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Injuries to the Thigh, Leg, and Knee PE 236 Amber Giacomazzi MS, ATC. Sports place extreme stress on the knee, and is one of the most traumatized joints Considered a _______________ which performs: _________ and ___________ The knee is extremely ______ in terms of _____________________
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Injuries to the Thigh, Leg, and KneePE 236Amber Giacomazzi MS, ATC
Sports place extreme stress on the knee, and is one of the most traumatized joints • Considered a _______________ which performs: _________ and ___________ • The knee is extremely ______ in terms of _____________________ • Support is provided by ________ and _________ • The knee is designed to provide ________ in ____________ and _________ in locomotion
Menisci • Two _________________ deepen the joint and _________ any stress on the knee joint • Medial meniscus—”__” shaped and has an attachment to the _______________ • Can easily be damaged • Lateral meniscus—”___” shaped • Generally the meniscus has a ______________ • _______________ provides nutrients
Knee Ligament Injuries The most commonly injured knee ligaments are the _____, and the ____ Common mechanisms include _______ maneuvers when running and _______ _______ to the joint.
Collateral Ligament Injuries • MCL injuries are from a ____________ or a Severe ___________ • Concern for the MCL, _______, and ____ with this type of injury • LCL injuries are from a ________, often with _______________ • An avulsion fracture (_____) can occur
Collateral Ligament Injuries • Signs and Symptoms • ____________ • ____________ • ____________ • ____________ • ____________ • Treatment • ____________ • ____________ • ____________ • ____________
Cruciate Ligament Injuries • Anterior Cruciate Ligament • ACL can be injured when the ______ moves forcefully in an _____________ or when the _____ gets pushed ________ while the tibia is held in place • ______________ associated with ____________ movements can also damage ACL • Most __________ and most ___________ disrupted ligament in the knee • Rule changes, surfaces, shoes, increase participation of females • If the following three structures, _____, _____, ____ are involved in an injury, it is referred to an “________ ________”
Cruciate Ligament Injuries • Posterior Cruciate Ligament • Prevents the _______ from moving too far _________ • PCL injuries most often happen when an athlete ______________, or receives a ___________ to the _____ of the knee while the _____ is _______________________ • Knee’s ______________ and is almost ______ as strong as the _____ • Provides a central axis about which the knee rotates
Cruciate Ligament Injuries Signs and symptoms: • Athlete reports the knee was _______________ ________________ • Pain at the site of the injury • _________ around the knee. • Athlete indicates the knee feels _____________ • Athlete reports having a _______ or __________ sensation at the time of injury
Cruciate Ligament Injuries Treatment • Immediately apply ____ and _________ • Have athlete ______ _____________ • _________________ _________________
Menisci Injuries • Menisci are typically damaged by _____, _____, _________ movements • Injury is more likely to occur if ______________ firmly on the playing surface • There are many different types of tears, and they affect each athlete differently • In some cases, a _______________ will __________ _______, causing it to ________
Menisci Injuries Signs and symptoms: • ____ or ________ when the knee was injured • May not see any significant _________ • May not be painful • _____________ • Athlete may be able to ____________________ • A feeling the knee is “____________” periodically
Menisci Injuries Treatment • Apply ________ _____________ • Have athlete use crutches • ____________ ___________
Fractures of the Femur and/or Patella • Direct trauma- _____________ • Indirect trauma- __________________ ________ against the femur when the knee is _____________
Fractures of the Femur and/or Patella Signs and symptoms: • Pain at the injury site • _________ and/or ______________ Athlete’s report of having suffered a ______________ • Athlete may report a _____ or _____ at the time of injury
Fractures of the Femur and/or Patella • Treatment: • _________________ • _______ the injured leg, preferably with _________________ • Apply _____________ to any ___________ • Monitor _________ and _________ to lower leg • Arrange for ________ to a nearby medical facility
Patellar Dislocation/Subluxation • Injury may be caused by a __________ ______ that generates a great deal of ____________ within the knee • Instead of moving normally within it’s groove, the _________________________________
Patellar Dislocation/Subluxation • Individuals predisposed to condition • ________________ • ________________ • ________________ • ________________________________ • ________________ • ________________ • ________________ • ________________
Patellar Dislocation/Subluxation • Signs and Symptoms: • Severe pain and abnormal movement of the patella when injury occurred • _____________ • _____________ • ____________ along the ____________ of the patella • Majority of subluxations/luxations displace ____________!!
Patellar Dislocation/Subluxation • Treatment: • ___________________ • ___________________ • ___________________
Dislocation of the Knee or Tibiofemoral Joint • Dislocation of the knee or the tibiofemoral joint can compromise _____________________________ • **Napoleon MCcallum • **Shaun Livingston • Signs and symptoms: • _________________ • Dislocation of the joint • _________________ • Treatment: • The injury must be ___________ • ___________________________________________
Patellofemoral Joint Injuries • Acute and chronic injuries can affect patellofemoral joint. Such injuries can be debilitating and must be treated • _______________________ or “_________” • Condition occurs when ________________ or __________ are dislodged from joint and _________ ________________ • A bone fragment can ____________ • Damage to _____________ can occur
Patellofemoral Joint Injuries • Signs and symptoms • Pain especially _____________ • _____________ • ______________ • Knee may lock; ______________________ • One or more ______________ may be ______ when palpated • Treatment • Application of ice and compression. • If necessary, ________________ • ___________________________
Chondromalacia Patella • Wear and tear of the under surface of the patella as it articulates on the femoral groove due to overuse • Three Stages • Stage 1-___________________________ • ________________ • Stage 2-___________________________ • ________________ • Stage 3-___________________________ • ________________
Chondromalacia Patella • Signs and Symptoms • _________________ • May have _________ present on the top of the knee • Pain with __________ after ________ for a _____________ ________ “__________ knee” • Quadriceps atrophy • _________________ • Treatment • Ice • _____________ • Knee sleeve • _____________
Bursa of the Knee Bursa are ___________ _____ sacs located at strategic points Numerous bursa are in the knee region; only a few are typically injured
Bursa of the Knee Inflammation can be caused by: • __________ • __________ • _________________________ The ___________ bursa is susceptible to _____________
Bursa of the Knee Signs and symptoms: • _________ and __________ at site • Pain when ________ _____________ is applied • Athlete may report direct trauma to knee • Posterior swelling—____________
Bursa of the Knee Treatment • Application of _________________ • _______________ for a short time • In chronic cases, ______________ _______ may be helpful
Patellar Tendonitis Sudden or _________ ______________ of the knee may begin the inflammatory process that will eventually lead to ________________ “____________”
Patellar Tendonitis Signs and Symptoms • Stage 1—_______________ (tight quads, pulling on the patellar tendon) • Stage 2—___________________ • Stage 3—________, _________ and _______________ (___________)
Patellar Tendonitis Treatment • First find cause ________, ______, ____________ • RICE • _________________ and ________ __________ • Taping and bracing • Do not overuse and stretch
Osgood-Schlatter Disease (OSD) OSD usually involve _______ of the _________ _______________ May result in an ________________ Occurs during _______________ Signs and symptoms: • Pain and tenderness on the patellar tendon complex • __________ in the area • __________ ability to use the ____________ • If inflammation continues, _______________ ______________________________
Osgood-Schlatter Disease (OSD) Treatment • Apply ice and compression • _____________ ____________ • Until inflammation subsides, _____ is important
Iliotibial Band Friction Syndrome (Runner’s Knee) • ______________ common in ________ and _________ that can be attributed to _____________ and _________ ____________ of the _____ and ___________ • Irritation develops over the _____________ _________ or at the _____________ where the friction is created as the knee ______ and _________
Iliotibial Band Friction Syndrome (Runner’s Knee) • Signs and symptoms: • _____________ • ______________ • Pain increases during __________ • Treatment: • __________________________ • ________________________________ • Cold pack or ice massage • ________________________________
Special Tests for Knee • ____________________________ • Used to assess the integrity of the MCL and LCL respectively • Testing at ___________ incorporates capsular testing while testing at ____________ of _______ isolates the ligaments Valgus Stress Test Varus Stress Test
Special Tests for Knee • _________________ • Will not force knee into painful flexion immediately after injury • Reduces hamstring involvement • At _________ of ________ an attempt is made to translate the tibia _________ on the femur • A positive test indicates _________ ____________
Special Tests for the Knee • ________________ • Knees are ______ to _________, athlete is __________ • Positive if _________ _________ of the _____ upon the femur
Special Tests for the Knee • _______________ • While knee is flexed, externally rotate the tibia, add valgus force, and extend the knee. Repeat with tibia internally rotated and a varus force • A ______________ is a positive
Special Tests for the Knee • ________________ • Hard downward pressure is applied w/ rotation • _______________ _______________ _______________ • Used to detect ____________
Special Tests for the Knee • _________________ • Athlete remains relaxed with no quadricep contraction, while examiner gently pushes the patella __________ • Positive is if _________ _________ or contracts the ___________ to protect against _______________
Special Tests for the Knee • _____________ (_______________) • Subject is asked to contract quadriceps muscle while examiner applies downward pressure and inferior pressure on the patella • Positive is __________ ___________________ ___________________