Gallery+Walk+for+Knee+Injuries+2nd+Period

= Virtual Gallery Walk for Knee Injuries = toc = **Patellar Tendinitis:** = == Anatomy Involved The anatomy involved is the patellar tendon, more specifically, the suprapatellar or infrapatellar tendons. Overloading the extensor mechanism can cause microtearing and inflammation of either of these tendons. ==

 Primary Function of Anatomy Involved The patellar tendon connects the patella or knee cap to the tibia or shinbone. The tendons primary function is to primarily assist the lower leg muscles, allowing for movement. You use this tendon while jumping, riding a bike, or kicking a ball.

**MOI **
Mechanism of injuries for patellar tendinitis are repetitive jumping (basketball, volleyball, long jump, triple jump), running, weight lifting (leg extensions, squats, lunges), strenuous overuse of the knee, playing baseball (catcher), football, gymnastics, repeated stress on the patellar tendon.

**Signs and Symptoms **
The signs are inflammation and mild swelling either superior or inferior to the patella; palpable tenderness and crepitus are often present over the inflamed tendon  The first **symptom of patellar tendinitis is pain, with the intensity of pain becoming worse as the length of the activity becomes longer. Patients also feel a persistent ache when they are taking part in a strenuous activity, thus causing the pain to be so intense where one cannot even walk up and down stairs. The pain becomes more noticeable to the point where one cannot sleep well at night. The patient complains of pain with passive stretching of the tendon and active or resisted knee extension. In chronic cases, degeneration and scarring within the tendon can weaken its structure and increase susceptibility to patellar tendon rupture. **

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= Patellar Tendon Rupture: =

**Description of the Anatomy involved: **
The patellar tendon attaches to the tibial tubercle on the front of the tibia just below the front of the knee. It also is attached to the bottom of the patella. At the top of the patella, the quadriceps tendon is attached. At the tope of the quadriceps tendon is the quadriceps muscle. The quadriceps muscle is the large muscle on the front of the thigh. As the quadriceps muscle contracts, it pulls on the quadriceps tendon, the patella, the patellar tendon, and the tibia to move the knee from a flexed position to an extended position. Conversely, when the quadriceps muscle relaxes, it lengthens. This allows the knee to move from a position of extension to a position of flexion.

- Knee extension
 * Primary function of anatomy involved: **

- Chronic tendonitis or inflammation weakens the structure. - Violent, rapid quadriceps contraction.
 * MOI: **

- Patellar tendon ruptures are extremely painful and may be accompanied with an audible 'pop' at the time of the injury - The 'pop' may also be felt - Appears to sit more superiorly - Superior swelling and echymosis within 24 hours - Palpable gap between the inferior pole of the patella and tibial tuberosity - Swelling of the knee - Inability to weight-bear - Inability to straighten the knee or hold it in a straightened position - Pain is immediate and severe
 * Signs & Symptoms: **



media type="youtube" key="Fx76EIcnp2I?fs=1" height="385" width="480" = = = = = Patellar Dislocation: =

For the injury in the picture, the patella is not in the patellofemoral groove. The patella is directly above the femur and the patellar and quadriceps tendons are not stabilizing the patella allowing it to move and limit mobility for the patient The patella rests in the patellofemoral groove, a cavity located on the knee between the distal femur and the tibia. The sides of the patella attach to certain ligaments and tendons to stabilize and support it. The superior border of the patella attaches to the common tendon of the quadriceps muscles, the medial borders are attached to the vastus medialis muscle, and the lower border is connected to the tibial tuberosity. The main ligament stabilizer, the patellofermoral ligament, rests directly over the femur and the patella while the lateral and medial collateral ligaments act as the secondary ligament stabilizers from either side of the patella.
 * <span style="background-color: #ffffff; color: #65be6d; font-size: 11pt; font-style: normal; line-height: normal; margin: 0px; vertical-align: baseline; white-space: pre-wrap;">Description of anatomy involved: **
 * <span style="background-color: #ffffff; color: #65be6d; font-size: 11pt; font-style: normal; line-height: normal; margin: 0px; vertical-align: baseline; white-space: pre-wrap;">Primary function of anatomy involved: **

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">There are 2 ways patellar dislocations occur: the first is a direct blow to the kneecap which knocks the patella out of place and the second is an awkward turning motion of the knee which dislocates it. It occurs when the quadriceps tendon and other ligament stabilizers attached to the patella is rotating pulling it out of place. Sports commonly involved in this injury is soccer, gymnastics and ice hockey.
 * <span style="background-color: #ffffff; color: #65be6d; font-size: 11pt; font-style: normal; line-height: normal; margin: 0px; vertical-align: baseline; white-space: pre-wrap;">MOI: **

media type="youtube" key="u4tG5I6VkzA?fs=1" height="385" width="480" <span style="background-color: transparent; display: block; font-family: Times; font-size: medium; line-height: normal; margin: 0px;">
 * <span style="background-color: #ffffff; color: #65be6d; font-size: 11pt; font-style: normal; line-height: normal; margin: 0px; vertical-align: baseline; white-space: pre-wrap;">Signs & Symptoms: **
 * <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Deformity
 * <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Pain along the inside of the knee especially along the patella
 * <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Swelling
 * <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Audible popping or feelings of instability
 * <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Impaired mobility of the knee
 * <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Feeling of the knee giving way at the time of the injury
 * <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Palpably tender along the medial border of the patellar and soft tissue structure

= = = = = Hamstring Strain: =

<span style="background-color: transparent; display: block; font-family: Times; font-size: medium; line-height: normal; margin: 0px;"><span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">**Description of Anatomy involved:** <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Hamstring muscles (posterior thigh muscles) which begin at the pelvis and run down to the knee include the semimembranosus, semitendinosus, and biceps femoris. The semimembranosus is located in the medial tibia condyle. The semitendinosus is located in the medial surface of the tibia. The biceps femoris is split by the long head and the short head and is located on the lateral side of the head of the fibula. media type="youtube" key="CqQQ67Gqt7I?fs=1" height="385" width="640" <span style="background-color: transparent; color: #000000; display: block; font-family: Times; font-size: medium; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: normal;"><span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">**Primary Function of Anatomy involved:** <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Generally, the hamstring is used for various physical activities. It covers basics from walking and running to more complex activities such as swimming and dancing. All four muscles that make up the hamstring allow the knee to bend/flex, while three of them allow the knee to straighten. The semitendinosus and semimembranosus allow the hip to extend and bend when the leg is straight. When the knee is bent, these two muscles allow the lower leg to rotate medially. The long head of the biceps femoris allows the hip to extend when walking while both the short and long heads help flex the knee. The biceps femoris also allows lateral rotation within the lower leg as the knee is bent.

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> <span style="background-color: transparent; display: block; font-family: Times; font-size: medium; margin: 0px; white-space: normal;"> <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">**MOI:** <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Hamstring strain injuries are usually caused by high speed running and sudden eccentric loading, like kicking a soccer ball and putting your leg too high or a high kick in martial arts.

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> <span style="background-color: transparent; display: block; font-family: Times; font-size: medium; margin: 0px; white-space: normal;"> <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">**Signs & Symptoms:** <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> When the hamstring is sprained the athlete will immediately feel a sharp or burning pain. Another signs and symptoms may include palpable tenderness and spasm over and around the injury. The athlete may avoid to fully extend the knee and stretching of the muscle. If the hamstring strain is a second or third degree sprain there might be delayed swelling and echymosis on the back of the thigh.

= = = = = Myositis Ossificans: =

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 14pt; font-style: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">**Definition:** <span style="background-color: #ffffff; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin-bottom: 0pt; margin-left: 0px; margin-right: 15pt; margin-top: 0pt; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> Myositis ossificans is an unusual condition that often occurs in athletes who sustain a blunt injury that causes deep tissue bleeding.

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 14pt; font-style: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">**Anatomy Involved:** <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> Most common within the quadricep muscle but can happen anywhere in the body where there is muscle.

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 14pt; font-style: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">**Primary Function of Anatomy involved:** <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> The primary function of the quadricep muscle is to extend and flex your knee.

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 14pt; font-style: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">**MOI:** <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> Comes from a hard and repetitive muscle contusion where the bone gets impacted and gives off bone cells creating a hematoma which builds in the muscle tissue. So now there is bone within the muscle.

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> Example: When a kickboxer repeatedly get kicked in the quadricep at the same spot, the bone gets impacted and then gives off bone cells which forms in the muscle tissue.

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 14pt; font-style: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">**Signs & Symptoms:** <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> -History of severe or repetitive insult to the quadriceps

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> -A palpable mass within the muscle belly <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">-Decreased knee flexion/extension range <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">-Decreased quadriceps strength <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">-Radiograph evidence within 3 to 4 weeks after injury <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">-Pain with movement <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">-Skin swelling over calcified site <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">-Rigid muscles and tendons <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">-Tendon weakness <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">-Calcium deposits in muscles <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">

media type="youtube" key="z2bS_CFZJnE?fs=1" height="385" width="640" = = = = = Lateral Collateral Ligament Sprain: =

o The lateral collateral ligament (LCL) connects the femur (the thigh bone) with the head of the fibula (outer bone of the lower leg.) It is a narrow, strong cord made out of collagen fibers that runs along the outside of the knee.



· ** Primary function of anatomy involved **
o The importance of the lateral collateral ligament is that it keeps the outer side of the knee joint stable by preventing the outer surfaces from opening or gapping.

· MOI

 * The LCL is most commonly injured in sports when a direct impact to the inner surface of the knee joint occurs, in which it pushes the knee joint from the inside. Some sports that this injury is likely to occur in are rugby or tackle football. The injury can be a stretch, partial tear, or complete tear of the ligament.
 * An LCL injury most offten occurs in contact sports when one player falls into or makes contact against the medial side of another player's planted lower extremity
 * This injury also commonly occurs when a varus force is applied to the medial aspect of the knee
 * This injury is less common than those affecting the medial collateral ligament (MCL), which occurs as a result of trauma to the outer surface of the knee joint. Also, because the LCL is not connected to the lateral menisus as the MCL is, they are not normally associated with meniscal tears.

· Signs & Symptoms

 * First Degree (minor stretch):
 * Mild tenderness on the lateral side of knee
 * No swelling
 * When force is applied to the knee, pain is felt but there is no joint laxity
 * Second Degree (partial tear):
 * Significant tenderness over ligament
 * Some swelling
 * When the knee is stressed, there is pain and laxity in the joint
 * Third Degree (complete tear):
 * Complete tear of LCL
 * May be less pain than a 2nd degree sprain since it’s completely torn
 * Significant joint laxity when knee is stressed
 * Unstable knee
 * Other sighs & symptoms include knee locking with movement, the sensation that the knee might give away, numbness, weakness, noticable looseness, and stiffness.
 * Lateral knee swelling, ecchymosis, and point tenderness over the fibular collateral ligament
 * May hear or feel a pop

media type="youtube" key="734NquOHhUE?fs=1" height="385" width="640"

= = = Apophysitis: =

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Apophysitis, or Osgood-Schlatter disease, is an overuse injury in which the bone, cartilage, and/or tendon at the top of the shinbone, or tibia, inflames. Avulsion fractures can occur because of the tension. It is painful, but usually self-resolving.
 * <span style="background-color: #ffffff; color: #65be6d; font-size: 11pt; font-style: normal; line-height: normal; margin: 0px; vertical-align: baseline; white-space: pre-wrap;">Description of Injury: **

==**<span style="background-color: #ffffff; color: #65be6d; font-size: 11pt; font-style: normal; line-height: normal; margin: 0px; vertical-align: baseline; white-space: pre-wrap;">Anatomy Involved: **<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">The patella, tibia, fibula, tibial tubercle, and patellar tendon are all involved in apophysitis. The patellar tendon pulls on the surface of the tibia to which its connected. But, since the tibia grows at a faster rate than the connecting tendon, an imbalance will occur and knee pain is the result. ==

** Primary Function of Anatomy Involved: **
<span style="background-color: transparent; color: #000000; display: block; font-family: Times; font-size: medium; line-height: normal; margin: 0px;"><span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">The <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">**patella** <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> is a small, round bone that’s under the llayer of cartilage and allows it to glide smoothly over the femoral groove as the knee is flexed. <span style="background-color: transparent; color: #000000; display: block; font-family: Times; font-size: medium; line-height: normal; margin: 0px;"><span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">The <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">**tibia** <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> provides movement of the legs and is located in the forelimb. <span style="background-color: transparent; color: #000000; display: block; font-family: Times; font-size: medium; line-height: normal; margin: 0px;"><span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">The <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">**fibula** <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> provides attachment for muscles. <span style="background-color: transparent; color: #000000; display: block; font-family: Times; font-size: medium; line-height: normal; margin: 0px;"><span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">The primary function of the <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">**tibial tubercle** <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> attachment is to give attachment to the patellar ligament. <span style="background-color: transparent; color: #000000; display: block; font-family: Times; font-size: medium; line-height: normal; margin: 0px;"><span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">The main function of the <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">**patellar tendon** <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> is knee extension.

**<span style="background-color: #ffffff; color: #65be6d; font-size: 11pt; font-style: normal; line-height: normal; margin: 0px; vertical-align: baseline; white-space: pre-wrap;">MOI: **
<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Apophysitis is repetitive stress on patellar tendon. It is most common in adolescents during the beginning of their growth spurts because their bones, muscles, and tendons are not growing at the same rate. With exercise, differences between the size and strength of the muscles place stress on the layer of cartilage at the top of the tibia.


 * <span style="background-color: #ffffff; color: #65be6d; font-size: 11pt; font-style: normal; line-height: normal; margin: 0px; vertical-align: baseline; white-space: pre-wrap;">SIGNS: **

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Big bump on tibial tuberosity (a bone growth) <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Swelling under the knee and over the shinbone <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Limping after exercise <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Inflammation

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Pain that worsens with exercise <span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Tenderness under knee and over shinbone
 * <span style="background-color: #ffffff; color: #65be6d; font-size: 11pt; font-style: normal; line-height: normal; margin: 0px; vertical-align: baseline; white-space: pre-wrap;">SYMPTOMS: **

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 11pt; font-style: normal; font-weight: normal; line-height: normal; margin: 0px; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> media type="youtube" key="e1CabiNKH4A?fs=1" height="385" width="480"

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