1. 1 Injuries to the Thigh, Leg, and Knee PE 236 Juan Cuevas, ATC

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5. 5 Fractures of the Femur and/or Patella Signs and symptoms include: –Pain at the injury site. –Swelling and/or ____________. Athlete’s report of having suffered a traumatic event. –Athlete may report a _________ at time of injury. The injury needs to be evaluated by a physician. _________________ is a serious complication.

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8. 8 Fractures of the Femur and/or Patella (continued) First Aid –Treat for ________. –Splint the injured leg, preferably with traction splint. –Apply _________ dressings to any open wounds. –Monitor vital signs and ___________ to lower leg. –Arrange for transport to a nearby medical facility… 911!

9. 9 Patellar Dislocation/Subluxation Injury may be caused by a quick _____ motion that generates a great deal of abnormal force within the knee. Instead of moving normally within it’s groove, the patella moves _______ and may dislocate.

10. 10 Patellar Dislocation/Subluxation (Continued) Signs and symptoms include: –Severe pain and abnormal movement of the patella when injury occurred. –____________. –Gross Deformity. –Extreme pain along the medial aspect of the patella. **_________________

11. 11 Patellar Dislocation/Subluxation (continued) First Aid –Apply ice and compression. –Splint the __________. –Transport to a medical facility.

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13. 13 Dislocation of the Knee or Tibiofemoral Joint Dislocation of the knee or the ___________ joint can compromise blood flow to the lower leg. **Napoleon MCcallum **Shaun ________________ Signs and symptoms include: Extreme pain. Dislocation of the ________. GROSS DEFORMTY First Aid –The injury must be splinted. –Refer athlete to the nearest medical facility... _____!

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15. 15 Patellofemoral Joint Injuries Acute and chronic injuries can affect patellofemoral joint. Such injuries can be ____________ and must be treated. Osteochondritis dissecans (_____) or “joint mice” –Condition occurs when small pieces of bone or cartilage are dislodged from joint and float within capsule. –A bone fragment can ________ a joint. –Damage to joint surface can occur.

16. 16 Patellofemoral Joint Injuries (continued) Signs and symptoms of OCD include: –Chronic knee pain with exertion. –________ swelling. –Knee may lock; quadriceps may atrophy. –One or more femoral condyles may be tender when palpated. First Aid –Application of ice and compression. –If necessary, crutches for walking. –______ athlete to physician.

17. 17 _________________ Patella Wear and tear of the under surface of the patella as it articulates on the femoral groove due to overuse. –__________ injury –May have swelling present on the _____ of the knee. –Pain with standing after sitting for a prolonged period of time. “movie-goer’s knee” –Quadriceps atrophy –“_____________” grinding –“__________ Grind Test”

18. 18 __________ of the Knee Bursa are small fluid- filled sacs located at strategic points. Numerous bursa are in the knee region; only a few are typically injured.

19. 19 Bursa of the Knee (continued) Inflammation can be caused by: – ___________. – Infection. – Overuse. The __________ bursa is susceptible to direct trauma.

20. 20 Bursa of the Knee (continued) Signs and symptoms include: –__________ and tenderness at site. –Pain when increased external pressure is applied. –Athlete may report ________ trauma to knee.

21. 21 Bursa of the Knee (continued) First Aid –Application of ice and compression. –________ activity for a short time. –In chronic cases, anti-inflammatory agents may be helpful.

22. 22 Osgood-Schlatter Disease (_____) OSD usually involve irritation of the patellar tendon complex. Signs and symptoms of OSD include: –Pain and tenderness on the patellar tendon complex. –Swelling in the area. –Decreased ability to use the ____________. –If inflammation continues, area over tibial ______________ may become solid when palpated.

23. 23 Osgood-Schlatter Disease (OSD) First Aid –Apply ice and compression. –_____ to physician for specific diagnosis. –Until inflammation subsides, _____ is important.

24. 24 Jumper’s Knee Signs and symptoms of Jumper’s knee (JK) include: –Pain and tenderness around the patellar __________________ that may spread to tibial tuberosity. –Decreased ability to use quadriceps for running or jumping. –Symptoms that ________ with activity. First Aid –Apply ice and compression. –Refer to physician for possible anti-inflammatory medications –Rest will be helpful.

25. 25 Menisci Injuries Menisci are typically damaged by quick, sharp, ______ movements. Injury is more likely to occur if the foot is _______ firmly on the playing surface. There are many different types of tears, and they affect each athlete differently. In some cases, a _________ of meniscus will get caught in the joint, causing it to lock.

26. 26 Menisci Injuries (continued) Signs and symptoms include: –_____ or snap when the knee was injured. –May not see any significant swelling. –May not be painful. –_______ of ROM. –Athlete may be able to continue participating. –A feeling the knee is “_____________” periodically. **_______________

27. 27 Menisci Injuries (continued) First Aid –Apply ice and compression. –Have athlete use crutches. –Refer athlete to a physician.

28. 28 Knee Ligament Injuries The most commonly injured knee ligaments are the ___, and the ___. Common mechanisms include cutting maneuvers when _________ and direct blows to the joint. Common mechanisms include cutting maneuvers when _________ and direct blows to the joint.

29. 29 Knee Ligament Injuries (continued) Sprain to MCL is common sports injury. Occurs as a result of valgus stress on MCL. **(______ Stress test) Varus stress can cause a sprain of the LCL. **(_____ Stress Test) Both types of sprains render knee unstable in side-to side movements.

30. 30 Knee Ligament Injuries (continued) _______ Ligament Injuries –ACL can be injured when the tibia moves forcefully in an _______ direction or when the femur gets pushed backward while the tibia is held in place. –Quick _______ associated with __________ movements can also damage ACL. –____ injuries most often happen when an athlete falls on both knees, or receives a forceful blow to the front of the knee while foot is planted on the ground.

31. 31 Cruciate Ligament Injuries (continued) Signs and symptoms include: –Athlete reports the knee was forced beyond its normal ROM. –Pain at the site of the injury. –Swelling around the knee. –Athlete indicates the knee feels ___________. –Athlete reports having a snapping or__________ sensation at the time of injury. **_________ Drawer Test **Lachman’s Test **Sag Test

32. 32 Cruciate Ligament Injuries (continued) First Aid –Immediately apply ice and compression. –Have athlete walk on ________. –Refer to a physician for medical ____________.

33. 33 Special Tests for Knee Instability –Use endpoint feel to determine __________ –Classification of Joint Instability Knee laxity includes both straight and rotary instability __________ (tibial translation) refers to the glide of tibial plateau relative to the femoral condyles As the damage to stabilization structures increases, _______ and translation also increase –Valgus and Varus Stress Tests Used to assess the integrity of the _____ and LCL respectively Testing at 0 degrees incorporates capsular testing while testing at 30 degrees of flexion isolates the ligaments

34. 34 Valgus Stress Test Varus Stress Test

35. 35 Lachman Drawer Test –Will not force knee into painful flexion immediately after injury –Reduces hamstring involvement –At 30 degrees of flexion an attempt is made to translate the tibia ________ on the femur –A positive test indicates damage to the ACL

36. 36 Apley’s Compression Test –Hard downward pressure is applied w/ rotation –Pain indicates a meniscal injury –Used to detect meniscus tear