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 _____________________ 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 ____________________________ Valgus Stress Test 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 __________ ___________________ ___________________