1
Injuries to the Thigh, Leg, and Knee
PE 236Amber Giacomazzi MS, ATC
Sports place extreme stress on the knee, and is one of the most traumatized jointsConsidered 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
2
3
MenisciTwo _________________ 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—”___” shapedGenerally the meniscus has a _____________________________ provides nutrients
4
5
6
7
Knee Ligament InjuriesThe 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
8
Collateral Ligament InjuriesSigns and Symptoms– ____________– ____________– ____________– ____________– ____________
Treatment– ____________– ____________– ____________– ____________
9
Cruciate Ligament InjuriesAnterior 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 “________ ________”
10
Cruciate Ligament InjuriesPosterior 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
11
12
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
13
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 surfaceThere are many different types of tears, and they affect each athlete differently– In some cases, a _______________ will __________
_______, causing it to ________
14
15
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
16
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 _____________
17
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
18
19
20
Treatment:– _________________– _______ the injured leg, preferably with
_________________– Apply _____________ to any ___________– Monitor _________ and _________ to lower leg– Arrange for ________ to a nearby medical
facility
21
Fractures of the Femur and/or Patella
22
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– ________________– ________________– ________________– ________________________________– ________________– ________________– ________________– ________________
23
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
____________!!24
Patellar Dislocation/Subluxation
Treatment:– ___________________– ___________________– ___________________
25
26
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 ___________– ___________________________________________
27
28
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
29
Patellofemoral Joint Injuries
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, ________________– ___________________________
30
31
Chondromalacia PatellaWear 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 PatellaSigns and Symptoms– _________________– May have _________ present on the top of the knee– Pain with __________ after ________ for a _____________
________ “__________ knee”– Quadriceps atrophy– _________________
Treatment– Ice– _____________– Knee sleeve– _____________
32
33
Bursa of the Knee
Bursa are ___________ _____ sacs located at strategic points
Numerous bursa are in the knee region; only a few are typically injured
34
Bursa of the Knee
Inflammation can be caused by:
– __________– __________– _________________________
The ___________ bursa is susceptible to _____________
35
Bursa of the Knee
Signs and symptoms:
– _________ and __________ at site
– Pain when ________ _____________ is applied
– Athlete may report direct trauma to knee
– Posterior swelling—____________
36
Bursa of the Knee
Treatment– Application of _________________– _______________ for a short time– In chronic cases, ______________ _______
may be helpful
Patellar TendonitisSudden or _________
______________ of the knee may begin the inflammatory process that will eventually lead to ________________
“____________”
37
Patellar TendonitisSigns and Symptoms
• Stage 1—_______________ (tight quads, pulling on the patellar tendon)
• Stage 2—___________________• Stage 3—________, _________ and
_______________ (___________)
38
Patellar TendonitisTreatment
• First find cause ________, ______, ____________
• RICE• _________________ and ________ __________• Taping and bracing• Do not overuse and stretch
39
40
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, _______________
______________________________
41
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 _________
42
Signs and symptoms:– _____________– ______________– Pain increases during __________
Treatment:– __________________________– ________________________________– Cold pack or ice massage– ________________________________
43
Iliotibial Band Friction Syndrome (Runner’s Knee)
Special Tests for Knee– ____________________________
Used to assess the integrity of the MCL and LCL respectivelyTesting at ___________ incorporates capsular testing while testing at ____________ of _______ isolates the ligaments
44Valgus Stress Test
Varus Stress Test
45
_________________– 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 Knee
Special Tests for the Knee________________– Knees are ______ to
_________, athlete is __________
– Positive if _________ _________ of the _____ upon the femur
46
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
47
48
________________ – Hard downward
pressure is applied w/ rotation
– _______________ _______________ _______________
– Used to detect ____________
Special Tests for the Knee
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 _______________
49
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 __________ ___________________ ___________________
50