Download Injury to the Knee

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One of the most complex joints in the human
body
Also one of the most frequently injured
Principal Movements of the Knee: Flexion &
Extension
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Cartilage: Medial Meniscus, Lateral Meniscus
Meniscus Increase Stability of Knee, Cushion
from Stresses
Ligaments: Connecting the Femur to the Tibia
or Fibula
Stabilize the Knee
ACL: Anterior Cruciate Ligament
PCL: Posterior Cruciate Ligament
(Cruciate : “Cross”)
Medial & Lateral Collateral Ligaments (MCL &
LCL)
fibula
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Four Bones: Femur, Tibia, Fibula, Patella
(Kneecap)
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Largest & Primary Muscles of the Knee:
Quadriceps & Hamstrings
“Quads” EXTEND the Knee
Hamstrings FLEX the Knee
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Proper Strength, Flexibility, Agility, Speed,
Balance is Key
Proper Shoes, Knee Braces
H.O.P.S.
Special Tests Pg. 361-363
Valgus / Varus Stress Tests : Tests MCL/LCL
Drawer Test: Tests the ACL / PCL
McMurray Test: Tests the Meniscus (Tear)
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Causes: A hit from the outside (lateral) side of
leg, or sudden rotation
Grades I, II, III
Pain, Swelling, Stiffness over MCL
Joint Instability: Knee will feel “unstable” to
walk
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Also will have Positive Valgus/Varus Stress Test
(Special Test in HOPS)
Treatment:
R.I.C.E., Crutches, Immobilization, Referral to
Doctor
Rehabilitation before Return to Play; Knee
Brace
Usually heals in 2-6 weeks depending on how
severe it is
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LCL: Lateral Collateral Ligament
LCL Sprain: Similar to MCL Sprain, except on
the Lateral (outside)
Usually caused by a force to the medial
(inside) knee
Similar Signs/Symptoms/Treatment
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Often injured
during a “cutting”
movement,
rotation, or quick
stop
Athlete may feel or
hear a “pop”,
followed by
immediate pain and
disability
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Rapid Swelling
Positive “Drawer” Test
Treatment: First Aid,
RICE & Crutches.
Immobilize or Wrap
with bandage.
If torn, surgery is
required if athlete
wants to return to
competitive athletics
fibula
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Surgery involves using
an Allograft (Cadaver
Tendon) or Autograft
(Tendon from your
own body) to replace
the torn ACL
Surgery involves a
brief hospital stay,
bracing, and 4-8
months of rehab
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During Rehab, ROM is
improved, strength
exercises
May require wearing a
brace
Drawer Test
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Similar
Signs/Symptoms,
Treatment, and
Rehab as that of an
ACL Sprain
Not as common
Some doctors may
not suggest surgery,
or just wear a brace
May result from
“hyperextension” of
knee
Posterior (Back) View of
Knee
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Meniscus is cartilage
that helps to cushion
the knee
Injury usually occurs
with rotation of the
knee
S/Sx: Pain, Swelling,
Loss of ROM,
“Locking”, “Clicking”,
“Giving Way”, Pain
when squatting
Tx: RICE, Crutches,
Referral to Doctor;
Arthroscopic surgery
may be required
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Bursa: Fluid filled sacs
that help joints move
smoothly
They can become
irritated with Acute or
Chronic Trauma
S/Sx: Swelling, Some
may have large
amounts of swelling,
Redness (Erythema),
Increased temperature,
Pain
Tx: RICE, Medication,
Compression, Drain
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Overuse injury
common in runners
(duh!) and cyclists
S/Sx: Pain over the
Lateral Knee, Swelling
Tx: RICE, Medication,
Proper Warm-Up,
Stretching, Orthotics,
Ultrasound
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Caused by a direct
hit or indirect
trauma (Quads
pulling a piece of
bone off)
S/Sx: Pain, Swelling,
Inability to move
knee
Tx: RICE,
Immobilization, XRays, Surgery
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Usually caused during a
“cutting” or quick stop
movement
Patella may dislocate out of
its groove, usually
LATERALLY
S/Sx: Pain, Swelling, Loss
of ROM, Deformity
Tx: Immobilize knee, Ice,
Hospital
Physician will “Reduce” the
dislocation
Immobilize; Splint; Rehab;
Brace
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Is Softening &
Deterioration of
cartilage underneath
kneecap
Caused by abnormal
movement of
patella/Overuse
S/Sx: Pain when walking,
running, stairs,
squatting. Swelling
around kneecap,
“Grating” sensation
when bending knee
Tx: RICE,
immobilization,
Splinting, Medication,
Rehab
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Overuse Injury
From lots of
Jumping (duh!)
Pain in the “front”
of the knee, along
Patellar Tendon
Tx: RICE, Brace,
Quad Strengthening