1. CARE & PREVENTION OF ATHLETIC INJURIES
THE KNEE JOINT
CARE & PREVENTION OF ATHLETIC INJURIES
MS. HERRERA

2. FACTS A.K.A “TIBIOFEMORAL JOINT” A hinge joint
ROM: flexion and extension
Unstable laterally and medially

3. Anatomy Bones: Femur, tibia, fibula, and patella Muscles:
Biceps femoris, semitendonosis, and semimembranosus
Rectus femoris, vastus medialis, vastus lateralis, vastus intermedius
Sartorius (longest muscle in body) and gastrocnemius

5. Anatomy Cont’d Mensicus (you have 2) Medial mensicus (C-Shaped)
Lateral mensicus (O-shaped)
Made of????
Ligaments (purpose of each?)
Anterior cruciate ligament
Posterior cruciate ligament
Medial collateral ligament
Lateral collateral ligament

6. Anatomy Cont’d Bursae As many as 2 dozen in the knee Nerve Supply
Sciatic
tibial
Femoral

7. Medial Collateral Ligament Sprain (MCL)
MOI: direct blow from lateral side creating excessive valgus stress
Excessive knee twist

8. MCL Sprain Cont’d Management Conservative tx usually
Ice, e-stim, ultrasound, rehabilitation
Surgery is indicated if MCL is sprained along with the ACL or PCL
Categorized into 3 grades
Signs & Symptoms (depends on grade)
Ligament fibers torn/stretched
Pain, swelling (mild- severe)
TTP over MCL and attachment sites
Loss of ROM, joint stiffness, weak
+ valgus stress test

9. Lateral Collateral Ligament Sprain
MOI: Blow to the medial side of the knee causing a varus force
Signs & Symptoms:
Pain, TTP over LCL, swelling
Laxity with varus testing
Management:
Same as MCL

10. Anterior Cruciate Ligament Sprain (ACL)
Prevents ant. movement of tibia
MOI: valgus force with tibia in external rotation
Noncontact tears more common in females
Why? Several reasons
Signs & Symptoms
Loud pop
Pain, laxity, immediate swelling, and hemoarthrosis (?)

11. ACL Cont’d Management:
Not repairing the ACL can lead to joint degeneration. (examples?)
Should be repaired with surgery cause if not it leads to knee instability
Before surgery rehab is usually given to strengthen quadriceps. Why?
Surgery can be allo- or autoGRAFT
difference?

12. Posterior Cruciate Ligament Sprain
Purpose: To prevent posterior translation of the tibia.
MOI: Falling directly on a bent knee
Signs & Symptoms:
Loud “pop” in back of knee
pain, swelling, tenderness over posterior knee, laxity

13. PCL Cont’d Management:
Conservative: Rehabilitation-some positive outcomes have been reported.
Surgery to repair torn ligament.

14. Mensicus Tears
Medial mensicus is MORE commonly injured than lateral mensicus.
Why? Lat. mensicus is more mobile
MOI: Twisting force while foot is planted, cutting motion when running, tears that occur overtime due to high stress (i.e. running)

15. Mensicus Tears Cont’d Signs & Symptoms: Swelling Locking, clicking
Pain when squatting
Giving way
Management:
Conservative if person is not an athlete or tear is in a vascular zone
Surgery: Indicated for high activity individuals
Can be repaired or resected depending on case

16. Joint/Muscle Contusions
A.K.A. “Charley Horse”
MOI: Direct blow to the thigh
Signs & Symptoms:
swelling and severe pain
Loss of ROM and strength
Management:
Rest, ice, light stretch
Complete ROM exercises
Apply pad for protection upon RTP
Complications: Myositis ossificans

17. Patellar Dislocations/Subluxations
MOI: planting leg, slowing down, and cutting suddenly (most common MOI)
Signs & Symptoms:
Obvious deformity, severe pain, swelling, complete loss of knee function

18. Patellar Dislocations/Subluxations Cont’d
Management:
Keep athlete still and activate EMS
Splint and transfer to ER
Reduce dislocation
Crutches NWB for 4 weeks +
Rehabilitation with focus on quad strengthening

19. Chondromalacia Patella
Wearing away of articular cartilage on the posterior patella
MOI: Most common abnormal patellar tracking
Causes?
Signs & Symptoms:
Pain, swelling, crepitus
Pain with running, walking, stairs, squatting

20. Osgood-Schlatter Disease
Pain in patellar tendon where it attaches on the tibial tubercle.
Occurs in adolescents
Athlete may experience multiple avulsions and in severe cases COMPLETE avulsion.
Signs & Symptoms:
Severe pain when kneeling, running, jumping
Inflammation
Enlarged tibial tubercle
Management: Rest, ice before and after activity, strengthening of quads and hamstrings

21. Patellar Tendinitis A.K.A. Jumper’s Knee
Extreme tension/overuse of the quads.
Places stress on patellar tendon
Signs & Symptoms:
Pain and TTP inferior to the patella
3 stages of severity
Management:
Nsaids
Rest, Ice, Modalities
Rehab
Cross friction massage

22. Prentice, William E. Arnheim’s principles of athletic training 12th ed
Prentice, William E. Arnheim’s principles of athletic training 12th ed. McGraw-Hill, New York Ny, 2006.