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Ch. 18 Knee Injuries

Ch. 18 Knee Injuries. Knee. Genu Valgum (knocked knee) Genu Varum (Bow legged) Genu Recurvatum (hyperextension). Patellofemoral Pain. Difficult injury to deal with because the MOI may be hard to isolate MOI: prolonged knee flexion, stairs, squats, running

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Ch. 18 Knee Injuries

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  1. Ch. 18 Knee Injuries

  2. Knee • Genu Valgum(knocked knee) • Genu Varum (Bow legged) • Genu Recurvatum (hyperextension)

  3. Patellofemoral Pain • Difficult injury to deal with because the MOI may be hard to isolate • MOI: prolonged knee flexion, stairs, squats, running • S/S: pain in the front of the knee or behind the kneecap, knee giving way, crepitus, mild swelling

  4. Patellofemoral Pain • Treatment: correct biomechanics that is causing misalignment, strengthen quads, patella tape, orthotics, braces

  5. Patella Tendonitis • Jumper’s Knee • MOI: sprinting, jumping, quick change in directions, repetitive • S/S: anterior knee pain below patella • Treatment: modify activity, ice, patella strap

  6. Patella Dislocation • MOI: knee bent and forced inward • S/S: obvious deformity, pain, immediate swelling • Treatment: reduce, immobilize, check ligaments, RICE • Rehab: strengthening, ROM

  7. Osgood-Schlatter • Involves tibial tubercle epiphysis • Males 12-16, Females 10-14 • MOI: traction of quads • S/S: pain, swelling, weakness in quads, lump, pain with palpation

  8. Osgood-Schlatter • Treatment: control pain, swelling, and flexibility • Wear protective pad or knee sleeve • Ice after all activity • Take NSAIDs • Stretch hamstrings

  9. IT Band Syndrome • Iliotibial Band: thick fibrous tissue on lateral side of thigh • ITB Syndrome is irritation of the ITB when it crosses muscles and bone at lateral epicondyle

  10. IT Band Syndrome • Caused by increased mileage, foot and knee misalignment, leg length discrepancies • Treatment: RICE, stretch, correct biomechanical problems

  11. MCL • MOI: blow to outside of knee resulting in valgus force • S/S: pain on medial joint line or at attachments of MCL, decreased ROM, swelling • Treatment: RICE, crutches • Rehab: ROM, strengthening

  12. ACL • Females who participate in basketball and soccer are four to six times more likely to tear ACL than males who play the same sport • 70% of ACL injuries in females are noncontact • Influencing factors • Biomechanical: quadriceps, landing • Hormones • Environmental: playing surface, shoe type • Anatomic: femoral notch, Q-angle

  13. ACL • MOI: noncontact or contact, rapid change of direction • No degrees—either torn or not • S/S: ‘pop’, swelling, ‘loose’ knee, pain • Special Test: Anterior Drawer, Lachman’s, should be performed before guarding sets in • Diagnosed with MRI • Treatment: RICE, crutches, knee immobilizer, surgery

  14. PCL • Most common MOI is car accident-knee hitting the dashboard • Use ‘sag’ test to diagnosis • Usually non-surgical • Rehab to restore strength and ROM

  15. Meniscus • Medial meniscus is attached more securely on the back and medial side of the knee. It does not more around easily which is why its torn more often • MOI: sudden knee twisting • S/S: clicking, pain with flexion • As one ages, meniscus lose rubbery consistency and tear more easily

  16. Special Tests • Apprehension: Patella dislocation • Valgus Stress Test: MCL • Varus Stress Test: LCL • Lachmen’s and Anterior Drawer: ACL • Posterior Drawer: PCL • McMurray’s: Meniscus

  17. Rehab • ROM: heel prop, heel slides • Strengthening: Straight leg raises, total knee extensions, step ups • Balance: on foam pad, rebounder • Functional: speed ladder, carioca, cutting

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