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Common Sports Injuries of the Knee & Shoulder James M. Farmer M.D. Sports Medicine & Orthopaedic Surgery Lewis-Gale Physicians James M. Farmer M.D. Sports.

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Presentation on theme: "Common Sports Injuries of the Knee & Shoulder James M. Farmer M.D. Sports Medicine & Orthopaedic Surgery Lewis-Gale Physicians James M. Farmer M.D. Sports."— Presentation transcript:

1 Common Sports Injuries of the Knee & Shoulder James M. Farmer M.D. Sports Medicine & Orthopaedic Surgery Lewis-Gale Physicians James M. Farmer M.D. Sports Medicine & Orthopaedic Surgery Lewis-Gale Physicians

2 James M. Farmer M.D Overview Knee Injuries Meniscal Tear Articular Cartilage Tear ACL Tear Patellofemoral Pain Iliotibial Band Syndrome Knee Injuries Meniscal Tear Articular Cartilage Tear ACL Tear Patellofemoral Pain Iliotibial Band Syndrome

3 James M. Farmer M.D Overview Shoulder Injuries Dislocation A-C Separation SLAP Lesion Rotator Cuff Tear Shoulder Injuries Dislocation A-C Separation SLAP Lesion Rotator Cuff Tear

4 James M. Farmer M.D Knee Anatomy Femur and Tibia Articular Cartilage Meniscus Ligaments Femur and Tibia Articular Cartilage Meniscus Ligaments

5 James M. Farmer M.D Meniscal Tear Mechanism Young: twisting or pivoting Older: minor trauma Signs and Sx Swelling Catching Giving way Locking Mechanism Young: twisting or pivoting Older: minor trauma Signs and Sx Swelling Catching Giving way Locking

6 James M. Farmer M.D Meniscal Tear

7 James M. Farmer M.D Preferred Treatment Acute: Rest, Ice, Activity Modification, Surgery Meniscal tears will not normally heal without help unless very young Chronic: Surgical excision Acute: Rest, Ice, Activity Modification, Surgery Meniscal tears will not normally heal without help unless very young Chronic: Surgical excision

8 James M. Farmer M.D Articular Cartilage Tear Mechanism Acute trauma Wear and tear Signs and Sx Pain Swelling Mechanism Acute trauma Wear and tear Signs and Sx Pain Swelling

9 James M. Farmer M.D Preferred Treatment Non Surgical: Activity Modification, Pain Medications, Injections Surgical: Arthroscopic debridement and removal of lose fragments Procedures to restore weight bearing surface Resurfacing, Cartilage Transplant, Joint Replacement Non Surgical: Activity Modification, Pain Medications, Injections Surgical: Arthroscopic debridement and removal of lose fragments Procedures to restore weight bearing surface Resurfacing, Cartilage Transplant, Joint Replacement

10 James M. Farmer M.D ACL Tear Mechanism Twisting Pivoting Sudden stop Signs and Sx Acute: swelling, pain, instability Chronic: frequent giving way, pain Mechanism Twisting Pivoting Sudden stop Signs and Sx Acute: swelling, pain, instability Chronic: frequent giving way, pain

11 James M. Farmer M.D ACL Tear

12 James M. Farmer M.D Preferred Treatment Non Surgical: Activity Modification, Rehabilitation, Bracing Surgical: Reconstruction of Ligament Goals of Surgery: Restore normal knee stability and function. Delay onset of degenerative arthritis Non Surgical: Activity Modification, Rehabilitation, Bracing Surgical: Reconstruction of Ligament Goals of Surgery: Restore normal knee stability and function. Delay onset of degenerative arthritis

13 James M. Farmer M.D Patellofemoral Pain Pain originating from behind the knee cap Very common condition Exact cause unknown (likely many) Signs and Sx Aching pain along front of knee Worse with sitting, stairs and squatting Giving way and buckling Pain originating from behind the knee cap Very common condition Exact cause unknown (likely many) Signs and Sx Aching pain along front of knee Worse with sitting, stairs and squatting Giving way and buckling

14 James M. Farmer M.D Patellofemoral Pain

15 James M. Farmer M.D Preferred Treatment Non Surgical!!! Activity modification Physical Therapy Taping, Bracing, Orthotics Injections Surgery Not many Good options Arthroscopy, Osteotomy, Resurfacing, Arthroplasty Non Surgical!!! Activity modification Physical Therapy Taping, Bracing, Orthotics Injections Surgery Not many Good options Arthroscopy, Osteotomy, Resurfacing, Arthroplasty

16 James M. Farmer M.D Iliotibial Band Syndrome Caused by tight ITB rubbing over lateral epicondyle of femur when running. Signs and Sx Sharp pain over lateral knee when running or cycling Occassional swelling Caused by tight ITB rubbing over lateral epicondyle of femur when running. Signs and Sx Sharp pain over lateral knee when running or cycling Occassional swelling

17 James M. Farmer M.D Iliotibial Band Syndrome

18 James M. Farmer M.D Preferred Treatment Non Surgical: Stretching Physical Therapy: Ice, Ultrasound Orthotics Medications Injections Surgical: ITB release Non Surgical: Stretching Physical Therapy: Ice, Ultrasound Orthotics Medications Injections Surgical: ITB release

19 James M. Farmer M.D Shoulder Anatomy Humerus and Scapula Labrum Biceps Tendon Rotator Cuff Humerus and Scapula Labrum Biceps Tendon Rotator Cuff

20 James M. Farmer M.D Shoulder Dislocation

21 James M. Farmer M.D Preferred Treatment Non Surgical: Acute: Immobilization, Rest, Ice, Rehab Chronic: Rehab, Meds Surgical: Arthroscopic stabilization as effective as open procedures Repair bankart lesion, tighten capsule Non Surgical: Acute: Immobilization, Rest, Ice, Rehab Chronic: Rehab, Meds Surgical: Arthroscopic stabilization as effective as open procedures Repair bankart lesion, tighten capsule

22 James M. Farmer M.D A-C Separation Sprain of joint between collar bone and shoulder blade at tip of shoulder Mechanism: Fall onto tip of shoulder Signs and Sx Pain Deformity Sprain of joint between collar bone and shoulder blade at tip of shoulder Mechanism: Fall onto tip of shoulder Signs and Sx Pain Deformity

23 James M. Farmer M.D AC Separation

24 James M. Farmer M.D Preferred Treatment Grades 1 & 2: Non Surgical Grades 4-6: Surgical Grade 3: Debatable Non Surgical: Adequate for most Rest acutely then resume activities Surgical: Primarily for overhead athletes and military Acute: reduce and stabilize joint Chronic: Reconstruct ligaments Grades 1 & 2: Non Surgical Grades 4-6: Surgical Grade 3: Debatable Non Surgical: Adequate for most Rest acutely then resume activities Surgical: Primarily for overhead athletes and military Acute: reduce and stabilize joint Chronic: Reconstruct ligaments

25 James M. Farmer M.D SLAP Lesion & Biceps Rupture Injuries to Biceps tendon origin in the shoulder Mechanism: Acute: sudden pull on arm. Chronic: Degenerative, overuse Signs and Sx Pain reaching upward with palm Weakness Possible deformity if ruptured Injuries to Biceps tendon origin in the shoulder Mechanism: Acute: sudden pull on arm. Chronic: Degenerative, overuse Signs and Sx Pain reaching upward with palm Weakness Possible deformity if ruptured

26 James M. Farmer M.D SLAP Lesion & Biceps Rupture

27 James M. Farmer M.D SLAP Lesion & Biceps Rupture Popeye Deformity John Elway won 2 Super Bowls AFTER Biceps rupture! Popeye Deformity John Elway won 2 Super Bowls AFTER Biceps rupture!

28 James M. Farmer M.D Preferred Treatment Non Surgical: Activity modification Physical Therapy Surgical: Repair of tendon attachment Release tendon Relocate tendon Non Surgical: Activity modification Physical Therapy Surgical: Repair of tendon attachment Release tendon Relocate tendon

29 James M. Farmer M.D Rotator Cuff Tear Continuum from Impingement to Complete Tear Mechanism: Acute: trauma. Chronic: degeneration with age due to poor blood supply to tendon Signs and Sx Pain reaching overhead Pain sleeping Weakness and dysfunction Continuum from Impingement to Complete Tear Mechanism: Acute: trauma. Chronic: degeneration with age due to poor blood supply to tendon Signs and Sx Pain reaching overhead Pain sleeping Weakness and dysfunction

30 James M. Farmer M.D Rotator Cuff Tear

31 James M. Farmer M.D Preferred Treatment Non Surgical: Activity modification Physical Therapy Injections Surgical: Arthroscopic or Open repair of tendon and removal of bone spurs Shoulder replacement Non Surgical: Activity modification Physical Therapy Injections Surgical: Arthroscopic or Open repair of tendon and removal of bone spurs Shoulder replacement


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