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Kin 3K03: Sports Injuries (Ligaments and Meniscus Summary)

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Krista M Baker

Sports Injuries: Kin 3K03 LIGAMENTS AND MENISCI Mechanisms  Contact and non-contact - Injury by contact with someone against your leg or just by planting and pivoting  Plant and pivot - Most injuries caused by this  Deceleration - Need to decelerating when changing directions  Multi-planar stress - Rotation - Valgus and Varus - Knee injuries take place in multiple planes, rarely see just one plane - Ex. Valgus and rotation, or hyperflexion and rotation History nd rd o The sense of “pop” sounds due to ACL (2 , 3 degree) - Clue for ligament damage (ACL + PCL) o “It felt like my knee shifted”; b/w tibia and patella - Clue for ligament damage (ACL + PCL) o Pain: variable magnitude + location - 3 degree ACL extremely painful immediately - Normally you feel pain after inflammation builds up - Menisci don’t have nerve endings to make you feel pain o WB: variable - Difficult to identify where pain is coming from - Can athlete walk it off? Depends on degree. - Does not tell you specifically what’s wrong o A locking knee? - Can’t flex/extend, rotate ... something’s blocking movement. (Can be torn meniscus) - Collateral ligaments are outside of knee (superficial), therefore not associated with locked knee - Cruciate and meniscal damage associated with locked knee Recognition Swelling - Isolated low level injury will not swell much (a little in medial side of knee). If big swell, anything is possible. - Timing; delayed onset usually (12-24 hours after injury) - Hemarthrosis; bleeding into joint results in rapid accumulation of fluid (if swelling occurs quick, it’s not synovial) Discolouration - Cruciate ligament injury bleeding won’t cause much discolour b/c its deep, same with meniscus - Collateral ligaments might get some bruising (more superficial) - Unless knee capsule opens and blood escapes, causes bruising (very rare) Local muscular responses - Causes impaired knee extension - Thigh will atrophy very quickly - Hamstrings will tighten up to make up for quads weakening, this allows knee to be slightly bent (to allow most amount of space for swelling to occupy) Change in WB status Sports Injuries: Kin 3K03 - Weight bearing status can change as injury progresses. As swelling increases, weight bearing abilities decrease. MCL  Valgus stress + slight knee flexion  Pain: into Medial Femoral Condyle (towards bottom), and into medial aspect of Tibial plateau  Extension and lateral rotation of tibia will maximally stress MCL  Other damage? nd rd - Damage to medial meniscus may come in tandem with MCL (especially 2 and 3 degree)  Dynamic stabilizers - Muscles to prevent excess valgus: pes anserines (try to save you from valgus but can be damaged) - Sartorius, gracilis, semitendinosus LCL  Harder to damage than MCL  Varus stress  Rarely damaged in isolation  PCL, popliteus and biceps femoris may be damaged also ACL  One legged landings: common way to damage ACL  Quick direction change  Typically non-contact - Body falls medially (hip is in abduction, knee in valgus) - Rotation (medial rotation of femur relative to tibia) - Knee near full extension - Or in
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