Acute knee injuries in adolescent female football

players

MOST COMMON INJURIES

Anterior Cruciate Ligament Injuries

The ACL is injured during recovery from falling backwards (in expert skiers) or hyperflexion and internal rotation of the knee (in lowerlevel skiers).

LACHMAN TEST

The test is performed with the patient in a supine position and the injured knee flexed to 30 degrees. The physician stabilizes the distal femur with one hand, grasps the proximal tibia in the other hand, and then attempts to sublux(dislocate) the tibia anteriorly. Lack of a clear end point indicates a positive Lachman test.

Collateral Ligament Injuries

The medial collateral ligamentis a medial stabilizer of the knee and is most commonly injured by a blow to the lateral aspect of the knee or by the patient planting the foot and then colliding with another athlete.

Injury of the lateral collateral ligament is less common but more disabling. It occurs via hyperextension with varus stress or from a direct blow or rotation.

Knee Dislocation

This often occurs as a result of a high-speed motor vehicle accident. Knee dislocations are classified according to the direction that the tibia is displaced in relation to the femur. Of knee dislocations, 50%-60% are anterior, but popliteal artery injury is most commonly associated with posterior dislocations

A knee dislocation occurs when the bones that form the knee are out of place. A knee dislocation, more specifically, is when the bones of the leg (the tibia and fibula) are moved in relation to the bone in the thigh (femur). The bones of the knee are held together by strong bands of tissue called ligaments. Each ligament is responsible for stabilizing the knee in a certain position. For a knee dislocation to occur, these ligaments must tear.

PREVENTION

15 minute neuromuscular warm-up programme (targeting: core stability, balance, and proper knee alignment) to be carried out twice a week throughout the season.

one legged knee squat

pelvic lift

two legged knee squat the bench(step over

knee)

the lunge

and jump/landing technique

Exercises

INTERVENTION INFORMATION The exercises were preceded by 5 minutes of low intensity running

and took about 15 minutes to complete after familiarisation. The intervention clubs were instructed to do the exercises during the warm-up at two training sessions a week throughout the whole season. All players started on the first level of difficulty and proceeded to the next level when exercises were performed with good control as assessed by the coach.

RESULTS OF PREVENTION

Seven players (0.28%) in the intervention group, and 14 (0.67%) in the control group had an anterior cruciate ligament injury. By Cox regression analysis according to intention to treat, a 64% reduction in the rate of anterior cruciate ligament injury was seen in the intervention group (rate ratio 0.36, 95% confidence interval 0.15 to 0.85). The absolute rate difference was −0.07 (95% confidence interval −0.13 to 0.001) per 1000 playing hours in favour of the intervention group. No significant rate reductions were seen for secondary outcomes.

A 15 minute neuromuscular warm-up programme reduced the overall rate of anterior cruciate ligament injury by 64% in adolescent female football players Players who carried out the programme at least once a week (compliers) additionally had lower rates of severe knee injury (>4 weeks’ absence) and any acute knee injury Neuromuscular training should be part of the warm-up programme for young female football players

TREATMENT

Almost all knee injuries will need more than one visit to the doctor. If no operation is indicated, then RICE (rest, ice, compression, and elevation) with some strengthening exercises and perhaps physical therapy will be needed. Sometimes the decision for surgery is delayed to see if the RICE and physical therapy will be effective. Each injury is unique, and treatment decisions depend on what the expectation for function will be. As an example, a torn ACL (anterior cruciate ligament) would usually require surgery in a young athlete or a construction worker, but the ACL may be allowed to heal with physical therapy in an 80-year-old who is not very mobile.

KNEE ARTHROSCOPY

is a minimally invasive surgical procedure in which an examination and sometimes treatment of damage of the interior of a joint is performed using an arthroscope, a type of endoscope that is inserted into the joint through a small incision. 

Knee arthroscopy is commonly performed for reconstruction of the anterior cruciate ligament. Can also be performed just for. Nowadays it’s replaced be magnetic resonance image. During an average surgery a camera is inserted into the joint. A special fluid is used to visualize the joint parts. Then other miniature instruments are used and the surgery is performed.

EXERCISE GUIDE AFTER KNEE ARTHROSCOPY

Before You StartRecommendation: approximately 20 to 30 minutes of exercises two or three times a day. As you increase the intensity of your exercise program, you may experience temporary set backs. If your knee swells or hurts after a particular exercise activity, you should lessen or stop the activity until you feel better. You should Rest, Ice, Compress (with an elastic bandage), and Elevate your knee (R.I.C.E.).

Initial Exercise: Hamstring Contraction

Intermediate Exercise: Terminal Knee Extension, Supine

Advanced Exercise: Step-ups, Forward

PREVENTION AND TREATMEN

Kinesiotaping

- Terapeutic method of taping some body area with special tape

- Amplify muscle strength

- Elastic cotton tape that is claimed to be able to stretch up to 120–140% of its original length

- Tape is applied with the affected muscle in a stretched position, taping from the origin of the muscle to the insertion point

THANKS FOR ATTENTION