CASE STUDY ASSIGNMENT
Submitted by,
Jisby Augustine
100632566
FITS- 2302
19-03-2017
Submitted to,
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Professor: Amy Roosenboom Introduction Case study 1: Alex Morgan, new client who is an elite level soccer player.
Ms. Morgan sustained an injury to her left knee which is second degree ACL sprain one year ago. After receiving treatment for the two months’ client is presenting with muscle atrophy and functional anterior pelvic tilt.
1) Describe the ligament (ie: location & purpose) involved in this injury and the mechanism of injury that can compromise this ligament
- ACL (anterior cruciate ligament) is a band of dense connective tissue which courses from the femur to the tibia. Key structure in the knee joint, as it resists anterior tibial translation and rotational loads. The ACL arises from the front of the medial femoral condyle and passes through the middle of the knee to attach between the outcroppings that are located between the tibial plateaus. Most ACL injuries occur due to sports injuries. A grade 2 sprain stretches the ligament to the point where it comes loose. This is often referred to as a partial tear of the ligament.
2) Describe the symptoms that would be present at the time of injury knowing it is a second degree
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sprain.? The symptom that would be present at the time of injury will be pain with walking, loss of ROM, severe pain and inability to continue the activity. Swelling can occur within few hours after the injury, sudden pain in the knee and an audible pop or crack at the time of injury and also instability to the knee. ‘ 3) For an athlete to be agile, they must be able to stop (or decelerate) quickly in order to change direction. Name the ligament that greatly stressed during deceleration movements and the primary muscle group that you should strengthen to reduce stress on this particular ligament? The cruciate ligament is the main ligament which got stressed out during the ACL injury. Cruciate ligament is found inside the knee joint, they crossed each other to form an “X” with the ACL ligament. This ligament controls the back and forth motion of the knee as well as provides rational stability to the knee. Primary muscle group that strengthen to reduce stress on this particular ligament is Quadriceps femoris muscles. 4) List 4 muscles that either directly cross the knee joint OR provide support/impact the knee joint and list each of their actions (Note: cannot be from the same muscle group) The muscles of the knee included quadriceps, hamstrings and muscles of the calf. Rectus femoris – rectus femoris muscle is attached to the hip and helps to extend or raise the knee. Semimembranosus –flexion of the leg at the knee, internal rotation of the knee when knee is flexed. Popliteus- a muscle located behind the knee joint which unlock the fully extended knee joint allowing for flexion. Sartorius- longest muscle and flexing the lower leg at the knee joint. 5) Name 2 structures you would expect to be tight with a functional anterior pelvic tilt?
Name 2 structures you would expect to be weak?
Anterior pelvic title is when the front side of the pelvis drops and back of the pelvis rises. Shortening of hip flexors causes anterior pelvic tilt. Hip flexors (iliopsoas that rotates it forward when tightened) and quadriceps (front thigh muscles) become tightened. Hamstrings and glute muscles become weak.
6) Design a home care program for your client. Provide them with 2 exercises, 2 stretches and 1 area to perform soft tissue work. Briefly describe and justify each exercise selection of your program
- Injuries to the ligaments are the on of the dangerous injuries that can happen and it also takes a long duration of time to heal the ligament from the injury. It is because the ligaments receive only a little amount of direct blood flow. There are various kinds of exercises that can be used for the stretch of ACL sprain. Knee flexion and extension can be done to stretch the ACL. Slowly bend and extend the knee to keep the knee mobile and to improve the range of motion. Hamstring stretch, it can be done to stretch for the ACL sprain. Keep the hands on the thigh muscle and gently push it down to stretch the ACL. One of the important method to recover from the ACL sprain is to do the Soft tissue work regularly till get recovered. Soft tissue work should be done on the
hamstrings. REFERNCE B. (2016, September 27). Muscles that Cause Movement at the Knee Joint - Boundless Open Textbook. Retrieved March 19, 2017, from https://www.boundless.com/physiology/textbooks/boundless-anatomy-and-physiology-textbook/muscular-system-10/muscles-of-the-lower-limb-107/muscles-that-cause-movement-at-the-knee-joint-579-9335/ Muscles of the Knee. (n.d.). Retrieved March 19, 2017, from http://www.innerbody.com/image/musc09.html Anterior Cruciate Ligament (ACL) Injuries-OrthoInfo - AAOS. (2014, March 01). Retrieved March 19, 2017, from http://orthoinfo.aaos.org/topic.cfm?topic=a00549 Mayo Clinic Staff Print. (2017, January 12). Symptoms and causes. Retrieved March 19, 2017, from http://www.mayoclinic.org/diseases-conditions/acl-injury/symptoms-causes/dxc-20167379 ACL Reconstruction soft tissue therapy. (n.d.). Retrieved March 19, 2017, from https://therawheel.myshopify.com/blogs/news/62743237-acl-reconstruction-soft-tissue-therapy Headquarters, A. P. (2014, June 21). What is Anterior Pelvic Tilt? - Anterior Pelvic Tilt HQ. Retrieved March 19, 2017, from http://www.anteriorpelvictilthq.com/anterior-pelvic-tilt/
Sometimes the UCL will weaken and stretch (technically a sprain), making it incompetent. Other times a catastrophic stress will cause the structure to "pop" or blow out. The injury isn't tremendously painful, and it can be incredibly diffic...
Witvrouw, E., Mahieu, N., Roosen, P., & McNair, P. (2007). The role of stretching in tendon injuries. British journal of Sports Medicine , 224-226.
The incidence and prevalence rate of anterior cruciate ligament (ACL) injuries in female athletes continues to increase over time (Prodromos, Han, Rogowski, Joyce, & Shi, 2007). With the growing rate in the amount of young women participating in sports, data has shown that the rate of ACL injury increases linearly with this participation ("The Relationship Between Static Posture and ACL Injury in Female Athletes," 1996). This epidemic of ACL injuries in female athletes, young or old, continues to be problematic in the athletic world. This problem not only affects the athlete themselves, but also the coaches and the sports medicine community.
The anterior cruciate ligament (ACL) is one of the most important of your four major knee ligaments. The function of the ACL is to provide stability to the knee and minimize stress across the knee joint. It restrains excessive forward movement of the lower leg bone (the tibia) in relation to the thigh bone (the femur). It also limits rotational movements of the knee. “Greater external knee valgus and internal rotation moments have been shown to increase loading on the ACL in vitro and are thought to be associated with the increased risk of noncontact ACL injury” (Effects 2011). A tear to the anterior cruciate ligament results from overstretching of this ligament within the knee. It’s usually due to a sudden stop and twisting motion of the knee, or a “...
In spite of this the rate of ACL injury is almost equal through all levels of sports, from beginner, to recreational, to professional athletes. The most widely publicized incident of ACL damage has come from Theresa Edwards who was a top female athlete. She was a basketball player who went to the limit with sports. She went beyond her capability and her ligament couldn’t withstand the pressure and snapped. She is not the only but just one example of many who have suffered this same problem. As female athletes continue to become more competitive and aggressive, ACL damage continues to rise.
The most common knee injury in sports is damage to the anterior cruciate ligament (ACL) through tears or sprains. “They occur in high demand sports that involve planting and cutting, jumping with a poor landing, and stopping immediately or changing directions” (University of Colorado Hospital). The ACL is a ligament that runs diagonally in the middle of the knee and found at the front of the patellar bone. Its function involves controlling the back and forth motion of the knee, preventing the tibia from sliding out in front of the femur, and providing rational stability to the knee. Interestingly, women are more prone to ACL injuries than men. The occurrence is four to six times greater in female athletes.
Anterior pelvic tilt is the top of the pelvis rotating forward such as the ASIS are forward relative to the pubic symphysis. In the frontal plane it looks as if the posterior part of the pelvis is swayed backwards. As dancers we try to work through this resistance and achieve the greatest turn out possible. In order for us to gain greater turn out while standing we often try to open the hips more by sabotaging our alignment, sending the pelvis into anterior pelvic tip. Although you can achieve greater turn out this way, it ruins the aesthetic and makes the deep outward rotators less effective. This means that if you tried to perform a simple tendu to the front, you would not be able to stay turned out through the foot during the exercise. Anterior pelvic tilt also limits a dancer’s execution when doing a back battement.
To understand the importance of the ACL, the knee as a whole must be examined. The knee is formed by the femur, the tibia, and the patella. Several muscles and ligaments control the motion of the knee and protect it from damage at the same time. Ligaments are dense structures of connective tissue that fasten bone to bone and stabilize the knee. Two ligaments on either side of the knee, called the medial and lateral collateral ligaments, stabilize the knee from side-to-side. The ACL along with the posterior cruciate ligament are of a pair of ligaments in the center of the knee joint that form a cross. T...
The quality of the home care must meet the essentials of the patients or service seekers. But it never means to fulfil the basic needs or requirements of the individuals who are seeking the service. On the other hand, if the home care is not able to meet the basic needs of the patients then this is important to analyse the certain reasons behind this (Janamian, et. al., 2014).
A 16-year-old, female high school soccer player, Lindsey Robinson, tore her anterior cruciate ligament (ACL) during a soccer game. Interestingly, she was not the only one in her team who injured her ACL, but several of her teammates have torn the same ligament as well during the soccer season. Lephart (2002) found that women involved in physical activity are more susceptible to acquiring the ACL injuries than men who are involved in the same physical activity (as cited in Ogden, 2002). According to “ACL Injury Prevention” (2004), the numbers of female ACL ruptures have increased for the past ten years. Over 1.4 million women have suffered from the ACL rupture, which is twice the rate of the previous decade.
All injuries are a serious matter, but upper body injuries are more delicate. “Although the majority of contusions to the most parts of the body result injuries that are self-correcting and without serious consequence, even relatively
There are many injuries in general, but sports injuries? Sprains and Strains are the most common injuries in sports. “Sprains are injuries to ligaments, the tough bands connecting in a joint. Suddenly stretching ligaments past their limits deforms or tears them” (Hoffman 1). Ligaments are like springs in a sense that when you stretch a spring, it will return to it’s normal state unless they are
Anterior knee pain plagues the athletic community, the most common being runner’s knee or patellofemoral pain syndrome (PFPS). One point or another in an athlete’s career they have experienced this kind of pain. When comparing between male and female athletes and who has the higher chance of knee pain, female athletes have a higher prevalence than male athletes (Dolak KL). There are several different mechanisms of patellofemoral pain a few being: pes planus,an increased Q angle, weak, tight or an imbalance in the quadriceps or hip muscles. Recently in my clinic site as the spring sports such as, baseball, soccer and track and field the athlete’s perform a lot of squatting, running, and kneeling which load the patellofemoral joint. We are now starting to see several and treat several athletes with patellofemoral knee pain. Each of them experiencing the pain from a different mechanism. As an athletic trainer we want to treat not only the symptoms, but the mechanism of injury to prevent further injuries down the road. If patellofemoral pain syndrome is not properly treated it can develop into chronic diseases such as chondromalacia or arthritis, maybe eventually leading to a total knee plan. (Lee SE) Treatment while the athletes are young and symptoms aren’t severe is key to preventing further injury.
The ACL is a dynamic structure whose main function is to provide primary restraint to anterior tibial subluxation. It provides secondary restraint limiting internal rotation and restraint with the knee in full extension. Along with the posterior crutiate ligament, it provides the axis for knee rotation and links rotation with flexion and extension.
Staff, Mayo Clinic. "Self Injury." Mayo Clinic. Mayo Foundation for Medical Education and Research, 03 Aug. 2010. Web. 10 Apr. 2012. .