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Basic Athletic Training Chapter 7 Knee and Thigh. Chapter Objectives. Name the anatomy of the knee and thigh Identify the steps in an evaluation format Compare the common injuries to the knee and thigh Demonstrate the principles of rehabilitation to the knee and thigh
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Chapter Objectives • Name the anatomy of the knee and thigh • Identify the steps in an evaluation format • Compare the common injuries to the knee and thigh • Demonstrate the principles of rehabilitation to the knee and thigh • Describe the preventive/supportive techniques and protective devices for the lower extremity
Anatomy • The knee is the largest joint in the body, but structurally weak • The instability of the knee is supported by four strong ligaments and 12 muscles • The femur (thighbone) is the longest and strongest bone in the body
Knee, Quadriceps, and Hamstring Anatomy • Bones • Ligaments • Cartilage • Muscles and tendons and their functions • Dermatomes • Myotomes • Range of motion
Evaluation Format • (H)istory • Mechanism of injury (How did it happen?) • Location of pain (Where does it hurt?) • Sensations experienced (Did you hear a pop or snap?) • Previous injury (Have you injured this anatomical structure before?) • (O)bservation—compare the uninjured to the injured lower extremity and look for bleeding, deformity, swelling, discoloration, scars, and other signs of trauma
Evaluation Format • (P)alpation—the physical inspection of an injury. Palpate the anatomical structures/joints above and below the injured site, then palpate affected area. Using bilateral comparison, these items should be palpated: • Neurological (motor and sensory) • Circulation (pulse and capillary refill) • Anatomical structures (palpate) • Fracture test (palpation, compression, and distraction)
Evaluation Format • (S)pecial Tests—look for joint instability, disability, and pain. Assess disability in the following areas: • Joint stability • Muscle/tendon • Accessory anatomical structures • Inflammatory conditions • Range of motion (active, assistive, passive, and resistive) • Pain or weakness in the affected area
Conditions that Indicate an Athlete Should be Referred for Physician Evaluation • Suspected fracture or dislocation • Abnormal sensations such as clicking, popping, grating, or weakness • Locked knee or excessive limited motion • Any doubt regarding the severity or nature of the injury • Gross deformity • Significant pain • Increased swelling • Circulation or neurological impairment • Joint instability
Common Injuries • Contusions • Ligament sprains • Meniscus tears • Patellar tendinitis • Chondromalacia patellae • The female athlete’s knee • Osgood-Schlatter condition • Muscular strains
Preventive/Supportive Techniques • Wrapping techniques for compression • Knee compression wrap • Wrapping techniques for support • Knee joint, hamstrings, quadriceps, hip flexor, and hip adductor wraps • Taping techniques for the knee, thigh and hip • Collateral knee • Hyperextended knee • Anterior cruciate • Patella tendon • Hip pointer
Rehabilitation • Included in any rehabilitation protocol is: • Range of motion exercises • Resistive exercises • Cardiovascular/fitness activities • Sport specific activities • Return to competition guidelines • Full range of motion • Strength, power, and endurance are proportional to the athlete’s size and sport • No pain during running, jumping, or agility movements • No loss of function
Preventing ACL Injuries in Females • Women 4-6 times more likely to tear ACL • Common mechanism of injury: non-contact torsion • Women—tend to land more straight-legged (ligament dominant) • Men—tend to land more with bent knee (muscular dominant) • Prevention program—shown to give significant reduction in ACL injuries. Includes: • Hamstring strengthening • Plyometric/agility drills • Proper biomechanics during landing • Knee over toes; avoid valgus position
Protective Devices • Closed/open patella neoprene sleeve • Hinged knee brace • Knee brace • Lateral patella subluxation braces • Patella stabilizing strap • Patella tendon tendinitis braces • Patella tendon strap • Pre-patella bursitis protectors • Prophylactics knee brace: rehabilitative and functional • Sport-specific pads
Musculoskeletal Disorders • Bursitis • Dislocation • Fracture • Iliotibial band friction syndrome • Meniscal tear • Myositis ossificans • Osteochondritisdissecans • Popliteal cyst