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Knee Injuries. Anatomy of the knee. Hinge joint at the articulation (point of contact) of 3 bones Stabilized by 4 major ligaments, cartilage, and strong musculature Knee also able to rotate. Bones of the knee. 3 bones form the knee joint Femur, tibia, fibula
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Anatomy of the knee • Hinge joint at the articulation (point of contact) of 3 bones • Stabilized by 4 major ligaments, cartilage, and strong musculature • Knee also able to rotate
Bones of the knee • 3 bones form the knee joint • Femur, tibia, fibula • Primary movement occurs at the POC of the tibia and femur • Patella = sesamoid (floating bone) • As the knee flexes and extends, the patella glides up and down on the front of the femur
Ligaments • 4 primary knee ligaments • Medial collateral ligament (MCL)-provides stability to the inside (medial) aspect of knee • Lateral collateral ligament (LCL)-helps stabilize outside (lateral) aspect
Ligaments • Anterior cruciate ligament (ACL)-keeps tibia from moving forward on the femur • Posterior cruciate ligament (PCL)-prevents tibia from moving backward on femur *PCL and ACL pass thru the middle of the knee joint and cross each other
Cartilage (menisci) • Ends of tibia and femur are covered and cushioned by pieces of tough cartilage tissue called menisci • Without menisci, tibia and femur would rub against each other, causing the bones to wear down quickly • Menisci also help stabilize the joint
Muscles • Provide movement and stability • Primary muscles include hamstring group and quadricep group • Knee extension primarily performed by the quads (4 muscles) • Knee flexion performed by the hamstrings (3 muscles)
Preventing Knee Injuries • Ligament sprains are the most common injuries at the knee • Athletes should develop strength in the muscles around the knee • If athlete has problems with knees, ATC should examine leg structure to determine if he/she has genu valgus (knock-knees) or genu varus (bowlegs)
Treating Knee Injuries • Knee vulnerable to injuries due to exposure to many forces • Ligaments extremely vulnerable but tendon and bone injuries do occur
Ligament Injuries • ACL-athlete often disabled, complaining of knee giving way, collapsing, and popping • Often the most serious and most frequently surgically reconstructed • Often injured as athlete attempts to change directions quickly and twists lower leg • May hear a popping sound • Immediate treatment includes PRICE, knee immobilizer, and crutches • Rehab focuses on strengthening hamstrings to help stabilize tibia
PCL injuries • Frequently injured when athlete falls and bent knee bears full weight, when knee is forcefully hyperflexed or blow is delivered to the front of the tibia • Often little swelling • Treatment includes PRICE and referral to physican • Rehab focuses on strengthening the quads and regaining full function
MCL injuries • Injured when athlete receives a blow to the outside of the knee • Treatment includes PRICE • Moderate to severe MCL needs an immobilizer • Rehab focuses on strengthening the muscles that cross the medial aspect of the knee
Degrees of MCL sprains • Mild MCL sprain-medial joint line pain, little if any swelling, no joint laxity, full flexion and extension • Moderate MCL sprain-mild swelling, discomfort, some joint laxity • Severe MCL sprain-moderate or severe swelling, loss of function, great deal of joint laxity
LCL injuries • Occur less frequently than MCL injuries • Symptoms are similar except discomfort is at the lateral aspect • Treatment same as MCL • Rehab focuses on strengthening the lateral thigh muscles and hamstrings
Muscle and Tendon Injuries • Patellar tendinitis-overuse disorder characterized by quad weakness and tenderness over patellar tendon • Treatment will attempt to control inflammation (apply ice, modify activity level) • Rehab will address flexibility problems or weakness of the leg
Patellar-Femoral Syndrome • Set of symptoms that include pain and discomfort around the patella • As the knee bends, instead of riding smoothly, the patella is grated across the femur, causing cartilage on the back of the patella to soften or wear away • Athlete reports a grinding sensation with flexion and extension • Grinding can be felt by placing hand over patella • Treatment involves correcting patellar tracking problems
Patella Dislocation • Patella forced to the lateral aspect of the knee • Occurs when knee is bent and forced to twist inward • Athlete is often in distress • Only physician should reduce a dislocated patella • Treatment involves immobilizing the knee