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March 5 - knees.doc

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Physical Education and Sport
Brad Kern

March 5 – Ch 16: The Knee and Related Structures • Complex joint that endures great amounts of trauma due to extreme amounts of stress that are regularly applied. Most sports place a stress on the knee • The knee is a Hinge joint with a rotational component. There is very little rotation in the tibia • Stability is due primarily to ligaments, joint capsule and muscles surrounding the joint. The 4 main ligaments are the LCL, ACL, PCL and MCL. Muscles surrounding the joint are the key in stability • The knee is designed for stability with weight bearing and mobility in locomotion • The knee consists of 4 bones: tibia, femur, patella and fibula • The knee has the largest synovial capsule in the body • The femoral condyles articulate with the tibial plateau (the superior part of the tibia). Together these create the main articulation of the knee joint • The fibula plays a small role. It doesn’t articulate with the femur. It articulates with the tibia and is held in place by a bunch of ligaments • The patella sits on the patellar groove and is a syndesmosis bone and located in the tendons. It functions as protection and creates a fulcrum (pivot point) for the quadriceps. • The PCL and ACL originate off the distal posterior aspect of the femur. One goes the to the anterior part of the tibial plateau. One goes to the posterior part of the tibial plateau • ACL and PCL are key stabilizers in the joint. The ACL stops the anterior translation of the tibia. The PCL is the opposite. It stops posterior translation of the tibia. If the femur is fixed and you get a drive that drives the tibia anteriorly, the ACL will stop it. Vice versa. • When the knee is in an extended position, and the femur is driven backwards, the ligament stopping it will be the ACL • In exam, ACL stops anterior translation of the tibia in respect to the femur • The ACL is responsible for stopping internal rotation. It stops internal rotation of the tibia. • The MCL and LCL. The MCL stops valgus force. We are planted and get hit on the outside of the knee, the MCL stops the knee from opening up due to valugus force. The LCL cause the knee to open up and stops the varus force • The MCL originates off the medial condyle of the femur. The LCL originates off the lateral condyle and head to the fibular head. • Both LCL are most tight due extension. When flexed, they are relaxed • The MCL has 2 portions. Theres a superficial band and a deep band. The deep band will insert on to the medial mensiscus. Theres an injury called the fun happy triad. This involves injures the MCL, ACL and medial meniscus. Meniscus • The meniscus is located on the tibial plateau • the meniscus functions as cushion between the femur and tibia and absorbs forces from the tibia to the femur. The meniscus is bowl shaped so it provides joint stability. • Meniscus are located in the synovial joint. If you injure the meniscus, its hard to heal on its own due to it not getting blood supply. • If you tear meniscus on the outside, it can be healed better due some blood flow going there • The lateral meniscus is more o-shaped Muscles of the Knee • 4 main groups of knees are: knee flexors, extensors, • The ones involved in knee flexion are in the posterior aspect of the thigh • Hamstrings are biceps femoris, semintendionsis, and semimembranosous • Biceps femoris go to the femur and attach • The gracilis is involved in knee flexion • The Sartorius is involved in flexion, abduction, and lateral rotation of the hip and flexion of the knee. • The Sartorius is know as the “faver” muscle and is the main muscle that crosses the legs • The gastroc crosses the knee joint and assists in flexion • The popliteus is the muscle that unlocks the knee • The main muscle in knee extension is the quadriceps. It is made up of 4 individual muscles: the rectus femoris, vastus intermedius, vastus lateralis, and vastus medialis. The tensor fascia latae also plays a small role in knee extension • The 2 joint muscle in the quads is the rectus femoris • The 2 joint muscle in the hamstring are all of them because they all originate on the ischial tuberostiy • Muscle responsible for external tibial rotation is the biceps femoris • Muscle responsible for internal tibial rotation is the popliteus • Look at the table in the book** Prevention of Knee Injuries Physical Conditioning and Rehab Total body conditioning is required • Strength, flexibility, cardiovascular and muscular endurance, agility, speed and balance • Building a strong base of knee muscles will reduce knee injuries • Muscles around the hip and knee must be conditioned to maximize stability • Hamstrings and quads aren’t equal strength. Hamstrings aren’t as strong as quads. Quads are stronger than hamstrings.hamstrings have 60-75% of quads str
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