position and relax for 10 seconds. Perform this sequence 10 times, 3 times daily. Rehabilitation Exercises (In Conclusion): 1)These exercises rehabilitate and may help prevent toe fractures.
2)Exercises should be part of daily warm-up routine.
3)Both sides/feet need stretched and exercised.
4)Stretching is key. this is hyperextension THERE IS NO WAY TO PREVENT IT!! Turftoe Surgery Video "Turf Toe Signs, Symptoms, & Treatment - MedFriendly.com." Turf Toe Signs, Symptoms, & Treatment - MedFriendly.com. N.p., n.d. Web. 13 Nov. 2012. <http://www.medfriendly.com/turftoe.html>. "PT Tip of the Month." Beantown Physio. N.p., n.d. Web. 13 Nov. 2012. <http://www.beantownphysio.com/pt-tip/index.html>. "Turf Toe: Symptoms, Causes, and Treatments." WebMD. WebMD, n.d. Web. 13 Nov. 2012. <http://www.webmd.com/fitness-exercise/turf-toe-symptoms-causes-and-treatments>.
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