1 Injuries to the Thigh, Leg, and Knee PE 236 Amber Giacomazzi MS, ATC

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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 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

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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

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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

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Collateral Ligament Injuries

Signs and Symptoms– ____________– ____________– ____________– ____________– ____________

Treatment– ____________– ____________– ____________– ____________

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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 “________ ________”

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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

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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

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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 ________

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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

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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 _____________

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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

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Treatment:– _________________– _______ the injured leg, preferably with

_________________– Apply _____________ to any ___________– Monitor _________ and _________ to lower leg– Arrange for ________ to a nearby medical

facility

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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 _________________________________


Individuals predisposed to condition– ________________– ________________– ________________– ________________________________– ________________– ________________– ________________– ________________

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Signs and Symptoms:– Severe pain and abnormal movement of the

patella when injury occurred– _____________– _____________– ____________ along the ____________ of

the patella – Majority of subluxations/luxations displace

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Treatment:– ___________________– ___________________– ___________________

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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 ___________– ___________________________________________

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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

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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, ________________– ___________________________

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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– _____________

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Bursa of the Knee

Bursa are ___________ _____ sacs located at strategic points

Numerous bursa are in the knee region; only a few are typically injured

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Bursa of the Knee

Inflammation can be caused by:

– __________– __________– _________________________

The ___________ bursa is susceptible to _____________

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Bursa of the Knee

Signs and symptoms:

– _________ and __________ at site

– Pain when ________ _____________ is applied

– Athlete may report direct trauma to knee

– Posterior swelling—____________

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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 ________________

“____________”

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Patellar TendonitisSigns and Symptoms

• Stage 1—_______________ (tight quads, pulling on the patellar tendon)

• Stage 2—___________________• Stage 3—________, _________ and

_______________ (___________)

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Patellar Tendonitis

Treatment• First find cause ________, ______,

____________• RICE• _________________ and ________ __________• Taping and bracing• Do not overuse and stretch

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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, _______________

______________________________

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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 _________

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Signs and symptoms:– _____________– ______________– Pain increases during __________

Treatment:– __________________________– ________________________________– Cold pack or ice massage– ________________________________

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Iliotibial Band Friction Syndrome (Runner’s Knee)

Special Tests for Knee– ____________________________

Used to assess the integrity of the MCL and LCL respectively

Testing at ___________ incorporates capsular testing while testing at ____________ of _______ isolates the ligaments

44Valgus Stress Test

Varus Stress Test

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_________________– 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

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_______________– 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

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________________ – Hard downward

pressure is applied w/ rotation

– _______________ _______________ _______________

– Used to detect ____________



_________________– Athlete remains relaxed

with no quadricep contraction, while examiner gently pushes the patella __________

– Positive is if _________ _________ or contracts the ___________ to protect against _______________

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_____________ (_______________)– Subject is asked to

contract quadriceps muscle while examiner applies downward pressure and inferior pressure on the patella

– Positive is __________ ___________________ ___________________

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Documents

1 Injuries to the Thigh, Leg, and Knee PE 236 Amber Giacomazzi MS, ATC