1. Knee & Thigh Chapter 7 Objectives: UNDERSTAND:
Anatomy of the knee & thigh
Principles of rehabilitation to the knee & knee
Preventive/supportive techniques and devices
IDENTIFY:
Assessment tests for injuries to the knee and thigh
RECOGNIZE:
Steps in the evaluation format
Common injuries to the knee and thigh

2. Anatomy
The Knee
Largest joint in the body, but structurally very weak.
Unstable bony structure: the femur (longest & strongest bone in the body) sits on top of the smaller tibia (main weight bearing bone of lower leg).

3. Anatomy Femur -longest and strongest
Tibia -main weight bearing bone of lower leg
Fibula -non-weight bearing bone of lower leg
Patella -(knee cap) encased in powerful patellar tendon

4. Ligaments Medial Collateral (MCL) -secure femur to tibia
- connects to the medial meniscus
-Reduce Valgus & varus movement (abduction & adduction of tibia and femur)
Lateral Collateral (LCL)-(not as strong)
-does not attach to the lateral meniscus
Anterior Cruciate (ACL)-form “X” control anterior & posterior movement of femur on the tibia.
Posterior Cruciate (PCL)

5. Other structures
Cartilage: (rest on top of tibia, form a cushion for the femur to rest on, and shock-absorption, joint stability, smooth gliding & rotating of the femur and tibia)
Medial Meniscus (cartilage)
Lateral Meniscus (cartilage)
Bursa -closed, fluid-filled sacs, cushion against friction over bone, or where tendon moves over a bone.
Synovial membrane -large sac that lines the inside of the knee joint, helps: tendons, ligaments, and bones.
Fat pads -soft tissue: weight bearing and absorbing impact

6. Muscles
Quadriceps: Anterior, extend (straighten) lower leg, form patellar tendon (attaches on front of tibia)
1. Rectus femoris
2. vastus medialis-patellar tracking
3. vastus lateralis
4. vastus medialis

7. Muscles
Hamstrings: posterior, flexes the knee, controls the rotary movements of the tibia.
1. Semitendinosus
2. semimembranosus
3. biceps femoris

8. Muscles & Tendons Vastus Medialis: extension of knee
Vastus Lateralis: extension of knee
Vastus Intermedius: extension of knee
Rectus Femoris: extension of knee, flexion of hip
Gracilis: adduction of hip and flexion of knee
Sartorius: flexion & rotation of hip & knee
Semitendinosus: knee flexion & medial rotation
Semimebranosus: Knee flexion & medial rotation

9. Muscles & Tendons Popliteus: flexion of knee & medial rotation
Biceps Femoris: flexion of knee & lateral rotation
Gastrocnemius: knee flexion
Plantaris: knee flexion

10. Assessment Tests Test for knee ligament stability:
- abduction or valgus stress: medial joint stability
-adduction or varus stress: lateral joint stability
-anterior drawer: acl
-posterior drawer: pcl
-Lachman’s: acl

11. Common Injuries Ligament sprains: 1st, 2nd, 3rd degrees.
-Contusion: direct blow to knee joint
-Torsion: feet are fixed and body/injured joint is twisted (most often menisci)
-Shearing: force delivered to opposite side of joint
Patellar Tendinitis: Inflammation above/below patella. (pain after exercise, swelling) Ice & rest

12. Common Injuries
Chondromalacis Patellae: irritation and softening of the cartilage on the posterior aspect of the patella, causing unusual tracking of the patella as it moves. (causes: muscle weakness, imbalance, females: wider pelvic)
Osgood-Schlatter: Adolescents due to rapid growth during growth spurts, swelling below one/both knees. (causes: inflammation of the tibial tubercle, where the patellar tendon attaches) Rest & maybe cast
Muscular strains: PRICES