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Common Athletic Injuries Instability, Dislocations, & Subluxations Today’s Topics • Laxity & instability • Dislocations & subluxations • Nerve injuries Laxity • Defined: “describes the amount of “give” within the joint’s supporting connective tissue..” STRUCTURE • Etiology 1. May be congenital 2. Systemic 3. Result of injury Instability • Definition: “the lack of ability to maintain alignment of bony segments…” “….usually due to torn or lax ligaments and weak muscles.” • Applied definition: “..joint’s inability to function under stress encountered during functional activities” Joint Dislocatons • Introduction 1. Second to fx’s in terms of disabling 2. Areas of highest incidence: Joint Dislocatons • Mechanism 1. Results in complete separation of articulating surfaces (bone ends) 2. Force causes joint to go beyond NORMAL anatomical limits 3. Force causes rupture of joint’s connective tissues 4. Avulsion fracture Joint Dislocatons • Clinical findings: 1. Obvious deformity 2. Loss of limb function 3. Immediate swelling & point tenderness Joint Dislocations 4. Skin may be ruptured 5. NO further evaluation! 6. Check for circulation & neurological responses 7. Treat ALL first timers as fx’s as well Subluxations • Pathology 1. Involves partial disassociation of articulating surfaces 2. Force may cause soft tissue or bony injury 3. Suspect fx, tearing of capsule and/or ligaments Subluxations • Mechanics 1. Progressive condition 2. First time subluxations Subluxations • Clinical findings: 1. Patient report 2. ROM limited by pain & instability 3. Chronically: joint displays instability during ligamentous/capsular testing 4. “Apprehension response” Nerve Injuries • Peripheral nerve lesions • S/Sx 1. Distorted sensation (paresthesia) 2. Usually distal to site of lesion 3. Decreased sensation, increased sensitivity, or NO sensation Nerve Injuries • Nerve stretch/compression: - sharp burning pain, radiates down a limb -accompanied muscle weakness • Neuritis: - inflammation of a nerve - from repeated trauma Summary • Knowledge of tissue properties & forces • Recognize mechanism of injury (MOI) • Familiarize with normal joint movements & limits • Recognize possible tissue involved by knowledge of anatomy