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Kin 3K03: Sports Injuries (Knee Extensors Summary)

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McMaster University
Krista M Baker

Sports Injuries: Kin 3K03 KNEE EXTENSORS Acute Care  Lab skills - Pressure pad: donut shaped with tensor wrap  Ice distribution - Apply ice all around joint (including backside of knee)  Crutches: PWB and NWB - If non weight bearing, need crutches  Bracing - Immobilize and restrict movement of joint to prevent excessive strain on healing structure - Can be customized (works well on cruciate ligaments and collateral ligaments but not for meniscus b/c braces can barely prevent rotation)  Pharmaceutical Interventions - For people with large joint effusions (non-steroidal anti-inflammatory) Beyond Acute  Technique training o Most important* o Teaching patient how to jump, land, change direction, decelerate in more effective ways to reduce strain on ACL  Surgical interventions  Long term challenges o Collateral ligaments are less of an issue o ACL, PCL and meniscus damage: increase risk of arthritis o When you take away part of protective covering at ends of bone  this will cause remainder protecting layers (articular cartilage) to shear and breakdown faster. o THP: if there’s damage to inner knee, then there may be a faster progression of osteoarthritic symptoms Patella Femoral Syndrome (PFS) -Syndrome: something is wrong but we don’t really know what (umbrella term) -PFS: patella not sitting and moving in the right positions, causing inflammation Pain Locations and “Theatre Sign” - Sometimes, well localized (medial or lateral patella) but more often, it will feel like deep ache under patella (anterior knee pain) - Theatre sign: aggravated by prolonged sitting with knee’s flexed Crepitus - Sense that something isn’t moving smoothly (grinding sensation) - Often noted under patella with PFS - Repetitive flexion/extension (on stairs) Buckling - Muscular inhibition (knee buckles) - Moment when quads fail to work Aggravated By - Repetitive flexion/extension - Squats, stair climbing/descending - Walking, running, jumping Sports Injuries: Kin 3K03 Factors  Hip ADD o People with PFS usually fall into position with hip adducted and medially rotated, results in valgus position of knees  Hip MR  Foot Posture o Often associated with collapsed/over-pronated foot (low arch of foot cause more valgus stress)  Tight Rectus Femoris o Compresses patella against femur more when in a flexed knee position, this causes crushing of the patella on the femur, and may also cause it to slide around  Weak VMO o Weakness and impaired function in vastus medialis oblique fibers o VMO anchors patella medially and prevents it from sliding laterally o Weak VMO won’t prevent patella from sliding laterally as well  Lateral Retinacular Restriction o Broadly anchors each side of patella to femur (side to side seatbelts of patella to prevent it from going too medial or lateral) o In people with PFS, lateral retinaculum is usually tight, has restricted movement, which will prevent patella from moving medially and consequently pull it laterally Patellar Tendinopathy  “Jumper’s knee”  Pain location o Pain is at apex of patella (peak/bottom of patella where tendon is grabbing onto bone)  Eccentric loading of patellar tendon o Shock absorption o Repetitive microtrauma; especially for heavier athletes o Tendinopathy process starts long before patient starts to experience pain o It is when tendon fibers are being failed, but don’t have enough time to rebuild due to repetitive micro-trauma o Not quite tendinitis because
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