1. The Knee

2. Injury to the Knee One of the most complex joints in the human body
Also one of the most frequently injured
Principal Movements of the Knee: Flexion & Extension

3. The Knee Cartilage: Medial Meniscus, Lateral Meniscus
Meniscus Increase Stability of Knee, Cushion from Stresses
Ligaments: Connecting the Femur to the Tibia or Fibula
Stabilize the Knee
ACL: Anterior Cruciate Ligament
PCL: Posterior Cruciate Ligament
(Cruciate : “Cross”)
Medial & Lateral Collateral Ligaments (MCL & LCL)

4. The Knee
fibula

5. The Knee
Four Bones: Femur, Tibia, Fibula, Patella (Kneecap)

6. Muscles of the Knee Largest & Primary Muscles of the Knee:
Quadriceps & Hamstrings
“Quads” EXTEND the Knee
Hamstrings FLEX the Knee

7. Prevention of Knee Injury & Assessing Knee Injuries (HOPS)
Proper Strength, Flexibility, Agility, Speed, Balance is Key
Proper Shoes, Knee Braces
H.O.P.S. Special Tests Pg
Valgus / Varus Stress Tests : Tests MCL/LCL
Drawer Test: Tests the ACL / PCL
McMurray Test: Tests the Meniscus (Tear)

8. Medial Collateral Ligament (MCL) Sprain
Causes: A hit from the outside (lateral) side of leg, or sudden rotation
Grades I, II, III
Pain, Swelling, Stiffness over MCL
Joint Instability: Knee will feel “unstable” to walk

9. MCL Sprain (cont.)
Also will have Positive Valgus/Varus Stress Test (Special Test in HOPS)
Treatment:
R.I.C.E., Crutches, Immobilization, Referral to Doctor
Rehabilitation before Return to Play; Knee Brace
Usually heals in 2-6 weeks depending on how severe it is

10. LCL Sprain LCL: Lateral Collateral Ligament
LCL Sprain: Similar to MCL Sprain, except on the Lateral (outside)
Usually caused by a force to the medial (inside) knee
Similar Signs/Symptoms/Treatment

11. Anterior Cruciate Ligament (ACL) Sprain
Often injured during a “cutting” movement, rotation, or quick stop
Athlete may feel or hear a “pop”, followed by immediate pain and disability

12. ACL Sprain Rapid Swelling Positive “Drawer” Test
Treatment: First Aid, RICE & Crutches. Immobilize or Wrap with bandage.
If torn, surgery is required if athlete wants to return to competitive athletics
fibula

13. ACL Sprain
Surgery involves using an Allograft (Cadaver Tendon) or Autograft (Tendon from your own body) to replace the torn ACL
Surgery involves a brief hospital stay, bracing, and 4-8 months of rehab

14. ACL Sprain During Rehab, ROM is improved, strength exercises
May require wearing a brace
Drawer Test

15. Posterior Cruciate Ligament (PCL) Sprain
Similar Signs/Symptoms, Treatment, and Rehab as that of an ACL Sprain
Not as common
Some doctors may not suggest surgery, or just wear a brace
May result from “hyperextension” of knee
Posterior (Back) View of Knee

16. Meniscus Injury Meniscus is cartilage that helps to cushion the knee
Injury usually occurs with rotation of the knee
S/Sx: Pain, Swelling, Loss of ROM, “Locking”, “Clicking”, “Giving Way”, Pain when squatting
Tx: RICE, Crutches, Referral to Doctor; Arthroscopic surgery may be required

17. Bursitis Bursa: Fluid filled sacs that help joints move smoothly
They can become irritated with Acute or Chronic Trauma
S/Sx: Swelling, Some may have large amounts of swelling, Redness (Erythema), Increased temperature, Pain
Tx: RICE, Medication, Compression, Drain

18. Runner’s Knee (Iliotibial Band Friction Syndrome)
Overuse injury common in runners (duh!) and cyclists
S/Sx: Pain over the Lateral Knee, Swelling
Tx: RICE, Medication, Proper Warm-Up, Stretching, Orthotics, Ultrasound

19. Patella Fracture
Caused by a direct hit or indirect trauma (Quads pulling a piece of bone off)
S/Sx: Pain, Swelling, Inability to move knee
Tx: RICE, Immobilization, X- Rays, Surgery

20. Dislocated Patella
Usually caused during a “cutting” or quick stop movement
Patella may dislocate out of its groove, usually LATERALLY
S/Sx: Pain, Swelling, Loss of ROM, Deformity
Tx: Immobilize knee, Ice, Hospital
Physician will “Reduce” the dislocation
Immobilize; Splint; Rehab; Brace

21. Chondromalacia
Is Softening & Deterioration of cartilage underneath kneecap
Caused by abnormal movement of patella/Overuse
S/Sx: Pain when walking, running, stairs, squatting. Swelling around kneecap, “Grating” sensation when bending knee
Tx: RICE, immobilization, Splinting, Medication, Rehab

22. Patellar Tendonitis ( Jumper’s Knee)
Overuse Injury
From lots of Jumping (duh!)
Pain in the “front” of the knee, along Patellar Tendon
Tx: RICE, Brace, Quad Strengthening