Gallery+Walk+for+Knee+Injuries+5th+Period

=** Gallery Walk for Knee Injuries **= toc

= Apophysitis = Description of Anatomy Involved · Tibial tubercle · Patellar tendon · Patella · Quadriceps · Apophysis Primary Function of Anatomy Involved · Quadriceps = Involved with extension · Patella = seasmoid bone; kneecap · Patellar tendon = flexion and extension · Tibial tubercle = point of insertion of the patellar tendon · Apophysis = lining of the tibial tubercle MOI · Over training · Repetitive jumping or running during growth spurts · Repetitive traction against the patellar tendon Signs and Symptoms · Focused anterior knee pain, · Swelling and tenderness over the tibial tuberosity, · Increased prominence of the tibial tuberosity. · Complains of increased pain with knee extension exercises, squatting, kneeling, and jumping.

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= = = Patellar Dislocation = Patellar dislocation Description: Patellar dislocation occurs when the patella slides out of position in the knee sideways. Result from direct or indirect forces in which the lateral femoral groove secondary to the more to the more lateral angular pull of the quadriceps and lesser height of the lateral femoral condyle compared to the medial femoral condyle. Symptoms include sharp pain, a pop in the anterior knee and a feeling of the knee giving way at the time of injury, may be deformity.

Function of anatomy: Patella and quadricep tendons slide out of place from the interior knee between the articular cartilage area and the femur.

MOI: Direct blow to knee cap that can laterally slide the patella out of place. Twisting motions can also cause the patella to slide out of place. If the vastus medialis oblique is not strong enough, or its fibers are not adequately oriented, the patella is much more susceptible to dislocation. Excessive pronation of the feet can cause dislocation. Younger female athletes are more likely to have patellar dislocations.

S&S: Possible deformity, tenderness along the medial border of the patella and soft tissue, swelling in the anterior knee. Patient can possible be apprehensive when the patella is moved laterally.

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= = = Epiphyseal Fractures =

__**Anatomy**__  Distal femoral  Proximal tibial  Patella

__**Function**__  tibia = support of upper leg  femur = connect upper body and lower body  patella = knee extension __**MOI**__  Fractures through the proximal tibial epiphysis, and less often through the distal femoral epiphysis, can result from rotational and shearing forces at the knee joint. Twisting, varus, or valgus forces directed at the knee with the foot firmly planted are the more common fracture mechanisms in the adolescent athlete.

__**Signs and Symptoms**__  Signs and symptoms include immediate pain, tenderness along the bone, swelling, loss of function, and possible deformity. The athlete may report hearing a pop or snap at the joint. You may observe crepitus with joint motion, but the athlete will typically be unwilling to move the extremity. False joint motion, or opening of the epiphyseal joint with varus and valgus testing, may make it difficult to distinguish an epiphyseal fracture from a collateral ligament injury = = = Patellar Tendinitis =

** Description of Anatomy involved ** ● Injury is also known as “jumper’s knee” ● An injury that affects the tendon connecting your kneecap (patella) to your shinbone ● Anatomy involved: ○ ** Patella ** : a small bone located in front of the knee ○ ** Patellar tendon ** : a structure that attaches the quadriceps muscle group to the tibia (shin bone)

** Primary function of anatomy involved ** ● Patellar tendon: ○ Helps your muscles extend your lower leg so that you can kick a ball, push the pedals on your bicycle and jump up in the air. ○ Keeps the kneecap in place which is an important part of the leg for all the activities.

** MOI ** <span style="color: black; font-family: Arial; line-height: 115%; margin-left: 0.5in; text-indent: -0.25in;">● Most common in athletes whose sports involve frequent jumping. For instance, basketball, soccer and volleyball players. However, anyone can suffer from patellar tendinitis, whether a frequent jumper or not. ● ** Intensity and frequency of physical activity: ** Repeated jumping is most commonly associated with patellar tendinitis. Sudden increases in the intensity of physical activity or increases in frequency of activity also put added stress on the tendon. ○ Running, jumping, frequent starts and stops, squatting, kneeling, weight leaving ● ** Being overweight: ** Additionally, being overweight or obese increases the stress on the patellar tendon, and some research suggests that having a greater waist circumference or higher body mass index may increase the risk of patellar tendinitis. ● ** Tight leg muscles: ** Reduced flexibility in your thigh muscles (quadriceps) and your hamstrings, which run up the back of your thighs, could increase the strain on your patellar tendon. ● ** Malalignment of your leg bones. ** :The way your leg bones line up could be off slightly, putting strain on your tendon. ● ** Raised kneecap (patella alta): ** Your kneecap may be positioned higher up on your knee joint, causing increased strain on the patellar tendon. ● ** Muscular imbalance: ** If some muscles in your legs are much stronger than others, the stronger muscles could pull harder on your patellar tendon. This uneven pull could cause tendinitis.
 * **Overloading of the extensor mechanism** can cause micro-tearing and inflammation of the suprapatella or infrapatellar tendons

** Signs & Symptoms ** <span style="color: black; font-family: Arial; line-height: 115%; margin-left: 0.5in; text-indent: -0.25in;">● Pain is usually is located in the section of your patellar tendon between your kneecap (patella) and the area where the tendon attaches to your shinbone (tibia). <span style="color: black; font-family: Arial; line-height: 115%; margin-left: 0.5in; text-indent: -0.25in;">● During physical activity, the pain may feel sharp, especially when running or jumping. <span style="color: black; font-family: Arial; line-height: 115%; margin-left: 0.5in; text-indent: -0.25in;">● After a workout or practice, the pain may persist as a dull ache. <span style="color: black; font-family: Arial; line-height: 115%; margin-left: 0.5in; text-indent: -0.25in;">● Pain and/or tightness/stiffness in the knee when squatting, bending, or straightening the leg <span style="color: black; font-family: Arial; line-height: 115%; margin-left: 0.5in; text-indent: -0.25in;">● Pain when you contract the quadriceps muscles <span style="color: black; font-family: Arial; line-height: 115%; margin-left: 0.5in; text-indent: -0.25in;">● Swelling in the front of the knee, and the area just below the knee joint ● Calf weakness may be present
 * Inflammation
 * Mild Swelling

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= = = Patellar Tendon Rupture﻿ =

<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;"> Patellar Tendon Rupture

<span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; text-decoration: none; vertical-align: baseline;">**Anatomy of Patellar Tendon:** <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;">The patellar tendon is actually a ligament connecting 2 bones, the tibia and the patella. <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; text-decoration: none; vertical-align: baseline;">**Function of Patellar Tendon:** <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;">Its function is to act as a lever arm for the quadriceps muscles. The quadriceps themselves insert into the upper surface of the patella and when contracted pull on the patella, and thus the patellar tendon, to straighten the knee joint. <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; text-decoration: none; vertical-align: baseline;">**M.O.I:** <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;">Patellar tendon rupture often occurs in the setting of long-standing patellar tendon irritation. The rupture is the final result of chronic tendon degeneration due to repetitive microtrauma

<span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; text-decoration: none; vertical-align: baseline;">**Signs:**
 * <span style="background-color: transparent; color: #333333; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline;">Patellar tendon ruptures are extremely painful and may be accompanied with an audible 'pop' at the time of injury
 * <span style="background-color: transparent; color: #333333; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline;">Swelling of the knee
 * <span style="background-color: transparent; color: #333333; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline;">Inability to weight-bear
 * <span style="background-color: transparent; color: #333333; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline;">Inability to straighten the knee or hold it in a straightened position

<span style="background-color: transparent; color: #333333; font-family: Arial; font-size: 12pt; font-style: normal; text-decoration: none; vertical-align: baseline;">**Symptoms:**
 * <span style="background-color: #ffffff; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline;">Knee pain: Pain worsens with movement of the knee
 * <span style="background-color: #ffffff; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline;">Knee swelling
 * <span style="background-color: #ffffff; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline;">Knee tenderness
 * <span style="background-color: #ffffff; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline;">Knee stiffness
 * <span style="background-color: #ffffff; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline;">Mild leg swelling (unilateral): Located below the kneecap Inability to straighten the leg at the knee
 * <span style="background-color: #ffffff; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline;">Difficulty walking: Inability to walk
 * <span style="background-color: #ffffff; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline;">Tenderness
 * <span style="background-color: #ffffff; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; list-style-type: disc; text-decoration: none; vertical-align: baseline;"><span style="background-color: #ffffff; color: #000000; font-family: Arial; font-size: 12pt; font-style: normal; font-weight: normal; text-decoration: none; vertical-align: baseline;">Cramping [[image:https://lh6.googleusercontent.com/sScnGKGEn4FvF-qPPqrJ8ezle61fFLbYNzrCW-IdOw_KkOwkRjP0dgeLuYcv9jmBnq3TScxLb5dihJ2u46uA82bxgQCZFdP3cSmuV2z9rPT65lSsDQ]]

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= = = Lateral Collateral Ligament = * Description of Anatomy involved- The lateral collateral ligament is also known as LCL. It runs parallel from the lateral epicondyle of the femur to its attachment on the fibular head. The LCL is completely unattached from the capsule and separates from the lateral meniscus.

* Primary function of anatomy involved- The LCL limits the extension and adduction of the tibia relative to the femur. It helps in limiting the lateral rotation of the tibia when the knee is in extension.

* MOI- this injury most commonly occurs when there is force applied on the medial side of the knee. the injury occurs mostly in contact sports and is worse when the lower leg is turned medially. * Signs & Symptoms- When an athlete has hurt their LCL they feel pain, there's swelling, ecchymosis, and the lateral side of the knee would be tender. If it has been completely torn then there is notable instability media type="youtube" key="734NquOHhUE?fs=1" height="385" width="640"

= Myositis Ossificans =


 * Myositis Ossificans ** —A condition that occurs when the body’s inflammatory response during absorption of a hematoma causes calcification or bony deposits to form in the muscle.

It is in the quadriceps when impact causes damage to the sheath that surrounds a bone as well as the muscle. This causes damage to the sheath that surrounds a bone as well as to the muscle. Bone will grow within the muscle.
 * Description of Anatomy Involved **


 * Primary Function of Anatomy Involved **
 * <span style="color: black; font-family: Arial; margin-bottom: 0.1pt; margin-top: 0in; vertical-align: baseline;">Quadricep muscle- the primary function of the quadricep muscles is knee extension

>
 * Mechanism of Injury **
 * Myositis Ossificans can occur when a blunt force is applied to a muscle, such as the quadriceps, causing a hematoma. As the body heals, the muscle calcifies, and bony deposits begin to build up within the muscle tissue.


 * Signs and Symptoms **
 * <span style="color: black; font-family: Arial; margin-bottom: 0.1pt; margin-top: 0in; vertical-align: baseline;">History of severe or repetitive insult to the quadriceps
 * <span style="color: black; font-family: Arial; margin-bottom: 0.1pt; margin-top: 0in; vertical-align: baseline;">Movement pain
 * <span style="color: black; font-family: Arial; margin-bottom: 0.1pt; margin-top: 0in; vertical-align: baseline;">A palpable mass within the muscle belly
 * <span style="color: black; font-family: Arial; margin-bottom: 0.1pt; margin-top: 0in; vertical-align: baseline;">Decreased knee flexion range
 * <span style="color: black; font-family: Arial; margin-bottom: 0.1pt; margin-top: 0in; vertical-align: baseline;">Decreased quadriceps strength
 * <span style="color: black; font-family: Arial; margin-bottom: 0.1pt; margin-top: 0in; vertical-align: baseline;">Radiography evidence within 3 to 4 weeks after injury
 * <span style="color: black; font-family: Arial; margin-bottom: 0.1pt; margin-top: 0in; vertical-align: baseline;">Rigid muscles
 * <span style="color: black; font-family: Arial; margin-bottom: 0.1pt; margin-top: 0in; vertical-align: baseline;">Rigid tendons
 * <span style="color: black; font-family: Arial; margin-bottom: 0.1pt; margin-top: 0in; vertical-align: baseline;">Skeletal malformation
 * <span style="color: black; font-family: Arial; margin-bottom: 0.1pt; margin-top: 0in; vertical-align: baseline;">Malformed toes
 * <span style="color: black; font-family: Arial; margin-bottom: 0.1pt; margin-top: 0in; vertical-align: baseline;">Calcium deposits in muscles

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__ Description of Anatomy involved __ : Occurs in the midbelly of the muscle, at the distal myotendon junction, or at the proximal ** The first degree strain is damage to a few muscle fibers, a second degree strain is damage to a larger number of muscle fibres, and a third strain is a rupture of the muscle itself. The posterior thigh muscles are made up of three muscles that start at pelvis and goes down to the thigh and along the knee, all the way down to the shins. We have gluteal muscles, ishchial tuberosity, semi- tendinosus, semi- membranosus, lateral hamstring tendon of biceps femoris, medial hamstring tendons, and fascia. ** __ Primary function of anatomy involved: __ **The function of the anatomy involved, is** **the hamstring has many functions, and they are to bring the heel towards buttocks, to extend hips, move legs backward, and move the shin.** __ MOI (mechanism of injury): __ **The mechanism of injury occurs a lot, is typically results from over stretching, hyperflextion of the hip with the knee extended.** __ Signs & Symptoms: __ **The symptoms and signs include palpable tenderness and spasm over and around the fibers that are injured. Has some first- degree sprains, pain and stiffness can be delayed until the next day. The athlete will experience sharp or burning pain in the hamstrings.**

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