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Common Sports Injuries of the Knee & Shoulder

Common Sports Injuries of the Knee & Shoulder. James M. Farmer M.D. Sports Medicine & Orthopaedic Surgery Lewis-Gale Physicians. Overview. Knee Injuries Meniscal Tear Articular Cartilage Tear ACL Tear Patellofemoral Pain Iliotibial Band Syndrome. Overview. Shoulder Injuries

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Common Sports Injuries of the Knee & Shoulder

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  1. Common Sports Injuriesof the Knee & Shoulder James M. Farmer M.D. Sports Medicine & Orthopaedic Surgery Lewis-Gale Physicians

  2. Overview • Knee Injuries • Meniscal Tear • Articular Cartilage Tear • ACL Tear • Patellofemoral Pain • Iliotibial Band Syndrome James M. Farmer M.D. 540-772-3530

  3. Overview • Shoulder Injuries • Dislocation • A-C Separation • SLAP Lesion • Rotator Cuff Tear James M. Farmer M.D. 540-772-3530

  4. Knee Anatomy • Femur and Tibia • Articular Cartilage • Meniscus • Ligaments James M. Farmer M.D. 540-772-3530

  5. Meniscal Tear • Mechanism • Young: twisting or pivoting • Older: minor trauma • Signs and Sx • Swelling • Catching • Giving way • Locking James M. Farmer M.D. 540-772-3530

  6. Meniscal Tear James M. Farmer M.D. 540-772-3530

  7. Preferred Treatment • Acute: Rest, Ice, Activity Modification, Surgery • Meniscal tears will not normally heal without help unless very young • Chronic: Surgical excision James M. Farmer M.D. 540-772-3530

  8. Articular Cartilage Tear • Mechanism • Acute trauma • Wear and tear • Signs and Sx • Pain • Swelling James M. Farmer M.D. 540-772-3530

  9. Preferred Treatment • Non Surgical: Activity Modification, Pain Medications, Injections • Surgical: • Arthroscopic debridement and removal of lose fragments • Procedures to restore weight bearing surface • Resurfacing, Cartilage Transplant, Joint Replacement James M. Farmer M.D. 540-772-3530

  10. ACL Tear • Mechanism • Twisting • Pivoting • Sudden stop • Signs and Sx • Acute: swelling, pain, instability • Chronic: frequent giving way, pain James M. Farmer M.D. 540-772-3530

  11. ACL Tear James M. Farmer M.D. 540-772-3530

  12. Preferred Treatment • Non Surgical: Activity Modification, Rehabilitation, Bracing • Surgical: Reconstruction of Ligament • Goals of Surgery: Restore normal knee stability and function. Delay onset of degenerative arthritis James M. Farmer M.D. 540-772-3530

  13. Patellofemoral Pain • Pain originating from behind the knee cap • Very common condition • Exact cause unknown (likely many) • Signs and Sx • Aching pain along front of knee • Worse with sitting, stairs and squatting • Giving way and buckling James M. Farmer M.D. 540-772-3530

  14. Patellofemoral Pain James M. Farmer M.D. 540-772-3530

  15. Preferred Treatment • Non Surgical!!! • Non Surgical!!! • Non Surgical!!! • Activity modification • Physical Therapy • Taping, Bracing, Orthotics • Injections • Surgery • Not many “Good” options • Arthroscopy, Osteotomy, Resurfacing, Arthroplasty James M. Farmer M.D. 540-772-3530

  16. Iliotibial Band Syndrome • Caused by tight ITB rubbing over lateral epicondyle of femur when running. • Signs and Sx • Sharp pain over lateral knee when running or cycling • Occassional swelling James M. Farmer M.D. 540-772-3530

  17. Iliotibial Band Syndrome James M. Farmer M.D. 540-772-3530

  18. Preferred Treatment • Non Surgical: • Stretching • Physical Therapy: Ice, Ultrasound • Orthotics • Medications • Injections • Surgical: • ITB release James M. Farmer M.D. 540-772-3530

  19. Shoulder Anatomy • Humerus and Scapula • Labrum • Biceps Tendon • Rotator Cuff James M. Farmer M.D. 540-772-3530

  20. Shoulder Dislocation James M. Farmer M.D. 540-772-3530

  21. Preferred Treatment • Non Surgical: • Acute: Immobilization, Rest, Ice, Rehab • Chronic: Rehab, Meds • Surgical: • Arthroscopic stabilization as effective as open procedures • Repair bankart lesion, tighten capsule James M. Farmer M.D. 540-772-3530

  22. A-C Separation • Sprain of joint between collar bone and shoulder blade at tip of shoulder • Mechanism: Fall onto tip of shoulder • Signs and Sx • Pain • Deformity James M. Farmer M.D. 540-772-3530

  23. AC Separation James M. Farmer M.D. 540-772-3530

  24. Preferred Treatment • Grades 1 & 2: Non Surgical • Grades 4-6: Surgical • Grade 3: Debatable • Non Surgical: Adequate for most • Rest acutely then resume activities • Surgical: Primarily for overhead athletes and military • Acute: reduce and stabilize joint • Chronic: Reconstruct ligaments James M. Farmer M.D. 540-772-3530

  25. SLAP Lesion &Biceps Rupture • Injuries to Biceps tendon origin in the shoulder • Mechanism: Acute: sudden pull on arm. Chronic: Degenerative, overuse • Signs and Sx • Pain reaching upward with palm • Weakness • Possible deformity if ruptured James M. Farmer M.D. 540-772-3530

  26. SLAP Lesion &Biceps Rupture James M. Farmer M.D. 540-772-3530

  27. SLAP Lesion &Biceps Rupture • Popeye Deformity • John Elway won 2 Super Bowls AFTER Biceps rupture! James M. Farmer M.D. 540-772-3530

  28. Preferred Treatment • Non Surgical: • Activity modification • Physical Therapy • Surgical: • Repair of tendon attachment • Release tendon • Relocate tendon James M. Farmer M.D. 540-772-3530

  29. Rotator Cuff Tear • Continuum from Impingement to Complete Tear • Mechanism: Acute: trauma. Chronic: degeneration with age due to poor blood supply to tendon • Signs and Sx • Pain reaching overhead • Pain sleeping • Weakness and dysfunction James M. Farmer M.D. 540-772-3530

  30. Rotator Cuff Tear James M. Farmer M.D. 540-772-3530

  31. Preferred Treatment • Non Surgical: • Activity modification • Physical Therapy • Injections • Surgical: • Arthroscopic or Open repair of tendon and removal of bone spurs • Shoulder replacement James M. Farmer M.D. 540-772-3530

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