1. Basic Athletic Training Chapter 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
Gross deformity
Significant pain
Increased swelling
Circulation or neurological impairment
Joint instability
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

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
Osteochondritis dissecans
Popliteal cyst

15. Questions ?