Chapter 18: The Knee. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2 Common...

Chapter 18:

The Knee

Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2

Common Injuries

Patellofemoral problems

Patellar tendonitis Fat pad syndrome MCL sprain LCL sprain Torn ACL Torn PCL

Meniscus tears Epiphyseal

injuries Osgood-

Schlatter condition

Iliotibial band syndrome

Fractures


Knee Treatments

The knee joint can suffer from either traumatic or overuse injuries.


Patella Taping

Apply cover roll skin tape across the patella and around the medial leg.


Patella Taping (cont.)

After tape is secured to the patella, use one hand to lift the medial leg muscles. Use a medially directed pull on the tape to glide the patella medially.


Fat Pad Unloading

Place cover roll skin tape in a V along the inferior borders of the fat pad.

Lift the fat pad upward while applying tension to the two short pieces of stretch tape.


Special Tests

Certain tests can be performed that aid in the evaluation of injury.


Patellar Tendonitis Test

With the subject sitting on the edge of a table and the knee at 90 degrees of flexion, tap the patellar tendon 1 to 3 times rapidly. Sharp pain is a positive sign.


Patellar Dislocation Apprehension Test

Use both thumbs to apply gentle pressure medially across the joint. A positive sign is contraction of the quadriceps.


Fat Pad Compression Test

Apply pressure to the proximal patellar tendon with the quadriceps contracted.

Apply pressure over the proximal patellar tendon with a relaxed tendon.


Valgus Stress Test

With the leg at full extension, press laterally at the knee while holding the ankle. Greater movement than the uninjured side may indicate MCL damage.


Varus Stress Test

With the leg at full extension, press medially at the knee while holding the ankle. Increased movement compared to the uninjured side indicates LCL damage.


Lachman’s Maneuver

With the subject in a supine position, place a knee under the subject’s knee, allowing a 20 degree flexion. Stabilize the femur and pull the proximal tibia forward. Excessive movement indicates ACL damage.


Anterior Drawer Test

With the athlete supine and the knee bent at 90 degrees, apply an anterior force to the proximal tibia. Excessive movement indicates ACL damage.


Meniscal Tears

With the subject supine, apply internal and external tibial rotation while moving the knee from flexion to extension. Feeling a “click” is a positive sign.


Iliotibial Band Syndrome 1

With the subject supine, passively flex and extend the knee while applying thumb pressure on the distal IT band. Pain at 20 to 30 degrees of flexion is a positive sign.


Iliotibial Band Syndrome 2

Have the subject lie on the unaffected side, lifting the upper leg and moving it in a bicycle pattern while the examiner presses down on the leg. IT band pain is a positive sign.

Chapter 18: The Knee. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2 Common...

Documents

Transcript of Chapter 18: The Knee. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2 Common...