Foot and Toes
History
Location of the Pain
 
Retrocalcaneal
   Inflammation of the Retrocalcaneal bursa or Achilles tendon
   Trigonum pathology.
Heel
   Plantar fasciitis or heel spur
   Referred pain from lumbar nerve roots or their peripheral nerves
Medial arch
   Tarsal tunnel syndrome
   Midfoot sprain
   Plantar fasciitis
   Navicular fracture
   Tibialis posterior tendonitis.
Metatarsal
   Stress fracture (March fracture)
   Impingement of the intermetatarsal nerves
   Metatarsalgia
Toes
   Hallux rigidus
   Hallux abducto Valgus
   Sesamoiditis
   Gout (A form of arthritis marked by inflammation and pain in the distal joints)
Lateral arch
   Compression of the posterior tibial nerve
   Fracture of the fifth MT (Jones’ fracture)
   Peroneal tendinitis
Onset of Injury
  Acute onset
  Insidious onset
Mechanism of injury
Playing surface
Running distance & duration
Shoes


Inspection
General Inspection

  Callus and blister
           Tinea Pedis (A fungal infection of the foot and toes)
  Foot type (Pronated / Supinated foot)
Toes
  Morton’s alignment
   Second ray during push off, causing hypertrophy of the second MT
  Claw toes (Pes cavus)
  Hammer toe
  Hallux (abducto) Valgus
   Cerebral palsy (A birth-related neurologic defect that results in motor dysfunction)
   Rheumatoid arthritis
   Osteoarthritis
  Bunion
   Bunionette (lateral aspect of the fifth MTP joint)
  Corns
   Hard corns (heloma dura) on toes and PIP joints
   Soft corns (heloma molle) between the toes
  Ingrown toenail
  Subungual hematoma
Medial Structures
  Medial arch
  Pes planus (flat foot)
  Pes cavus (high arch foot)
Lateral Structures
  Fifth metatarsal
Dorsal Structures
  Plantar Surface
   Plantar warts
   Callus
Posterior Structures
Achilles tendon
   Pes planus (Bowing of the tendon)
  Calcaneus
   Retrocalcaneal Exostosis (Haglaund’s deformity or “pump bumps”)
Foot Alignment
  Forefoot varus
  Forefoot Valgus
  Rearfoot varus (Calcaneovarus); supination of subtalar joint associated with calcaneal inversion.
  Rearfoot Valgus (Calcaneovalgus); pronation of subtalar joint caused by eversion of Calcaneus.
Non-Weight Bearing
  Inspection of foot alignment
  Assessment of talar position

Palpation
Medial Structures

  First MTP joint
  First metatarsal
  First cuneiform
  Navicular
  Talar head
  Sustentaculum tali
  Spring ligament
  Medial talar tubercle
  Calcaneal dome
  Flexor Digitorum longus
  Flexor Digitorum longus
  Tibialis posterior
  Posterior tibial artery
Lateral structures
  Fifth MTP joint
  Fifth metatarsal
  Styloid process
  Cuboid
  Lateral border of the Calcaneus
  Peroneal tendons
Dorsal structures
  Sinus tarsi
  Dome of the talus
  Cuneiforms
  Rays
  Tibialis anterior
  Extensor hallucis longus
  Extensor Digitorum longus
  Extensor Digitorum brevis
  Inferior extensor retinaculum
  Dorsalis perdal artery
  Intermetatarsal neuromas
Plantar structures
  Medial calcaneal tubercle
  Plantar fascia
  Sesamoid bones of the great toe
  Metatarsal heads

Range of Motion Tests
Toes AROM/ PROM/ RROM (Flexion & Extension)
Related Motions

  Subtalar joint (Inversion & eversion)
  Talocrural joint (Dorsiflexion & plantarflexion)

Ligamentous Capsular Tests
MTP and IP joints

  Valgus stress testing (MCL sprain)
  Varus stress testing (LCL sprain)
Metatarsal and Tarsal joints
  Intermetatarsal glide (Transverse metatarsal ligament or interosseous ligament)
  Tarsometatarsal joint glide
  Midtarsal joint glide
  Mobility of the first ray

Neurologic Tests
Tarsal tunnel
Peroneal nerve
Sciatic nerve
Lumbar or sacral nerve root impingement


Special Tests