 Anatomy  Injuries (Mechanism/Signs&Symptoms)  Evaluation  Surgical procedures  Immediate Care  Rehabilitation

 Bones  Ligaments  Meniscus  Bursa  Muscles  Tendons

 Femur  Tibia  Fibula  Patella

 Medial Collateral  Lateral Collateral

 Anterior Cruciate  Posterior Cruciate

 Medial meniscus  Lateral meniscus

 A bursa is a fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body.

 Quadriceps-function is knee extension.

 Hamstring-function is knee flexion.

 Quadriceps tendon  Patellar tendon  Hamstring tendon

 Quadricep strain  Hamstring strain  Contusion  Patellar/Quadriceps tendonitis  Patellar/Quadriceps tendon rupture  Patellar dislocation  Condromalacia  Osgood-Slatter disease  Bursitis  Meniscal tear  MCL sprain  LCL sprain  ACL sprain  PCL sprain

 Grade 1:  What are the symptoms?  Tightness in the thigh.  Unable to walk properly.  Probably not much swelling.  Trying to straighten the knee against resistance probably won't produce much pain.

 Grade 2:  What are the symptoms?  Probably cannot walk properly.  Occasional sudden twinges of pain during activity.  The athlete may notice swelling.  Pressing on the muscle causes pain.  Straightening the knee against resistance causes pain.  Unable to fully bend the knee.

 Grade 3:  What are the symptoms?  Unable to walk properly without the aid of crutches.  In severe pain.  Bad swelling appearing immediately.  A static contraction will be painful and might produce a bulge in the muscle.  Expect to be out of competition for 3 to twelve weeks.

 Grade 1: What does it feel like?  Might have tightness in the back of thigh.  May be able to walk properly.  Probably won't have much swelling.  Lying on front and trying to bend the knee against resistance probably won't produce much pain.

 Grade 2: What does it feel like?  Probably cannot walk properly.  May get occasional sudden twinges of pain during activity.  May notice swelling.  Pressing in causes pain.  Bending the knee against resistance causes pain.  Might be unable to fully bend the knee.

 Grade 3: What does it feel like?  Unable to walk properly without the aid of crutches.  In severe pain.  Bad swelling appear immediately.  A static contraction will be painful and might produce a bulge in the muscle.  Expect to be out of competition for 3 to twelve weeks or more.

 Caused by a direct blow to the muscle. Most likely to occur in the quadriceps.

 In this injury, your knee extends beyond its normally straightened position so that it bends back on itself.

 A person experiencing quadriceps tendonitis will have particular pain straightening the lower leg, or decelerating when walking. The major point of pain coming from above the kneecap.

 What is patellar tendonitis?  Patellar tendonitis, also called jumper's knee, is inflammation in the band of tissue (the patellar tendon) that connects the kneecap (patella) to the shinbone (tibia).  How does it occur?  The most common activity causing patellar tendonitis is too much jumping. Other repeated activities such as running, walking, or bicycling may lead to patellar tendonitis. All of these activities put repeated stress on the patellar tendon, causing it to be inflamed.

 What is a dislocated patella? A dislocated patella occurs when the kneecap (patella) pops out from its normal position. This can occur as the result of force or, is more often related to a developmental condition that leads to an improper alignment of the kneecap with the thighbone (femur). This is sometimes called "unstable kneecap."

 Chondromalacia of the patella is the grating or grinding sensation during extension of the knee. The cause is thought to be related to overuse, trauma and/or abnormal forces on the knee, such as a mildly abnormal alignment of the patella (knee cap) and femur. Symptoms include knee tenderness, pain in the knee after sitting for a prolonged period of time, knee pain that is worse with stairs or getting out of a chair, and a grating sensation in the knee.

 Osgood-Schlatter (OS) disease is one of the most common causes of knee pain in the adolescent.  During periods of rapid growth, stress from contraction of the quadriceps is transmitted through the patellar tendon onto a small portion of the partially developed tibial tuberosity.  This may result in a partial avulsion fracture through the a small portion of the partially developed tibial tuberosity. This may result in a partial avulsion fracture.

 “Housemaid” or “Carpet layers” knee. This is caused by direct trauma.

 One may tear the meniscus by twisting the knee, pivoting, cutting or decelerating. In athletes, meniscal tears often happen in combination with other injuries such as a torn ACL (anterior cruciate ligament).

 Signs and Symptoms  Pain and “clicking” while walking or bending knee.  Pain and clicking while going upstairs.  Remedies: RICE with medication, or surgery.

 What causes Medial Collateral Ligament Sprain? By far the most common cause of medial collateral ligament sprain is a blow or sudden impact to the outside (lateral) of the knee joint. This causes the outside of the knee to collapse inward toward the midline of the body and the inside of the knee (where the medial collateral ligament is located) to widen and open up. This opening up stretches the ligament, which results in the injury.

 What are the Signs & Symptoms of Medial Collateral Ligament Sprain?  The most common symptom of a MCL injury is pain around the inside of the knee joint. Also common is bruising and swelling.

 Apply everything from an MCL injury, except the mechanism of injury is a direct blow from the medial side of the knee.

 How is the anterior cruciate ligament injured? The ACL or anterior cruciate ligament is injured either through twisting the knee or through an impact to the side of the knee - often the outside.

Signs and Symptoms Pain at time of the injury. Athlete and/or people in the area will hear a “pop”. Swelling. In the later stages when the swelling has decreased there may be instability in the joint. For a partial rupture pain may be felt on the Anterior Drawer test where the tibia is pulled.

 NCAA study showed that women suffered ACL injuries four times more often in basketball; three times more often in gymnastics; and two- and-a-half times more often in soccer.

 Anterior Drawer test

 Lachman test

 Mechanism of injury  PCL tears can occur when a football or soccer player falls on a bent knee. Motor vehicle accidents are another common cause of injury to the PCL. When the driver or passenger strikes the bent knee just below the kneecap (patella) against the dashboard, the force can tear the PCL and damage other ligaments, bones and muscles.

 Signs and symptoms  Marked, immediate swelling (within three hours of the injury)  Difficulty walking after the injury  Painful to move the knee  Occasionally, a feeling of instability, or the knee "giving way"

 Medial Meniscus tear  Medial Collateral ligament tear  Anterior Cruciate ligament tear

 Chondromalacia Test  Apprehension Test- Patellar Subluxation Apprehension Test-  Valgus Test- MCL Valgus Test-  Varus Test- LCL  Anterior Drawer- ACL Anterior Drawer-  Lachman’s Test- ACL

 Posterior Drawer- PCL Posterior Drawer-  Sag Test- PCL Sag Test-  McMurray Test- Meniscus McMurray Test-  Apley Compression Test- Meniscus