Injuries to the Thigh, Leg, and Knee PE 236 Juan Cuevas, ATC

1. Injuries to the Thigh, Leg, and KneePE 236Juan Cuevas, ATC

5. Signs and symptoms include: Pain at the injury site. Swelling and/or ____________. Athlete’s report of having suffered a traumatic event. Athlete may report a _________ at time of injury. The injury needs to be evaluated by a physician. _________________ is a serious complication. Fractures of the Femur and/or Patella

8. Fractures of the Femur and/or Patella (continued) First Aid • Treat for ________. • Splint the injured leg, preferably with traction splint. • Apply _________ dressings to any open wounds. • Monitor vital signs and ___________ to lower leg. • Arrange for transport to a nearby medical facility… 911!

9. Patellar Dislocation/Subluxation • Injury may be caused by a quick _____ motion that generates a great deal of abnormal force within the knee. • Instead of moving normally within it’s groove, the patella moves _______ and may dislocate.

10. Patellar Dislocation/Subluxation (Continued) Signs and symptoms include: • Severe pain and abnormal movement of the patella when injury occurred. • ____________. • Gross Deformity. • Extreme pain along the medial aspect of the patella. **_________________

11. Patellar Dislocation/Subluxation (continued) First Aid • Apply ice and compression. • Splint the __________. • Transport to a medical facility.

13. Dislocation of the Knee or Tibiofemoral Joint Dislocation of the knee or the ___________ joint can compromise blood flow to the lower leg. **Napoleon MCcallum **Shaun ________________ Signs and symptoms include: • Extreme pain. • Dislocation of the ________. • GROSS DEFORMTY First Aid • The injury must be splinted. • Refer athlete to the nearest medical facility... _____!

15. Patellofemoral Joint Injuries Acute and chronic injuries can affect patellofemoral joint. Such injuries can be ____________ and must be treated. Osteochondritis dissecans (_____) or “joint mice” • Condition occurs when small pieces of bone or cartilage are dislodged from joint and float within capsule. • A bone fragment can ________ a joint. • Damage to joint surface can occur.

16. Patellofemoral Joint Injuries (continued) Signs and symptoms of OCD include: • Chronic knee pain with exertion. • ________ swelling. • Knee may lock; quadriceps may atrophy. • One or more femoral condyles may be tender when palpated. First Aid • Application of ice and compression. • If necessary, crutches for walking. • ______ athlete to physician.

17. _________________ Patella • Wear and tear of the under surface of the patella as it articulates on the femoral groove due to overuse. • __________ injury • May have swelling present on the _____ of the knee. • Pain with standing after sitting for a prolonged period of time. “movie-goer’s knee” • Quadriceps atrophy • “_____________” grinding • “__________ Grind Test”

18. __________ of the Knee Bursa are small fluid-filled sacs located at strategic points. Numerous bursa are in the knee region; only a few are typically injured.

19. Bursa of the Knee (continued) Inflammation can be caused by: • ___________. • Infection. • Overuse. The __________ bursa is susceptible to direct trauma.

20. Bursa of the Knee (continued) Signs and symptoms include: • __________ and tenderness at site. • Pain when increased external pressure is applied. • Athlete may report ________ trauma to knee.

21. Bursa of the Knee (continued) First Aid • Application of ice and compression. • ________ activity for a short time. • In chronic cases, anti-inflammatory agents may be helpful.

22. Osgood-SchlatterDisease (_____) OSD usually involve irritation of the patellar tendon complex. Signs and symptoms of OSD include: • Pain and tenderness on the patellar tendon complex. • Swelling in the area. • Decreased ability to use the ____________. • If inflammation continues, area over tibial ______________ may become solid when palpated.

23. Osgood-Schlatter Disease (OSD) First Aid • Apply ice and compression. • _____ to physician for specific diagnosis. • Until inflammation subsides, _____ is important.

24. Jumper’s Knee Signs and symptoms of Jumper’s knee (JK) include: • Pain and tenderness around the patellar __________________ that may spread to tibial tuberosity. • Decreased ability to use quadriceps for running or jumping. • Symptoms that ________ with activity. First Aid • Apply ice and compression. • Refer to physician for possible anti-inflammatory medications • Rest will be helpful.

25. Menisci Injuries Menisci are typically damaged by quick, sharp, ______ movements. • Injury is more likely to occur if the foot is _______ firmly on the playing surface. There are many different types of tears, and they affect each athlete differently. • In some cases, a _________ of meniscus will get caught in the joint, causing it to lock.

26. Menisci Injuries (continued) Signs and symptoms include: • _____ or snap when the knee was injured. • May not see any significant swelling. • May not be painful. • _______ of ROM. • Athlete may be able to continue participating. • A feeling the knee is “_____________” periodically. **_______________

27. Menisci Injuries (continued) First Aid • Apply ice and compression. • Have athlete use crutches. • Refer athlete to a physician.

28. Knee Ligament Injuries The most commonly injured knee ligaments are the ___, and the ___. Common mechanisms include cutting maneuvers when _________ and direct blows to the joint.

29. Knee Ligament Injuries (continued) Sprain to MCL is common sports injury. • Occurs as a result of valgus stress on MCL. **(______ Stress test) • Varus stress can cause a sprain of the LCL. **(_____ Stress Test) Both types of sprains render knee unstable in side-to side movements.

30. Knee Ligament Injuries (continued) _______ Ligament Injuries • ACL can be injured when the tibia moves forcefully in an _______ direction or when the femur gets pushed backward while the tibia is held in place. • Quick _______ associated with __________ movements can also damage ACL. • ____ injuries most often happen when an athlete falls on both knees, or receives a forceful blow to the front of the knee while foot is planted on the ground.

31. Cruciate Ligament Injuries (continued) Signs and symptoms include: • Athlete reports the knee was forced beyond its normal ROM. • Pain at the site of the injury. • Swelling around the knee. • Athlete indicates the knee feels ___________. • Athlete reports having a snapping or__________ sensation at the time of injury. **_________ Drawer Test **Lachman’s Test **Sag Test

32. Cruciate Ligament Injuries (continued) First Aid • Immediately apply ice and compression. • Have athlete walk on ________. • Refer to a physician for medical ____________.

33. Special Tests for Knee Instability • Use endpoint feel to determine __________ • Classification of Joint Instability • Knee laxity includes both straight and rotary instability • __________ (tibial translation) refers to the glide of tibial plateau relative to the femoral condyles • As the damage to stabilization structures increases, _______ and translation also increase • Valgus and Varus Stress Tests • Used to assess the integrity of the _____ and LCL respectively • Testing at 0 degrees incorporates capsular testing while testing at 30 degrees of flexion isolates the ligaments

34. Valgus Stress Test Varus Stress Test

35. Lachman Drawer Test • Will not force knee into painful flexion immediately after injury • Reduces hamstring involvement • At 30 degrees of flexion an attempt is made to translate the tibia ________ on the femur • A positive test indicates damage to the ACL

36. Apley’s Compression Test • Hard downward pressure is applied w/ rotation • Pain indicates a meniscal injury • Used to detect meniscus tear