Athletic%20Injuries%20ATC%20222 - PowerPoint PPT Presentation
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Athletic%20Injuries%20ATC%20222
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Title: Athletic Injuries ATC 222 Author: Allan and Brooke Liggett Last modified by: CHHS SMSU Created Date: 10/26/1997 9:33:22 PM Document presentation format – PowerPoint PPT presentation
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Title: Athletic%20Injuries%20ATC%20222
1
Athletic InjuriesATC 222
- The Knee
- Chapter 19
2
Anatomy
- bony
- muscular
- cartilage
- ligaments
- bursa
- etc
3
Functional Anatomy
- Motions
- flexion/extension
- 140 degrees
- __________ flexion limited
- rotation
- last 15 degrees of extension
- app. 10 degrees int/ext rotation
- referred to as _______ _______ mechanism
- rolling and gliding?
4
Functional Anatomy
- ACL
- generally tight in extension
- limits rotation, hyper______, and anterior tibial
translation - PCL
- tight in flexion
- limits rotation, hyperflexion, and _______tibial
translation - MCL
- tight in extension
- limits valgus and external tibial rotation
- LCL
- tight in extension
- limits varus and _______ tibial rotation
5
MCL Sprain
- Mechanism
- lateral force
- external tibial rotation
- More severe and common than LCL
- part of capsule
- attaches to medial __________
- Signs and Symptoms
- pain over MCL
- none to moderate edema/effusion
- possible laxity with valgus stress
- possible ROM and strength loss
- pain with passive extension and external tibial
rotation
6
MCL Sprain Treatment
- RICER
- Crutches?
- Immobilization?
- Meniscal involvement?
- Rehabilitation
7
LCL Sprain
- Mechanism
- varus force, internal tibial rotation
- Less prevalent that MCL
- no ______________ attachment
- action of _______________ muscle
- common peroneal nerve
- Signs and Symptoms
- pain over LCL
- none to mild edema/effusion
- possible laxity with varus stress
- possible ROM and strength loss
- pain with passive extension and internal tibial
rotation - Treatment
8
ACL Sprain
- Mechanism
- external tibial rotation with valgus
- internal tibial rotation
- hyper_______
- deceleration
- Most common knee ligament to be seriously injured
- Signs and Symptoms
- heard/felt a pop
- rapid effusion/hemarthrosis (1-2 hours)
- knee gives out
- positive ligament testing
9
ACL Sprain Treatment
- RICER
- Crutches?
- Immobilization?
- Conservative vs surgical intervention
- commonly associated with meniscal tear
10
PCL Sprain
- Mechanism
- force to anterior tibia with knee flexed
- hyperflexion
- rotation
- Signs and Symptoms
- Pop
- Effusion
- Positive ligament testing
- Treatment
- usually non-operative
11
Meniscal Lesions
- Mechanism
- _______ while weight bearing
- MCL or ACL sprain
- chronic knee instability or degeneration
- Signs and Symptoms
- clicking, catching, locking
- ------- developing effusion
- positive McMurrays or Apleys
- pain on joint line
- chronic effusion
- Treatment
- healing rate?
- Arthroscopic surgery
- removal vs repair
12
Patellar Subluxation/Dislocation
- Mechanism
- external tibial rotation
- valgus
- functional/structural deviations
- Signs and Symptoms
- deformity
- positive __________ sign
- effusion
- pain on medial patellar border
- Treatment
- RICER
- immobilization and crutches?
- reduction
- rehabilitation
13
Patellofemoral Syndrome
- Structural/functional deviations
- Signs and Symptoms
- medial peripatellar pain
- pain with stairs
- crepitus
- pain with stairs/prolonged sitting
- Treatment
- symptomatic
- correct functional/structural deviations
14
Apophyseal Injuries(apophysitis)
- Apophysis __________ Epiphysis
- Types
- Osgood-Schlatters Syndrome
- Sinding-Larson-Johanson Syndrome
- Signs and Symptoms
- pain at tendon attachment
- tibial tubercle enlargement
- pain with prolonged sitting
- Treatment
- symptomatic
- flexibility
- activity modification
- straps and sleeves
15
Other Injuries
- Tendonitis
- Osteochondral defects
- ITB syndrome
16
Special Tests of the Knee
- tibial/fibular compression/percussion
- patellar apprehension
- ballotable patella and stroke test
- patellar excursion and compression
- valgus/varus stress
- 0 and 30 degrees
- Lachman
- anterior/posterior drawer
- McMurrays
- Apleys compression/distraction
- sag test
17
Other Special Considerations
- Girth measurements
- quality of VMO
- leg length discrepancy
- Q-Angle
- 10 males, 15 females
- over ____ is abnormal
18
Assessment
- History
- Observation
- Palpation
- Special Testing
19
Rehabilitation
- Muscular strength and endurance
- ROM and flexibility
- Proprioception
- Functional exercises
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