Anatomy Injuries (Mechanism/Signs&Symptoms) Evaluation Surgical procedures Immediate Care Rehabilitation

Bones Ligaments Meniscus Bursa Muscles Tendons

Femur Tibia Fibula Patella

Medial Collateral Lateral Collateral

Anterior Cruciate Posterior Cruciate

Medial meniscus Lateral meniscus

A bursa is a fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body.

Quadriceps-function

is knee extension.

Hamstring-function is knee flexion.

Quadriceps tendon

Patellar tendon Hamstring tendon

Quadricep strain Hamstring strain Contusion Patellar/Quadriceps tendonitis Patellar/Quadriceps tendon rupture Patellar dislocation Condromalacia Osgood-Slatter disease Bursitis Meniscal tear MCL sprain LCL sprain ACL sprain PCL sprain

Grade 1: What are the symptoms? Tightness in the thigh. Unable to walk properly. Probably not much swelling. Trying to straighten the knee against

resistance probably won't produce much pain.

Grade 2: What are the symptoms? Probably cannot walk properly. Occasional sudden twinges of pain during

activity. The athlete may notice swelling. Pressing on the muscle causes pain. Straightening the knee against resistance

causes pain. Unable to fully bend the knee.

Grade 3: What are the symptoms? Unable to walk properly without the aid of

crutches. In severe pain. Bad swelling appearing immediately. A static contraction will be painful and might

produce a bulge in the muscle. Expect to be out of competition for 3 to twelve

weeks.

Grade 1: What does it feel like? Might have tightness in the back of

thigh. May be able to walk properly. Probably won't have much swelling. Lying on front and trying to bend the

knee against resistance probably won't produce much pain.

Grade 2: What does it feel like? Probably cannot walk properly. May get occasional sudden twinges of pain

during activity. May notice swelling. Pressing in causes pain. Bending the knee against resistance causes

pain. Might be unable to fully bend the knee.

Grade 3: What does it feel like? Unable to walk properly without the aid of

crutches. In severe pain. Bad swelling appear immediately. A static contraction will be painful and might

produce a bulge in the muscle. Expect to be out of competition for 3 to twelve

weeks or more.

http://www.train.tcu.edu/ross/HAMSTRING2.JPG

Caused by a direct blow to the muscle. Most likely to occur in the quadriceps.

In this injury, your knee extends beyond its normally straightened position so that it bends back on itself.

A person experiencing quadriceps tendonitis will have particular pain straightening the lower leg, or decelerating when walking. The major point of pain coming from above the kneecap.

What is patellar tendonitis? Patellar tendonitis, also called jumper's knee, is

inflammation in the band of tissue (the patellar tendon) that connects the kneecap (patella) to the shinbone (tibia).

How does it occur? The most common activity causing patellar tendonitis is

too much jumping. Other repeated activities such as running, walking, or bicycling may lead to patellar tendonitis. All of these activities put repeated stress on the patellar tendon, causing it to be inflamed.

What is a dislocated patella? A dislocated patella occurs when the kneecap (patella) pops out from its normal position. This can occur as the result of force or, is more often related to a developmental condition that leads to an improper alignment of the kneecap with the thighbone (femur). This is sometimes called "unstable kneecap."

Chondromalacia of the patella is the grating or grinding sensation during extension of the knee. The cause is thought to be related to overuse, trauma and/or abnormal forces on the knee, such as a mildly abnormal alignment of the patella (knee cap) and femur. Symptoms include knee tenderness, pain in the knee after sitting for a prolonged period of time, knee pain that is worse with stairs or getting out of a chair, and a grating sensation in the knee.

Osgood-Schlatter (OS) disease is one of the most common causes of knee pain in the adolescent.

During periods of rapid growth, stress from contraction of the quadriceps is transmitted through the patellar tendon onto a small portion of the partially developed tibial tuberosity.

This may result in a partial avulsion fracture through the a small portion of the partially developed tibial tuberosity. This may result in a partial avulsion fracture.

“Housemaid” or “Carpet layers” knee. This is caused by direct trauma.

One may tear the meniscus by twisting the knee, pivoting, cutting or decelerating. In athletes, meniscal tears often happen in combination with other injuries such as a torn ACL (anterior cruciate ligament).

Signs and Symptoms Pain and “clicking” while walking or

bending knee. Pain and clicking while going upstairs. Remedies: RICE with medication, or

surgery.

What causes Medial Collateral Ligament Sprain?By far the most common cause of medial collateral ligament sprain is a blow or sudden impact to the outside (lateral) of the knee joint. This causes the outside of the knee to collapse inward toward the midline of the body and the inside of the knee (where the medial collateral ligament is located) to widen and open up. This opening up stretches the ligament, which results in the injury.

What are the Signs & Symptoms of Medial Collateral Ligament Sprain?

The most common symptom of a MCL injury is pain around the inside of the knee joint. Also common is bruising and swelling.

Apply everything from an MCL injury, except the mechanism of injury is a direct blow from the medial side of the knee.

How is the anterior cruciate ligament injured?

The ACL or anterior cruciate ligament is injured either through twisting the knee or through an impact to the side of the knee - often the outside.

Signs and Symptoms

Pain at time of the injury.Athlete and/or people in the area will hear a “pop”.Swelling. In the later stages when the swelling has decreased there may be instability in the joint. For a partial rupture pain may be felt on the Anterior Drawer test where the tibia is pulled.

NCAA study showed that women suffered ACL injuries four times more often in basketball; three times more often in gymnastics; and two-and-a-half times more often in soccer.

Anterior Drawer test

Lachman test

Mechanism of injury PCL tears can occur when a football or soccer

player falls on a bent knee. Motor vehicle accidents are another common cause of injury to the PCL. When the driver or passenger strikes the bent knee just below the kneecap (patella) against the dashboard, the force can tear the PCL and damage other ligaments, bones and muscles.

Signs and symptoms Marked, immediate swelling (within

three hours of the injury) Difficulty walking after the injury Painful to move the knee Occasionally, a feeling of instability, or

the knee "giving way"

Medial Meniscus tear Medial Collateral ligament tear Anterior Cruciate ligament tear

Chondromalacia Test Apprehension Test- Patellar Subluxation Valgus Test- MCL Varus Test- LCL Anterior Drawer- ACL Lachman’s Test- ACL

Posterior Drawer- PCL Sag Test- PCL McMurray Test- Meniscus Apley Compression Test- Meniscus