1. Injuries to the Thigh, Leg, and Knee
Chapter 15
Injuries to the Thigh, Leg, and Knee

2. Anatomy Review
Bones of the Region *
Patella-sesmoid bone
Tibia

3. Musculature
Muscles of the Region
Quadriceps *
Abductors

4. Ligaments Knee Ligaments Major ligaments are:
Tibial or medial collateral.
Fibular or lateral collateral. *
Posterior cruciate.
Medial and lateral collaterals protect the knee from * forces.

5. Meniscus
There are two semicircular fibrocartilaginous disks in the knee known as the menisci.
These disks are located in the space between the *and *.
Responsible for lubrication and nourishment of the knee joint, weight distribution, and assistance with joint biomechanics.

6. Common Sports Injuries
Fractures of the Femur and/or Patella
Femoral fractures result from an extremely traumatic event, and are * in sports.
These injuries may also be in the form of a *, especially in the femoral neck region.
Patellar fractures almost always occur as a result of a traumatic event.

7. Fractures of the Femur and/or Patella
In the adolescent, femoral fractures may include slipped capital epiphysis injuries (growth plate injuries).
In the adult, fractures of the femoral neck may result in * of the femoral head.
This injury results from disrupted * to the articular cartilage on the femoral head.

8. Fractures of the Femur and/or Patella (cont.)
MOI: Foot is planted and they are hit in the hip or upper thigh with a great deal of force.
Signs and symptoms include:
Pain at the injury site.
Difficulty walking on the affected leg.
Swelling and/or *. Athlete’s report of having suffered a traumatic event.
Athlete may report a * at time of injury.
The injury needs to be evaluated by a physician. Avascular necrosis is a serious complication.

9. Fractures of the Femur and/or Patella (cont.)
First Aid *
Splint the injured leg, preferably with traction splint.
Apply sterile dressings to any open wounds.
Monitor * and circulation to lower leg.
Arrange for transport to a nearby medical facility.

10. Dislocation of the Knee or Tibiofemoral Joint
Dislocation of the knee or the tibiofemoral joint can compromise blood flow to the lower leg.
Not commonly seen in sports.
Signs and symptoms include:
* pain.
Dislocation of the joint.
First Aid
The injury must be *.
Refer athlete to the nearest medical facility.

11. Soft Tissue Injuries to the Thigh
These injuries usually result from direct contact with an opponent or self-inflicted muscle strain.
* traumatica may develop.
Signs and symptoms of a muscle contusion include:
History of forceful impact to the area and a
feeling of tightness.
Swelling may occur in affected area.
Inability to forcibly * the muscle.
Difficulty * with affected leg.

12. Muscular Strains to the Thigh
Hamstrings and adductor muscles are most likely to sustain strains.
Strains to adductor muscles are called “*.”
Hamstrings usually are weaker and more susceptible to strains than quadriceps.
Groin injuries take a *.
* is a part of recovery program.

13. Muscular Strains to the Thigh (cont.)
Signs and symptoms include:
A sharp pain in the affected muscle.
Swelling and redness in the immediate area. *.
Inability to contract the muscle forcibly.
* of the area.
A defect is visible in severe cases.
First Aid:
Apply *
Athlete should rest, and if necessary, use crutches.
Obtain a medical evaluation of the injury

14. Patellofemoral Joint Injuries
Acute and chronic injuries can affect * joint. Such injuries can be debilitating and must be treated.
Osteochondritis dissecans (OCD) or “*”
Condition occurs when small pieces of bone are dislodged from joint and float within capsule.
A bone fragment can block or lock a joint’s motion.
Damage to * can occur.

15. Patellofemoral Joint Injuries (cont.)
Signs and symptoms of OCD include:
Chronic knee pain with exertion. *.
Knee may lock; quadriceps may atrophy.
One or more femoral condyles may be tender when palpated.
First Aid
Application of ice and compression.
If necessary, *.
Refer athlete to physician.

16. Bursa of the Knee
A bursa is a small fluid-filled sac located at strategic points.
Numerous bursae are in the knee region; * are typically injured.

17. Bursa of the Knee (cont.)
Signs and symptoms include:
* and tenderness at site.
Pain when increased external pressure is applied.
Athlete may report *.

18. Bursa of the Knee (cont.)
First Aid
Application of ice and compression.
Reduced activity for a short time.
In chronic cases, * agents may be helpful.

19. Patellar Dislocation/Subluxation
Injury may be caused by a quick cutting motion that generates a great deal of abnormal force within the knee.
Instead of moving normally, the patella moves * and may dislocate.

20. Patellar Dislocation/Subluxation (Cont.)
Signs and symptoms include:
First Aid:
Severe pain and abnormal movement of the patella when injury occurred. *.
Patella may be obviously out-of-place.
Extreme pain along the * of the patella.
Apply ice and compression. *.
Splint the entire leg.
Transport to a medical facility.

21. Osgood-Schlatter vs Jumper’s Knee
Differences include:
Age of the athlete
Location of pain *

22. Osgood-Schlatter Disease and Jumper’s Knee
Osgood-Schlatter and “jumper’s knee” usually involve irritation of the * complex.
Signs and symptoms include:
Pain and tenderness about the patellar tendon complex.
Swelling in the area.
Decreased ability to use the *.

23. Osgood-Schlatter Disease and Jumper’s Knee
First Aid
Apply ice and *.
Refer to physician for specific diagnosis.
Until inflammation subsides, rest is important.

24. Patellofemoral Conditions
Some conditions of the patella may be related to the Q angle.
The Q angle is the difference between a straight line drawn from the anterior superior iliac spine and the center of the patella and a line drawn from the center of the patella through the center of the tibial tuberosity.

25. Patellofemoral Conditions (cont’d)
An angle of * is acceptable.
An excessive Q angle may be related to problems such as patellar *.
More common in females due to the *.

26. Meniscus Injuries
Menisci are typically damaged by quick, *, cutting movements.
Injury is more likely to occur if the foot is planted firmly on the playing surface.
There are many different types of tears, and they affect each athlete differently.
In some cases, a torn flap of meniscus will get caught in the joint, *.

27. Types of Meniscus Tears

28. Meniscus Injuries (cont.)
Signs and symptoms include:
Pop or snap when the knee was injured.
May *significant swelling.
May not be painful.
Loss of *.
Athlete may be able to continue participating.
A feeling the knee is “giving out” periodically.
First Aid:
Apply ice and compression
Crutches if needed
Refer to physician *

29. Knee Ligament Injuries
Injury may occur to the *, LCL, ACL, or *.
Common mechanisms:
cutting maneuvers when running
direct blows to the joint
planted foot with a rotational force

30. Knee Ligament Injuries (cont.)
Sprain to MCL is a * sports injury.
Occurs as a result of valgus stress.
Varus stress can cause a sprain of the LCL.
Both types of sprains render knee unstable in * movements.

31. Knee Ligament Injuries (cont.)
Cruciate Ligament Injuries
ACL can be injured when the tibia moves forcefully in an anterior direction or when the femur gets pushed backward while the tibia is held in place.
Quick rotational movements can also damage ACL.
The stronger the * activation during eccentric contraction, the greater the likelihood of ACL injury, especially in female athletes.
Other reasons female athletes have a higher incidence of ACL tears??

32. Cruciate Ligament Injuries
Signs and symptoms include:
Athlete reports the knee was forced beyond its normal ROM.
Pain at the site of the injury.
Swelling around the knee.
Athlete indicates the knee feels *.
Athlete reports having a * sensation at the time of injury.

33. Cruciate & Collateral Ligament Injuries (cont.)
First Aid
Immediately apply ice and compression.
Have athlete walk with crutches.
Straight leg brace.
Refer to a physician for medical evaluation.
* for strengthening.

34. Prevention
Research is continuing to outline techniques that will hopefully prevent various injuries.
Proper * and stretching is important.
Protective bracing should be the *.
Jump and landing training programs may reduce the chance of an ACL tear, especially females.

35. Knee Bracing Prophylactic Braces
The general consensus regarding prophylactic knee braces indicates that they do not prevent knee ligament injuries.
Courtesy of DJO Incorporated
Courtesy of Mueller Sports Medicine

36. Knee Bracing (cont.) Functional Knee Braces
These braces tend to work better than prophylactic braces for assisting athletes after reconstructive knee surgery.
Monitor athletes to make sure they wear braces during participation.
Athletes should continue wearing braces until *.