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Ch. 18 Knee Injuries

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

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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

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

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Patella Tendonitis Jumpers Knee MOI: sprinting, jumping, quick change in directions, repetitive S/S: anterior knee pain below patella Treatment: modify activity, ice, patella strap

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

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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

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

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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

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

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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

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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

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ACL MOI: noncontact or contact, rapid change of direction No degreeseither torn or not S/S: pop, swelling, loose knee, pain Special Test: Anterior Drawer, Lachmans, should be performed before guarding sets in Diagnosed with MRI Treatment: RICE, crutches, knee immobilizer, surgery

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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

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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

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Special Tests Apprehension: Patella dislocation Valgus Stress Test: MCL Varus Stress Test: LCL Lachmens and Anterior Drawer: ACL Posterior Drawer: PCL McMurrays: Meniscus

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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