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Injuries of the Knee • Left knee from behind • There are five ligaments in the knee that help connect the femur to the tibia and keep your legs stable: – Medial Collateral Ligament (MCL) • connects your femur to your tibia • inside of your knee; Keeps inside of knee stable - Lateral Collateral Ligament (LCL) • connects your femur to your tibia • outside of your knee; keeps outer part of knee stable – Anterior Cruciate Ligament (ACL) • connects your femur to your tibia • at the center of the knee; helps control forward motion and rotation – Posterior Cruciate Ligament (PCL) • connects your femur to your tibia • At the back of the knee; helps control the knee's backward motion – Ligament of Wrisberg • Right behind the attachment of the posterior cruciate ligament • This ligament does nothing important Main types of Injuries • • • • • Sprains Strains Mensical Tears Fractures and Dislocations Cartilage Injuries • Common causes of injuries include overuse, sudden stops and twists, or a direct blow to the knee • SPRAINS – A stretched or torn ligament – Common sprains usually involve damage to the anterior cruciate ligament (ACL) and/or medial collateral ligament (MCL) • The ACL is the smallest ligament in the knee • connects the femur to the tibia at the center of knee • When the tibia and femur rotate too far in opposite directions/when the knee is bent in the wrong direction -the ACL can be torn or sprained. • Often when damaging the ACL there will be damage to other ligaments such as the Medial Collateral ligament (MCL) • Symptoms of ACL injuries – Popping; swelling; hard to walk on – Feeling as though your knee will give out/buckle or even bend backwards • Causes and risk factors – Quick changes in direction while running cause most ACL injuries – Girls who play sports are up to four times more likely to injure their ACL than male athletes • The medial collateral ligament extends from the end of the femur (thigh bone) to the top of the tibia (shin bone) and is on the inside of the knee joint. The MCL prevents "opening-up" of the knee. Medial Collateral Ligament (MCL) INJURIES • Usually injured outside of the knee is struck • This causes the outside of the knee to buckle, and the inside to “open up”. • Can be torn/injured if stretched too far • Sometimes tearing of other ligaments such as the ACL occurs along with the injury of the MCL • SYMPTOMS of MCL injuries – Pain and swelling over ligament ; bruising and generalized joint swelling are common 1 to 2 days after the injury. – In worse injuries, knee may feel unstable, or feel as though it may 'give out' or buckle. – MCL injuries are graded on a scale of 1-3 • Grade 1 MCL Tear – incomplete tear of the MCL. – symptoms are usually minimal. – usually pain with pressure on the MCL – may be able to return very quickly. May be out miss 1-2 weeks • Grade 2 MCL Tear – also considered incomplete tears of the MCL. – May have instability when attempting to cut or pivot. – pain and swelling is worse, – usually a period of 3-4 weeks of rest is necessary • Grade 3 MCL Tear – a complete tear of the MCL. – Patients have significant pain and swelling, difficulty bending the knee. Instability, or giving out, is common – A knee brace or a knee immobilizer is usually needed for comfort – healing may take 6 weeks or longer • The collateral ligaments are damaged by a direct contact blow on the side of the knee while the foot is 'planted' on the ground. This forces the joint to bend sideways and tears the ligament on the opposite side; landing badly from a jump so that the knee is forced sideways by the weight of the body. • Strains are a complete/partial tear of a muscle or tendon. Symptoms are similar to sprains and bruises may appear. • Tendonitis happens because of overuse and is when a tendons get inflamed or irritated. Tendonitis usually involves pain and tenderness when walking, bending a leg, and/or extending/lifting a leg • Meniscal Tears is very common in sports. A sudden change in speed or side-to-side movement causes the Meniscal to tear. This tear often occurs along with sprains, especially those sprains involving the ACL. These injuries can cause tenderness, tightness and swelling in the front of the knee. Fluid sometimes collects around the knee (Effusion) • Fractures and Dislocations – Cracked, broken, or shattered bone – Involves a lot of pain – Trouble moving bone • Patellar dislocation happens when the patella (Knee cap) is knocked off to the side of the knee by being twisted or some other type of impact • Cartilage Injuries – a small piece of bone or cartilage softens or breaks off from the end of a bone cause long-term knee pain this is called Osteochondritis dessicans (OCD) – Chondromalacia happens when the cartilage in the knee softens because of injury, muscle weakness, or overuse and the patella and the thighbone may rub together. Unhappy triad of O'Donoghue • The combination of a medial collateral ligament (MCL) tear, with tears of the meniscus and anterior cruciate ligament (ACL) is called 'the unhappy triad'. • Very common in football Preventing Knee Injuries • Preventions include: – wearing appropriate protective equipment during practices, games, competitions, ect. – Wearing supportive shoes that appropriate for your sport – Always remember to work up your training level slowly; increasing duration or intensity of workouts can lead to overuse injuries – Weightlifting can help to strengthen your muscles and prevent injuries – Yoga/stretching can improve your flexibility