Knee and Lower Leg Injuries

1. Knee and Lower Leg Injuries Shin Splints, ACL Tear

2. Objectives • To identify the causes, symptoms, treatment, and prevention of various knee and lower leg injuries.

3. Shin Splints

4. Shin Splints • Also known as medial tibial stress syndrome. • Occur during physical activity and result from too much force being placed on your shinbone and connective tissues that attach your muscles to the bone. • The overload is often caused by specific athletic activities, such as: • Running downhill • Running on a slanted or tilted surface • Running in worn-out footwear • Engaging in sports with frequent starts and stops, such as basketball and tennis • Shin splints can also be caused by training errors, such as engaging in a running program with the "terrible toos" — running too hard, too fast or for too long.

5. Symptoms of Shin Splints • Tenderness, soreness or pain along the inner part of your lower leg. • Mild swelling in your lower leg. • At first, the pain may stop when you stop running or exercising. Eventually, however, the pain may be continuous.

6. Risk Factors for Shin Splints • You're more at risk of shin splints if: • You're a runner, especially just beginning a running program. • You have flat feet or rigid arches, causing your feet to roll inward when running. • You increase the intensity of your workouts by doing more high-impact activities. • You play sports on hard surfaces, with sudden stops and starts. • You're in military training.

7. Treatment for Shin Splints • Rest. Avoid activities that cause pain, swelling or discomfort — but don't give up all physical activity. • Ice.Apply ice packs to the affected shin for 15 to 20 minutes at a time, four to eight times a day for several days. • Compression.to compress the area with an elastic bandage or compression sleeve. • Elevation. Elevate the affected shin above the level of your heart, especially at night. • Take an over-the-counter pain reliever. Try ibuprofen (Advil, Motrin, others), naproxen sodium (Aleve, others) or acetaminophen (Tylenol, others) to reduce pain. • Wear proper shoes. Your doctor may recommend a shoe that's especially suited for your foot type, your stride and your particular sport. • Consider arch supports. Arch supports can help cushion and disperse stress on your shinbones. Off-the-shelf arch supports come in various sizes and can be fitted immediately. More durable arch supports can be custom-made from a plaster cast of your foot.

8. Prevention of Shin Splints • Choose the right shoes. • Consider arch supports. • Lessen the impact. • Strengthen your calves. • http://www.youtube.com/watch?v=gYUNjQN7RLI • http://www.youtube.com/watch?v=Dt-KoSNVwUQ

9. ACL Tear • The tearing of the anterior cruciate ligament. • Most commonly occurs during sports that involve sudden stops and changes in direction — such as basketball, soccer, football, tennis, and volleyball.

10. ACL Tear Symptoms • At the time of an ACL injury, signs and symptoms may include: • A loud "pop" sound • Severe pain and inability to continue activity • Knee swelling that usually worsens for hours after the injury occurs • A feeling of instability or "giving way" with weight bearing.

11. ACL Tear Causes • The ligament may tear when you slow down suddenly to change direction or pivot with your foot firmly planted, twisting or hyperextending your knee. • Landing awkwardly from a jump can also injure your ACL, as can falls during downhill skiing.

12. ACL Tear Risk Factors in Female Athletes • Women are significantly more likely to have an ACL tear than are men participating in the same sports. • Women tend to have a strength imbalance, with the quadriceps being stronger than the hamstrings. • Increased Ligament laxity • Increased Q angle • Narrower femoral notch

13. ACL Tear Treatment • Initial treatment for an ACL injury aims to reduce pain and swelling in your knee, regain normal joint movement and strengthen the muscles around your knee. • Surgery plus rehabilitation, or rehabilitation alone. • The choice depends on several factors, including the extent of damage to your knee and your willingness to modify your activities. • Athletes who wish to return to sports involving cutting, pivoting or jumping usually pursue surgical reconstruction to prevent episodes of instability.

14. ACL Surgery and Rehab • A torn ACL cannot be successfully sewn back together. • The ligament is usually replaced with a piece of tendon from another part of your knee or leg. • The use of crutches and, possibly, a knee brace • Range-of-motion exercises to regain your full knee motion • Muscle-strengthening and stability exercises

15. Prevention • Training. Strengthening and stability exercises, plyometric exercises, balance training, agility training, and risk-awareness training. • Strengthen your hamstrings. Women athletes in particular should make sure to strengthen their hamstring muscles as well as their quadriceps. • Use proper techniques. If your sport involves jumping, learn how to land safely. Studies have shown that if your knee collapses inward when you land from a jump, you are more likely to sustain an ACL injury. • Warm up and stretch. Being flexible enough to move freely can help you maintain ideal form. • Wearing a knee brace has not been found to be helpful in preventing ACL injuries.

16. ACL Tear & Prevention • http://www.youtube.com/watch?v=xE8BkzxxTEU • http://www.youtube.com/watch?v=YR5SLtcQxrI • http://www.youtube.com/watch?v=gLZE2g1B5fM • http://www.youtube.com/watch?v=tU_EwsIiT5E • http://www.youtube.com/watch?v=76Y6KQ2ipbE