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Knee and Thigh Anatomy: Evaluation, Injuries, and Rehabilitation

Learn about knee and thigh anatomy, evaluation techniques, common injuries, preventive methods, and rehabilitation principles. Discover preventive/supportive techniques, protective devices, and conditions requiring physician referrals.

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Knee and Thigh Anatomy: Evaluation, Injuries, and Rehabilitation

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  1. Basic Athletic TrainingChapter 7 Knee and Thigh

  2. Chapter Objectives • Name the anatomy of the knee and thigh • Identify the steps in an evaluation format • Compare the common injuries to the knee and thigh • Demonstrate the principles of rehabilitation to the knee and thigh • Describe the preventive/supportive techniques and protective devices for the lower extremity

  3. Anatomy • The knee is the largest joint in the body, but structurally weak • The instability of the knee is supported by four strong ligaments and 12 muscles • The femur (thighbone) is the longest and strongest bone in the body

  4. Knee, Quadriceps, and Hamstring Anatomy • Bones • Ligaments • Cartilage • Muscles and tendons and their functions • Dermatomes • Myotomes • Range of motion

  5. Evaluation Format • (H)istory • Mechanism of injury (How did it happen?) • Location of pain (Where does it hurt?) • Sensations experienced (Did you hear a pop or snap?) • Previous injury (Have you injured this anatomical structure before?) • (O)bservation—compare the uninjured to the injured lower extremity and look for bleeding, deformity, swelling, discoloration, scars, and other signs of trauma

  6. Evaluation Format • (P)alpation—the physical inspection of an injury. Palpate the anatomical structures/joints above and below the injured site, then palpate affected area. Using bilateral comparison, these items should be palpated: • Neurological (motor and sensory) • Circulation (pulse and capillary refill) • Anatomical structures (palpate) • Fracture test (palpation, compression, and distraction)

  7. Evaluation Format • (S)pecial Tests—look for joint instability, disability, and pain. Assess disability in the following areas: • Joint stability • Muscle/tendon • Accessory anatomical structures • Inflammatory conditions • Range of motion (active, assistive, passive, and resistive) • Pain or weakness in the affected area

  8. Conditions that Indicate an Athlete Should be Referred for Physician Evaluation • Suspected fracture or dislocation • Abnormal sensations such as clicking, popping, grating, or weakness • Locked knee or excessive limited motion • Any doubt regarding the severity or nature of the injury • Gross deformity • Significant pain • Increased swelling • Circulation or neurological impairment • Joint instability

  9. Common Injuries • Contusions • Ligament sprains • Meniscus tears • Patellar tendinitis • Chondromalacia patellae • The female athlete’s knee • Osgood-Schlatter condition • Muscular strains

  10. Preventive/Supportive Techniques • Wrapping techniques for compression • Knee compression wrap • Wrapping techniques for support • Knee joint, hamstrings, quadriceps, hip flexor, and hip adductor wraps • Taping techniques for the knee, thigh and hip • Collateral knee • Hyperextended knee • Anterior cruciate • Patella tendon • Hip pointer

  11. Rehabilitation • Included in any rehabilitation protocol is: • Range of motion exercises • Resistive exercises • Cardiovascular/fitness activities • Sport specific activities • Return to competition guidelines • Full range of motion • Strength, power, and endurance are proportional to the athlete’s size and sport • No pain during running, jumping, or agility movements • No loss of function

  12. Preventing ACL Injuries in Females • Women 4-6 times more likely to tear ACL • Common mechanism of injury: non-contact torsion • Women—tend to land more straight-legged (ligament dominant) • Men—tend to land more with bent knee (muscular dominant) • Prevention program—shown to give significant reduction in ACL injuries. Includes: • Hamstring strengthening • Plyometric/agility drills • Proper biomechanics during landing • Knee over toes; avoid valgus position

  13. Protective Devices • Closed/open patella neoprene sleeve • Hinged knee brace • Knee brace • Lateral patella subluxation braces • Patella stabilizing strap • Patella tendon tendinitis braces • Patella tendon strap • Pre-patella bursitis protectors • Prophylactics knee brace: rehabilitative and functional • Sport-specific pads

  14. Musculoskeletal Disorders • Bursitis • Dislocation • Fracture • Iliotibial band friction syndrome • Meniscal tear • Myositis ossificans • Osteochondritisdissecans • Popliteal cyst

  15. Questions ?

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